Licence Appeal Tribunal

Safety, Licensing Appeals and Standards Tribunals Ontario

Tribunal d’appel en matière de permis

Tribunaux de la sécurité, des appels en matière de permis et des normes Ontario

Date: 2017-12-14

Appeal under subsection 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H. 8, from a decision of the Registrar of Motor Vehicles to suspend a driver’s licence under subsection 47(1) of the Act

Between:

E.K. Appellant

and

Registrar of Motor Vehicles Respondent

DECISION AND ORDER

Panel: Peter Savage M.D., Member Luisa Ritacca, Member

APPEARANCES:

For the Appellant: Self-represented

For the Respondent: Sonia De Santis, Agent

Place and date of hearing via teleconference:

December 4, 2017

REASONS FOR DECISION AND ORDER:

A. Overview

1This is an appeal from a decision of the Registrar of Motor Vehicles to suspend the appellant’s licence to drive, effective September 18, 2017. The appellant is a 35-year-old male, who suffers from type 1 diabetes. He was involved in a car accident on July 14, 2017. The Registrar made his decision to suspend the appellant’s licence following the receipt of a motor vehicle collision report and follow-up medical condition reports of diabetes and hypoglycemia.

2The appellant filed his Notice of Appeal on October 17, 2017. In his reasons for Appeal, the appellant stated that his diabetes is well under control and that in his 17 years of driving he never had an incident of hypoglycemia impact his driving until the night of his accident in July 2017. The appellant further stated that he needs his driver’s licence for work as he is often required to travel long distances.

3For the reasons that follow, we find that the appellant’s medical conditions of diabetes and hypoglycemia are not likely to significantly interfere with his ability to drive safely.

4The Registrar’s suspension is therefore set aside.

ISSUES:

5The appellant acknowledged that he suffers from type 1 diabetes and that an episode of hypoglycemia played a part in his car accident in July 2017. As such, the only issue for the panel to determine is:

a. Are the appellant’s medical conditions of diabetes and hypoglycemia likely to significantly interfere with his ability to drive safely?

THE LAW:

6The Registrar has the power under s. 47(1) of the Highway Traffic Act (the “HTA”) to suspend or cancel a driver’s licence for any of the specified grounds listed in paragraphs (d) through (f) of that subsection, which involve misconduct and criminal behaviour. Subsection (g) provides that the Registrar may suspend or cancel a driver’s licence for “any other sufficient reason not referred to in clauses (d), (e), or (f)”.

7Subsection 47(1) (g) is engaged where the driver suffers from a medical condition or disability likely to significantly interfere with his or her ability to drive safely.

8Subsection 14(1) of O. Reg. 340/94 (the “Regulation”) under the HTA 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;

9Pursuant to s. 14(2)(a) of the Regulation, in determining whether subsection 14(1) is triggered, the Minister of Transportation may consider the CCMTA Medical Standards for Drivers, which are published by the Canadian Council of Motor Transport Administrators. Similarly, this panel may take the CCMTA Medical Standards for Drivers into consideration, although they are not binding requirements.

10The Registrar has the burden to establish the ground for suspending the licence on a balance of probabilities.

11Pursuant to section 50(2) of the HTA, following a hearing, this panel may confirm, modify or set aside the decision or order of the Registrar.

EVIDENCE AND ANALYSIS:

12The appellant is a 35-year-old male, who suffers from type 1 diabetes. He has been living with the disease since childhood. He is a welder with the pipefitters union in his community. The appellant’s profession requires him to travel far distances for work and to work in precarious environments.

13Based on his testimony, it is clear that the appellant has good insight into managing his disease. He wears a personal constant glucose monitoring device (Dexcom 4 glucose monitor), which alerts him if his glucose levels get too high or too low. The appellant spends upwards of $3000 to $4000 per year on maintaining this device.

