Licence Tribunal
Appeal d'appel en
Tribunal matière de permis
FILE: 8200/MED
CASE NAME: 8200 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 Suspend a Licence
Applicant
Applicant
-and-
Registrar of Motor Vehicles
Respondent
REASONS FOR DECISION AND ORDER
ADJUDICATOR: D. Ian Turnbull, M.D., Member
APPEARANCES:
For the Applicant: Self-represented
For the Respondent: Russell McKnight, Agent
Heard in Belleville: August 9, 2013
DECISION AND REASONS
This is an appeal to the Licence Appeal Tribunal (the "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 72-year-old businessman whose driving privileges were suspended for seizures the third time in eight years in a letter from the Registrar dated May 27, 2013 (Exhibit 3, Tab 22). The Registrar had received an unsolicited report from a physician dated April 4, 2013 (Exhibit 3, Tab 21), reporting pursuant to Section 203 of the Highway Traffic Act (HTA) stating "please be advised (The Applicant) has had multiple seizures in the past week, including one while driving. Also, please note he has been dishonest in the past about having seizures in order to keep his licence."
An "Epilepsy and Seizures" form was attached to the letter of suspension dated May 27, 2013 (Exhibit 3, Tab 22). The covering letter states, "take this form to your treating physician, specialist or nurse practitioner when your condition improves and have the following information sent to the Medical Review Section."
In a letter dated June 30, 2013 (Exhibit 2), the Applicant wrote his family physician and asked the physician to complete the "Epilepsy and Seizures" form.
In a letter to the Applicant dated July 19, 2013 (Exhibit 6, Page 3/10), the physician stated that "because of your recent threats and insults regarding my reporting of your seizure disorder to the Ministry of Transport, there has been a breakdown of trust in our doctor-patient relationship ...." and goes on to say, "I therefore regret to inform you that I will not be in a position to provide you with further medical services, effective immediately."
The Applicant presented the "Epilepsy and Seizures" form completed by his chiropractor (Exhibit 4), dated July 27, 2013, at the August 1, 2013 hearing.
The Registrar's agent said the form would be reviewed on an urgent basis by the Medical Review Section of the Registrar and asked the Tribunal for an adjournment, which was granted. A new hearing date was set for August 9, 2013. An order was released by the Tribunal dated August 6, 2013 adjourning the matter to August 9.
In the letter dated August 6, 2013 (Exhibit 5), the Deputy Registrar of Automobiles stated the "Epilepsy and Seizures" form had been reviewed, as well as the Applicant's entire file. The letter went on to say, "this form must be completed by your treating physician, specialist or nurse practitioner and "the physician completing this form must be involved in the primary care/ management of your neurologic condition, and attached another copy of the "Epilepsy and Seizures" form for the Applicant's convenience.
The initial suspension of the Applicant's initial driving privileges occurred April 8, 2005, following a nocturnal seizure, witnessed by his wife (Exhibit 3, Tab 1).
The Applicant's driving privileges were restored in a letter dated November 10, 2005 (Exhibit 3, Tab 12). His neurologist's report (Exhibit 3, Tab 11c) attributed the "one single episode of blackout with witnessed seizure on April 8, 2005 to "it was very likely related to metabolic factors and that should not happen again." The neurologist stated there was no need of anticonvulsant therapy.
The second suspension of the Applicant's driving privileges followed receipt of a Medical Condition Report dated December 20, 2010 (Exhibit 3, Tab 15). In a barely legible report from the same neurologist, he states "this person had several blank spells in the night with seizure activity in sleep and two in the daytime."
The same neurologist supplied the medical information required by the Registrar and the Applicant's driving privileges were again reinstated in a letter dated July 28, 2010 (Exhibit 3, Tab 20). The neurologist's report stated, "the risk of him having a major seizure problem appears remote."
In April 2010, on the recommendation of a friend, the Applicant states he attended a neurology centre in the southern United States. The Applicant was given a three-month supply of an anticonvulsant (not available in Canada) (Exhibit 6, Page 2/10). The drug was prescribed "in order to correct any problems that may occur."
