Personal Injury and Social Security Disability Blog

Friday Fun

I doubt any U.S. cities would pay for a parking system like this anytime soon, but this video of the future of parking is awesome. I would love to see them all over Dallas.

Older Teens Benefit Least From Driving Restrictions, Study Finds

There must be more to this story than meets the eye. It doesn't seem to make sense. But as reported by the San Francisco Chronicle, in states with restrictions on the driver license of young teenage drivers, older teenagers are more likely to have fatal crashes than in states without restrictions. The so-called graduated driver licenses appear to be a good idea, but not if the result is more deaths among older teens. Here are excerpts from the newspaper article:

Older teen drivers are more likely to have fatal crashes in states with restrictions aimed at protecting inexperienced young drivers in a study that may spur policy makers to re-evaluate the programs.

The rules limit passengers and night-time driving for beginners younger than age 18. While the states with the strictest restrictions experienced a lower rate of fatal crashes among 16-year-olds, the rate was higher for 18-year-olds, according to research released today in the Journal of the American Medical Association.

The study is one of the first to suggest that driving restrictions may not help keep older teenagers safe behind the wheel, said Anne McCartt, senior vice president of research at the Insurance Institute for Highway Safety in Arlington, Virginia, who wrote an accompanying editorial in the journal. More studies are needed to determine if some teens are delaying getting their license until after they turn 18 when most state graduated licensing programs end, she said.

"It's great we're saving 16-year-old drivers," said Scott Masten, the lead author and a research manager with the California Department of Motor Vehicles in Sacramento. "Our goal was to make them safer drivers. How can we save more lives?

"I hope this starts some discussion," Masten said in a Sept. 12 telephone interview. "As the laws are currently implemented, we're not saving older teen lives. Why?"

Graduated driver licensing programs vary by state and the laws are changing, Masten said. As of July, all 50 states and the District of Columbia have enacted these programs, he said.

Generally, the laws require teens first to obtain a learner's permit mandating they drive under an adult's supervision. In California, teens may apply for a learner's permit at age 15 1/2, which they are required to hold for at least six months, Masten said. California teenagers can obtain a driver's license at 16 that allows them to drive on their own, but bans any passengers younger than 20 and prohibits driving from 11 p.m.-5 a.m. The restrictions lift a year after a teenager obtains the license, he said.

"The approach is meant to allow the extensive learning that occurs during the initial several months of driving to be gained in realistic -- yet the safest possible -- conditions," the authors wrote.

Researchers in the study analyzed fatal crashes involving 16- to 19-year-old drivers for all U.S. states and Washington, D.C. from 1986 to 2007. They ranked states based on strong programs with passenger and night-time restrictions, and weaker programs that had only one of the two limitations. The groups were compared with states that at the time had no similar rules.

In states with the strongest programs, a 12 percent increase in fatal crashes occurred involving 18-year-old drivers compared with states that had no restrictions, Masten said. In those with weaker programs, there was a 10 percent increase.

Sixteen-year-old drivers in states with strong programs had a 26 percent reduction in fatal accidents compared with those in states with no laws, while 16-year-olds in states with weaker programs had a 16 percent reduction in fatal crashes, Masten said.

The researchers also saw evidence of a reduction in fatal crashes for 17-year-olds in states with the driving restrictions, he said.

Masten and his colleagues noted their research is limited because the best available data are for fatal motor vehicle crashes, which are often associated with alcohol abuse and excessive speeding.

Crashes involving 16- and 17-year-olds tend to occur because they aren't experienced drivers and fail, for example, to check their blind spots, Masten said. For older teens, alcohol use and speeding are more often reasons for accidents regardless of the driving restrictions.

In states with graduated license programs, 18-year-olds seem to have more accidents because they didn't get enough practice driving at a younger age or "they are skipping out on driving before age 18 and are complete novices," he said.

McCartt, with the Insurance Institute for Highway Safety, said if today's findings are true and teens are waiting until 18 to avoid graduated licensing laws, policymakers should consider strengthening regulations. In New Jersey, the minimum age for an intermediate license is 17 and graduated licensing restrictions apply to all new license applicants younger than 21, according to the editorial.

"We don't know for sure whether graduated licensing makes older teens less safe, safer or has no effect," McCartt said today in a telephone interview. "If there is a benefit or a dis-benefit, we haven't tested the hypotheses for why this might be. We need to learn more."

