Licence Tribunal
Appeal d'appel en
Tribunal matière de permis
2012-06-18
FILE:
7407/MED
CASE NAME:
7407 v. Registrar of Motor Vehicles
Appeal under Section 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8, from a Decision of the Registrar of Motor Vehicles Pursuant to Section 47(1) of that Act - to Appeal a Suspended Licence
Applicant
Applicant
-and-
Registrar of Motor Vehicles
Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR:
Dr Garry Fisher, Member
APPEARANCES:
For the Applicants:
Self-Represented
For the Respondent:
Russell McKnight, Agent
Heard in Windsor
June 7, 2012
DECISION AND REASONS
This is an appeal to the Licence Appeal Tribunal by the Applicant respecting a decision of the Registrar of Motor Vehicles (the “Registrar”) pursuant to section 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”).
FACTS
The Applicant is a 36 year old man who presented in an urban E.R. on Dec 17 2010. He described his symptoms vividly in a letter to the MTO dated June 11 2011. The E.R. visit culminated in the Applicant apparently having a “seizure.” His “elderly” mother (75yr) had accompanied him and according to the story was the sole witness to this event. The presenting symptoms were nausea, vomiting, diarrhea, and an inability to get much further than his bed for several weeks. He was in the E.R. for 10 hours before being seen and taken to a room and a bed. A nurse started an IV. The needle in the arm provoked marked emotional upheaval and seemed to result in a “seizure.”
At that point he hadn’t yet been seen by a doctor.
Dr. D. B. filed a form 203 on the basis of what he was told and wrote “1st episode seizure, patient denies recent alcohol abuse.” The Applicant did have a history of variable alcohol excess and abuse in the past and blood work done on that visit indicated significant abnormality in liver function tests.
GGT >2400 norm<85, Lipase 490 norm <400, Alk Phos153 norm <136, AST 198 norm <37 and the Bilirubin and MCV were above normal.
Essentially, all the Tribunal has from the E.R. visit is a form 203 and a battery of lab tests. The Tribunal rarely obtains a copy of the ER chart to determine what the thinking was on the visit. We must presume that the E.R doctor (Dr.D.B) inquired about alcohol at some point after the lab results came back.
The question of seizure led to a referral to Dr. H. D., a neurologist. He found nothing of note from a neurological standpoint, but he did file another form 203 with the MTO dated Dec 22 2010. His note describes the mother’s account of the seizure “as told to me by him.” He noted that the Applicant had left the hospital against medical advice. An EEG was ordered and was normal.
Clobazam 10 mgm three times a day was prescribed as a preventive for possible seizure. The Applicant declined the medication. A suggestion was made that he see a gastroenterologist to assess the meaning of the abnormal liver function tests. That didn’t happen.
On Dec 20 2010 the MTO sent a letter to the Applicant, suspending his driver’s licence under section 47(1) of the Highway Traffic Act. That letter dealt with following up seizure activity.
Dr. J. C. is the Applicant’s family doctor (FP). He wrote June 26, 2011, that the Applicant had previous problems with alcohol abuse from a time three years earlier. There was no comment as to alcohol intake leading up to the Dec 17 2010 E.R. visit but, he did volunteer that it was “most likely an alcohol withdrawal seizure.”
This note was to comment on a “relapse in alcohol consumption” occurring in April 2011 wherein the Applicant “wound up in the ER with severe hypertension and tachycardia which he attributes to alcohol withdrawal.” After that the Applicant attended an alcohol detox session and an AA meeting. He was encouraged to attend an alcohol rehab meeting.
Lab tests in May 2011 show the GGT remains elevated moderately. The MCV and MGH are above normal limits.
The Applicant had letters from the MTO July 18, 2011, and Aug 29, 2011. Each of these requested follow up reports from his treating physician and that a Substance Abuse Assessment form be completed. That form was received by the MTO Jan 14, 2012, completed by the Applicant and Dr.J.C. The health history was enlightening in the number of checked positive boxes:
− Liver Disease
− Hospitalizations within the past twelve months
− Psychiatric disorders
− Chronic anxiety or tension
− Loss of consciousness
− Seizures
Medications : Adalat for blood pressure and Ativan for anxiety.
Specifically noted was a history of schizoid personality and anxiety and at that time abstinence from alcohol was recommended.
For a month from mid September until mid October 2011, the Applicant attended a program at a nearby city hospital run by social workers and named “ONWARD.” During the program he abstained from alcohol but resumed imbibing modest quantities shortly thereafter.