The Applicant's local family physician prescribed an anticonvulsant, Carbamazepine, beginning December 16, 2010.
The dose was halved by the same physician on March 28, 2012, and the Applicant was seizure-free until the incident while driving on March 31, 2013. The initial dosage was restored, and the Applicant has been seizure-free the last four months.
The Applicant filed a Notice of Appeal dated July 3, 2013 (Exhibit 2). The Tribunal arranged an in-person hearing for August 1, 2013.
ISSUES
Should the decision of the Registrar to suspend the Applicant's licence be confirmed, modified or set aside?
In particular:
Does the Applicant suffer from a mental, emotional, nervous or physical disability likely to significantly interfere with his 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.
Section 47(1) of the Act gives the Registrar the power to suspend or cancel a driver's licence on the ground(s) set out in section 14 (1) of the Regulation set out above.
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
The Registrar has made the case that the Applicant's driving privileges should remain suspended until the medical information requested in the Registrar's letter dated May 27, 2013, has been reviewed and approved by the Registrar's Medical Review Section.
The Applicant asks why the information provided by the chiropractor is not of any value.
As pointed out in the Deputy Registrar's letter dated August 6, 2013 to the Applicant, this information must be provided by a medical doctor (physician).
In view of the eight-year history of seizures, the Tribunal believes the Registrar's request for responsible medical information is reasonable. The Registrar acted correctly in suspending the Applicant's driving privileges following receipt of his family practitioner's note of April 4, 2013.
The Applicant has two major complaints about his former family physician. The Applicant believes the 50% reduction in his daily dose of Carbamazepine beginning March 28, 2013, is directly responsible for his seizure while driving on March 31, 2013. In fact, the Applicant had been seizure-free on the reduced dose since March 28, 2012. The Applicant belief is reinforced by being seizure-free since the initial dose was restored.
The Applicant believes that had his anticonvulsant medication not been changed "for no reason" on March 28, 2012, "we wouldn't be here." He likens his current position to "going to jail; you never get out of it."
The Applicant is extremely upset over his family physician's note to the Registrar, dated April 4, 2013, leading to his third driver's licence suspension (effective May 28, 2013). The Applicant states the information in the letter "is not true and slanders him."
The Registrar's agent points out the family doctor had a chance in the letter dated July 19, 2013, to modify his comments in his letter to the Registrar dated April 4, 2013, but did not.
The Applicant remembers the "slight breakthrough." On a March 31 drive with his daughter, she said, "Dad, you can't drive." He pulled the car over and did not lose consciousness. His right arm did not appear to work properly and "his adrenalin was up." He was somewhat incoherent and didn't feel well the rest of the day.
His daughter phoned his family physician that day to report the seizure. The Applicant disputes the physician's note (Tab 3, Exhibit 21) regarding that telephone conversation. He states he did not have multiple seizures and the remark about his hiding seizures "addresses his integrity." The Applicant believes his family physician severed their relationship and did not complete the "Epilepsy and Seizures" form because the Applicant had provided copies of the drugstore's records, showing the halving of the Carbamazepine daily dosage on March 28, 2012.
The Applicant is currently seeking a new family physician and a referral to a neurologist. He continues to visit his chiropractor who is helping him with his spinal problems.
The Tribunal believes that the Applicant can supply the Registrar with the required medical information (as he has done twice previously), so the Registrar can consider the restoration of the Applicant's driving privileges.
In considering the evidence and applying the law, the Tribunal is mindful of the safety of both the Applicant and the motoring public.
(1) Ann 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
With complete, confirmed and up-to-date medical information, the Medical Review Section of the Registrar may consider the Applicant eligible for restoration of his driving privileges.
The Tribunal has considered all the evidence and finds, based on the balance of probabilities, the Registrar has acted properly in continuing the suspension of the Applicant's driving privileges (Exhibit 3, Tab 22).
DECISION
Upon the application by the Applicant to appeal the decision effective May 27, 2013 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
D. Ian Turnbull, M.D., Member
Released: August 20, 2013