More Physicians Facing Charges Over Handling of Prescription Drugs

Reuters reported that increasingly, more and more US physicians are finding themselves charged with medical negligence or criminal malpractice in cases regarding how prescription medications were handled. Concerned about the small but growing trend, the American Medical Association warns that the increased number of such cases may interfere with how medicine is practiced, particularly since physicians were found liable for monetary damages in court. Reuters quoted an AMA resolution adopted in 1995 that opposes the "attempted criminalization of health care decision-making especially as represented by the current trend toward the criminalization of malpractice."

From the American Association for Justice news release.

 

20% of Texas Drivers Lack Insurance Despite State's Verification Program

It seems that for the entire 40 years I've been practicing law the uninsured driver rate in Texas has been in the 2o% to 25% range. The government has tried various measures to reduce this percentage, but to no avail. The latest data, as reported by the Dallas Morning News, show no significant change. Here are excerpts from the newspaper article:

More than one in five Texas motorists lack the insurance that state law requires and the ratio is virtually unchanged from a year ago, a blow to the state’s 3-year-old program to sharply reduce the number of uninsured drivers on the road.

In addition, Dallas County continues to have the largest percentage of uninsured drivers among the state’s six largest counties, with 24.1 percent of cars and trucks lacking insurance coverage. That figure is down slightly from a year ago, state figures show.

Although the TexasSure vehicle insurance verification program showed good results the first two years after it began in 2008, reducing the number of uninsured vehicles from 24.3 percent to 21.6 percent in 2010, new statistics compiled in July show that progress has stagnated.

That means about 4.2 million drivers have no insurance, and law-abiding motorists shell out nearly $1 billion a year to protect themselves from damage done by drivers without insurance, state officials say.

Insurance industry groups say the economy and a decline in publicity for the TexasSure program are factors in the decline. Jerry Hagins, a spokesman for the Texas Department of Insurance, said officials are unsure why the momentum of the first two years has stalled.

The department is sending letters to thousands of drivers found to be uninsured. The letters remind them of the mandatory insurance requirement and ask them to verify their coverage by mail, email or telephone.

Texas’ financial responsibility law, in place for several years, requires drivers to buy insurance that contains at least liability coverage to pay for injuries and damages caused by the driver.

The insurance department hasn’t analyzed why Dallas has such a high percentage of uninsured drivers. Industry representatives said they had no explanation for the trend, either.

TexasSure relies on a massive database containing the names of all insured drivers and their insurance companies — matched to their license plates and vehicle identification numbers. Insurers provide the information.

When a driver is involved in an accident or stopped for an infraction, an officer can enter the license plate number or VIN into the TexasSure system to verify insurance coverage. In addition, the data is available to county tax assessor-collectors to confirm whether a driver has insurance before issuing or renewing a registration sticker.

Those who lack insurance are ticketed, subject to a fine of up $350 on the first offense and up to $1,000 and possible suspension of their license on the second offense. Those who rack up multiple offenses and take no action are subject to arrest.

Some states fine drivers who are found to lack insurance. But in Texas, fines kick in only after a driver is stopped by a law enforcement officer.

“[States] that made the fastest progress in getting their uninsured numbers down had a fine associated with the notification program,” said Hagins of the insurance department, but Texas’ law does not allow for fines.

Considering that a vendor for the state agency is sending out 25,000 letters a week to drivers who are found to have a car registered but no insurance policy, the impact of a fine could be significant, not only in pressuring those drivers to obtain insurance but also producing significant revenue for the effort.

Hagins said an estimated 1.9 million Texas drivers are in the pool of those receiving notification letters. Those who don’t respond are warned that they are subject to fines and can lose their driver’s license if they don’t comply with the law. But those fines can be assessed only if the driver is stopped for another violation.

NTSB Recommends Trucker Cell Phone Ban

A proposal was made very recently by the National Transportation Safety Board that mobile phone use by commercial truck drivers be banned. I have mixed feelings about this proposal.

Obviously, we're all safer drivers when we're not chatting on a cell phone. On the other hand, long-distance truckers do need to have the ability to be contacted in emergencies by both their families and their employers. From repeated personal experiences I can tell you it's frustrating to have clients off on cross-country trips when you need to talk with them.

Texting while driving is much more dangerous than talking on a hands-free cell phone, and I have no objection at all (other than the difficulty in enforcement) of a ban on all texting while driving, whether by commercial drivers or private drivers.