The social work staff referred the Applicant to a clinical psychologist, Dr A.S. His note is thorough and the upshot (after six pages of small print), is that the bottom line is “Schizotypal personality with associated features of Paranoid personality.” Much of what the doctor described in his note was apparent at the hearing. The Applicant has what would appear to be superior language skills but they are getting in his way. He refuses to accept the position of the MTO or the CCMTA. The need for abstinence from alcohol for a year following a “withdrawal seizure” was mentioned a number of times by the Respondent but denied by the Applicant as invalid.
April 26 2012, Dr J.C. stated that the Applicant drinks one to two glasses of wine a night for his “cardiovascular health.” He went further and declared the Applicant safe to drive.
The Applicant has never seen an addiction specialist and has never had a satisfactory explanation of the problems of Dec 17, 2010.
ISSUES
Should the decision of the Registrar to suspend the Applicant’s licence be confirmed, modified or set aside?
Is the Applicant no longer addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his or her ability to drive a motor vehicle safely?
LAW
O. Reg. 340/94, Section 14 states:
(1) An applicant for or a holder of a driver’s licence must not,
(a) suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle of the applicable class safely; or
(b) be addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his or her ability to drive a motor vehicle safely.
(2) In determining whether an applicant for or a holder of a driver’s licence of any class meets the qualifications described in subsection (1), the Minister,
(a) may take into consideration the relevant medical standards for applicants or holders of that class of driver’s licence set out in the CCMTA Medical Standards for Drivers; and
(b) may require the applicant or holder to provide evidence satisfactory to the Minister that he or she is able to drive a motor vehicle of the applicable class safely, including,
(i) any reports of examinations under section 15, and
(ii) any additional medical information.
(3) Despite clause (2) (a) and unless otherwise provided in this Regulation, if there is a difference between a medical standard set out in the CCMTA Medical Standards for Drivers and a medical standard set out in this Regulation, the Minister shall take into consideration the standard set out in this Regulation instead of the standard set out in the CCMTA Medical Standards for Drivers.
(4) In this section, the CCMTA Medical Standards for Drivers means the document entitled CCMTA Medical Standards for Drivers, published by the Canadian Council of Motor Transport Administrators and dated March 2009, as it may be amended from time to time, that is available on the Internet through the website of the Canadian Council of Motor Transport Administrators.
Section 47(1) states:
Subject to section 47.1, the Registrar may suspend or cancel,
(b) a driver’s licence; …
on the grounds of,
(d) misconduct for which the holder is responsible, directly or indirectly, related to the operation or driving of a motor vehicle;
(e) conviction of the holder for an offence referred to in subsection 210(1) or (2);
(f) the Registrar having reason to believe, having regard to the safety record of the holder or of a person related to the holder, and any other information that the Registrar considers relevant, that the holder will not operate a commercial motor vehicle safely or in accordance with this Act, the regulations and other laws relating to highway safety; or
(g) any other sufficient reason not referred to in clause (d), (e) or (f).
Section 50 of the Act states:
50 (1) Every person aggrieved by a decision of the Minister made under subsection 32(5) for which there is a right of appeal pursuant to a regulation made under clause 32 (14) (n) or a decision of the Registrar under section 17 or 47 may appeal the decision to the Tribunal.
(2) The Tribunal may confirm, modify or set aside the decision of the Minister or the Registrar.
APPLICATION OF THE LAW TO FACTS
(1) (1) An applicant for or a holder of a driver’s licence must not,
(a) suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle of the applicable class safely;
The personality problems of the Applicant are not likely to change or become more conventional any time soon. At the same time, it is unlikely that the personality would make him a danger on the road. The traits do get in the way of accepting guidelines from the CCMTA. If he wants to get his licence back, he needs to listen to the collective wisdom of those who write safety standards.
(b) be addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his or her ability to drive a motor vehicle safely.
The question of the etiology of his “seizures”, whether he had a seizure at all, and why his liver enzymes were sky high in mid Dec 2010 are all unanswerable at this Tribunal. The Applicant told the Tribunal that he hadn’t been drinking prior to his Dec 2010 ER admission, but “alcohol withdrawal” was judged most likely by attending staff. He refuses to abstain. He declined going to an addiction treatment facility in his city on the basis that he was much too bright to associate with common alcoholics. He did have a “relapse” and drink a large quantity of “fortified” wine in mid April 2011 resulting in another E.R. visit. He had his last glass of wine a night or two before the hearing.
DECISION
Upon the application by the Applicant to appeal the decision dated December 20, 2010, of the Registrar to suspend his driver’s licence pursuant to Section 47(1) of the Act, and having considered the evidence filed with the Tribunal, and the submissions of the Registrar and of the Applicant;
IT IS THE DECISION OF THE TRIBUNAL pursuant to the authority vested in it under section 50(2) of the Act that the decision of the Registrar be confirmed.
LICENCE APPEAL TRIBUNAL
Dr. Garry Fisher, Presiding Member
RELEASED: June 18, 2012