14At the Registrar’s request, the appellant delivered a Medical Report, dated August 31, 2017, which was completed by one of his family physicians and a Diabetes Assessment Form, dated October 24, 2017, which was completed by another of his family physicians. In both forms, the physicians confirm that the appellant suffers from type 1 diabetes, which is well-controlled and under constant monitoring. In a separate note dated October 10, 2017, one of the appellant’s family physicians indicated that in his view the appellant has “good blood sugar control” and that his control has been “excellent” but for the one episode of hypoglycemia at the time of his traffic accident.

15The appellant acknowledged that on the evening of July 14, 2017, he was in a car accident involving another vehicle. The appellant was driving home from a friend’s house where he had eaten dinner and had assisted his friend with some work in his garage. The appellant checked his glucose level before leaving his friend’s house. He could not recall his precise level, but he stated that he would not have started to drive if his level was below 5 mm/l.

16The appellant believes that at some point during his drive home his glucose monitoring device fell out of its case and fell in between the driver’s seat and the door. As a result, the device was not able to alert the appellant as to his glucose levels.

17The appellant believes that he had a drop in his glucose level that caused him to become not as alert as usual and which then resulted in him getting into the car accident.

18Immediately following the accident, the appellant got out of his car and asked the driver of the other vehicle to call for an ambulance. Once the paramedics arrived, the appellant advised them that he was a diabetic and as a result he was tested and treated with a ½ dose of glucagon at the scene. At the time the paramedics tested the appellant, he had a glucose level of 4.6 mm/l.

19The appellant testified that his glucose levels rose to over 6 mm/l within approximately 20 minutes. He did not require any further treatment or intervention, and he was allowed to drive his car home.

20The appellant explained that a glucose level of 4.6 mm/l was “right on the border” for him and that his average was closer to 5 mm/l. He believed that while 4.6 mm/l was not by definition hypoglycemic, it was low for him.

21Even though the appellant stated that he was not shaky or sweaty before the accident, he believed that he was possibly hypoglycemic at the time of the accident and that was a factor in the accident.

22Based on the evidence before it, the panel was satisfied that the appellant does suffer from type 1 diabetes and that on July 14, 2017 he had an incident of hypoglycemia, which played a part in his car accident.

23The respondent took the panel through the CCMTA Standards for Drivers as they relate to persons with diabetes. Chapter 7, section 7.6.4 provides in part that where a non-commercial driver has had an episode of “severe hypoglycemia”, there should be evidence of no further severe hypoglycemic episodes while awake or asleep for six months prior to issuing (or in this case reinstating) a licence.

24The respondent argued that the appellant had an episode of “severe hypoglycemia” on the night of his car accident in July 2017. It was the respondent’s position that the episode was “severe” because the appellant required intervention from a third party to get his glucose levels back to a normal state. In this case, the respondent argued that the fact the paramedics chose to provide the appellant with a ½ dose of glucagon demonstrated that the episode was “severe”.

25The panel does not accept the respondent’s position with regard to the hypoglycemic episode. The appellant was awake and alert immediately after the accident. He did not require assistance to get out of his car and he did not require any significant medical intervention. Neither the police nor the paramedics had any concern about the appellant driving away after the accident. The paramedics provided him with a ½ dose of glucagon, which is the equivalent of providing a candy bar or juice to a patient suffering with hypoglycemia. Further, the appellant testified that he did not experience any sweating, shakiness or other symptoms in his car just prior to the accident.

26Even if the panel were to accept that the appellant suffered a “severe hypoglycemic” episode in July, we do not accept that in this case it is necessary for the appellant to demonstrate that he has had no further severe hypoglycemic episodes within the last six months. The CCMTA Standards are not binding on this panel and in the circumstances the panel finds that the six-month time period is excessive.

27The evidence shows that the appellant has taken significant steps to manage his diabetes and that his family physicians believe that he has his disease well under control. The appellant’s attention to his diet, exercise and his decision to purchase and use a glucose monitoring device shows remarkable insight into the management of his disease.

28The panel finds that the appellant’s physical condition is not likely to significantly interfere with his ability to drive a motor vehicle safely.

Conclusion

29For the reasons set our above, pursuant to section 50(2) of the HTA, the Registrar’s decision to suspend the appellant’s driver’s licence is set aside.

Peter Savage M.D., Member

Luisa Ritacca, Member