The NTSB proposal was written up in detail at a Web site called Trucking Info. Here are excerpts:

The National Transportation Safety Board recommended banning mobile phone use by commercial drivers Tuesday following its investigation of 2010 cross-median truck crash that claimed 11 lives. The NTSB issued more than a dozen other recommendations,, designed to address cross-median crashes, crashes in general and safety habits.

On March 26, 2010, at about 5:14 a.m. CDT, near Munfordville, Ky., a tractor-trailer driven by 45-year-old Kenneth Laymon of Jasper, Ky., departed the left lane of southbound Interstate 65, crossed a 60-foot- wide median, overrode a cable barrier system and collided head-on with a 15 passenger van carrying nine adults, two small children and an infant. Only the two children, who were in safety seats, survived the crash. The group was traveling to a wedding in Iowa.

Investigators determined that the driver used his mobile phone for calls and text messages a total of 69 times while driving in the 24-hour period prior to the accident. The driver made four calls in the minutes leading up to the crash, making the last call at 5:14, coinciding with the time that the truck departed the highway.

Citing the apparent distraction, the NTSB recommended banning the use of mobile phones by commercial drivers except in emergencies. At the time of the accident, texting had already been banned for commercial drivers.

"Distracted driving is becoming increasingly prevalent, exacerbating the danger we encounter daily on our roadways," said Deborah Hersman, NTSB chairman. "It can be especially lethal when the distracted driver is at the wheel of a vehicle that weighs 40 tons and travels at highway speeds."

The NTSB also determined that the median barrier system, which had recently been installed following another cross-median fatal accident on the same section of I-65, contributed to the severity of the accident because it was not designed to redirect or contain a vehicle of the accident truck's size. Because median crossover accidents involving large vehicles are so deadly, the NTSB made recommendations regarding the use of appropriately designed median barriers on roadways with high volumes of commercial vehicles.

The NTSB does not have any rulemaking power, but can advise other agencies. The recommendations were made to the Federal Highway Administration, the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration, the American Association of State Highway and Transportation Officials, the Governors Highway Safety Association, all 50 states, and the District of Columbia. The Safety Board also reiterated two previously issued recommendations to the FMCSA.

Cell phone distraction and regulation has been a hot topic recently in the industry. Texting was successfully banned last year, and hand-held cell phone use is expected to be banned later this year. While texting rules were accepted largely universally, other proposed bans have received mixed reactions from the industry.

 

Friday Fun

If you're one of the few people who has not yet seen Webcam 101 for Seniors, here it is:

Study Suggests NSAIDs Raise Risk of Miscarriage

ABC World News reported in one of its "healthy living," segments that "some over the counter painkillers are a risk to pregnant women and their unborn children, doubling the risk of miscarriage." ABC explained, "This is a study out of Canada that looked at 4,700 women that had a miscarriage, and they compared those to 47,000 who did not. What they found was that the women who had miscarriages, in the first 20 weeks, were more than twice as likely to take a certain type of painkiller. This is a painkiller called NSAID. It's in Aleve, Motrin, Ibuprofen." Besser added that pregnant women should "think about taking Tylenol, acetaminophen" for pain.

NBC Nightly News reported, "While the experts keep trying to learn more about what causes miscarriages, and how to prevent them, a new study of 47,000 women has found one more piece of the puzzle that women may want to consider, and it involves some big brand name pain relievers that are in so many of our homes in this country." NBC added, "Some of the most popular over-the-counter pain relievers, so-called NSAIDs, could be cause for concern early in pregnancy including ibuprofen...and naproxyn." These drugs "already carry warnings against use late in pregnancy, but the study out today from the team of University of Montreal, shows that taken early in pregnancy during the first 20 weeks, the drugs may more than double the risk of miscarriage."

The Los Angeles Times reports in its "Booster Shots" blog, "The greatest risk was among women who had taken diclofenac, and the lowest among women who had taken rofecoxib alone." It also notes that "some previous studies on the connection between non-steroidal anti-inflammatory drugs and miscarriage or birth defects have shown a link," including "a 2003 study in the British Medical Journal" that linked NSAIDs "with an 80% greater risk of miscarriage," though "a subsequent BMJ study found the data flawed." The current study is published in the Canadian Medical Association Journal.

Medscape says that the study "analyzed associations between different types and dosages of nonaspirin NSAIDs and spontaneous abortion using conditional logistic regression, with adjustment for confounding variables," and found "no apparent dose-response effect."

HealthDay reports that "Individual drugs had different risks associated with them, the highest being diclofenac, which tripled the risk, naproxen (Aleve), which involved a 2.64-times increased risk and ibuprofen (Advil, Motrin), which carried about double the risk."

Reuters adds celecoxib to the list of NSAIDS, and notes that the study also suggests that NSAIDs may interfere with prostaglandin production.

From the American Association for Justice news release.

 

Plaintiff and Defense Lawyers Agree — Medicare Claims Procedures Need Improvement

In continuing coverage, Business Insurance reported insurers groups and "trial attorneys represented by the American Assn. for Justice" are supporting the Strengthening Medicare and Repaying Taxpayers Act, which "would require Medicare to respond within 65 days of a party's request for information on Medicare's final payment demand." The Medicare Secondary Payer System requires parties to "notify the Centers for Medicare and Medicaid Services of all workers comp and other liability settlements or payments that involve Medicare recipients." But according to attorney David Farber, "insurers and employers often are stymied from reaching settlements with workers comp claimants or parties to a liability claim because Medicare can take months to notify insurers and employers of its final demand." The AAJ said "plaintiff attorneys are siding with defense attorneys as well as organizations representing their common foes, since the situation adversely affects plaintiffs."

From the American Association for Justice news release.

 

Some Data on Physicians' Financial Connections Becoming Available

Coverage of payments to physicians from pharmaceutical and device makers received extensive coverage last Thursday primarily pointing out local payment patterns, frequently with a focus on one or a few physicians. The Los Angeles Times reported that "a recent string of scandals has raised questions about whether patients need to know more" about financial connections between pharmaceutical and medical device makers and physicians. "Only recently have some tools become available to help patients learn about their doctors' financial ties before they are in the exam room." The Affordable Care Act requires that "by 2013, every drug and device company operating in the United States will have to" reveal payments they've made to "doctors for consulting, research, even a dinner." Already, "ProPublica has created a database, Dollars for Docs."

The Boston Globe reported, "Total payments to doctors for promoting pharmaceutical companies' products to their colleagues appear to be falling in Massachusetts, suggesting that new restrictions designed to distance doctors from industry are leading some to abandon the lucrative speaking circuit." The story reports on payments by Eli Lilly and Co., down 46 percent since 2009; GlaxoSmithKline down 29 percent. The story was based on data from ProPublica.

The Star-Ledger (NJ) reported, "In 2010, 11 drug makers, including New Jersey-based Merck and Johnson & Johnson, paid out more than $446 million to doctors across the country, according to the news organization ProPublica." But "the current ProPublica database does not include a number of drug makers, including Roche and Bristol Myers Squibb."

The Oregonian reported, "A database released today by the nonprofit ProPublica provides new details about the depth and breadth of the pharmaceutical industry payments, including in Oregon. The list includes 12 companies which cover more than 40 percent of US drug sales."

The Orlando Sentinel reported, "Doctors in Florida have received more than $56 million from a dozen pharmaceutical companies since 2009, according to data released Wednesday by ProPublica."

The Cleveland (OH) Plain Dealer reported, "Doctors in Northeast Ohio have been paid $5.8 million by drug companies since 2009 for talks about the companies' medications." The St. Louis Post-Dispatch reports that payments are declining in "a nationwide trend."

From the American Association for Justice news release.

 

Study Reveals Grandparents Better Drivers Than Parents

Here's an interesting tidbit from a recent study by Children's Hospital of Philadelphia — grandparents may be better drivers than are parents. One of the many places this was reported was on theSmartAboutHealth site:

Most statistics on car crashes indicate an increase in accidents as drivers age, especially after age 65. In a recent study of car crashes that examined the injury rate for child passengers, grandparents were found to be safer drivers than parents. The study was done by Children’s Hospital of Philadelphia. The researchers reviewed State Farm insurance claims for the years 2003-2007. The claims were filed in 15 states. Children up to age 15 were involved. Altogether, almost 12,000 children were involved. The researchers also conducted interviews with some of the drivers involved.

The children who were passengers of their parents had an injury rate 1.05 percent. Children who were riding with their grandparents had an injury rate of 0.70 percent, 33 percent lower. The injuries were similar for both groups, broken bones and head injuries, including concussions. There were not enough deaths involved in claims to warrant any study.

The lead author of the study was Dr. Fred Henretig, an emergency medicine specialist at the Children’s Hospital of Philadelphia. He became interested in the subject after he became a grandfather at age 60. He attributes the lower injuries to extra caution when driving their “precious cargo” as he described grandchildren.