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:
S.S.
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION AND ORDER
Panel: Dr. Dimitri Louvish, Member Joanne E. Foot, Member
Appearances: For the Appellant: Self-represented For the Respondent: Sonia De Santis, Agent
Place and Date(s) of Hearing: By Teleconference September 20, 2018
REASONS FOR DECISION AND ORDER
A. Overview
1The appellant is a 26-year-old man who appeals the suspension of his driver’s licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”).
2The appellant has Type 1 diabetes and suffered an extreme hypoglycemic event during his sleep. He was taken to the hospital and treated by an emergency room physician who filed a Medical Condition Report with the Registrar of Motor Vehicles (the “Registrar”). As a result, the Registrar suspended the appellant’s driver’s licence under s. 47(1) of the Act, effective May 1, 2018.
3The question for our determination is whether the appellant suffers from a physical condition to an extent that is likely to significantly interfere with his ability to drive safely.
4For the reasons set out below, we find that the appellant does not suffer from a physical condition to an extent that is likely to significantly interfere with his ability to drive safely.
5For these reasons, we set aside the Registrar’s decision to suspend the appellant’s driver’s licence.
B. ISSUES
6The issue in this appeal is whether the appellant suffers from a physical condition that is likely to significantly interfere with his ability to drive safely.
7To answer that question, we will address the following issues:
a. Does the appellant have a physical condition?
b. Is the appellant’s physical condition, if any, likely to significantly interfere with his ability to drive safely?
C. LAW
8The Registrar has the power under s. 47(1) of the Act to suspend or cancel a driver’s licence. In this case, s. 47(1)(g) is the relevant ground for suspension. It states that a licence may be suspended for “any other sufficient reason not referred to in clause (d), (e) or (f).”
9One sufficient reason to suspend a driver’s licence under s. 47(1)(g) of the Act is that the driver suffers from a medical condition or disability likely to significantly interfere with his or her ability to drive safely. Subsection 14(1) of O. Reg. 340/94 (the “Regulation”) under the Act 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;
10According to s. 14(2)(a) of the Regulation, if the Minister of Transportation is determining whether the requirements of s. 14(1) are met, the Minister may take into consideration the Canadian Council of Motor Transport Administrators Medical Standards for Drivers (the “CCMTA Standards”). Similarly, the Tribunal may take the CCMTA Standards into consideration, although they are not binding requirements.
11The Registrar has the burden to establish the grounds for suspending the licence on a balance of probabilities. Following a hearing, the Tribunal may, under s. 50(2) of the Act, confirm, modify or set aside the decision or order of the Registrar.
D. ANALYSIS
a. Does the appellant suffer from a physical condition?
12It is not in dispute that the appellant has Type 1 diabetes and that he suffered an extreme hypoglycemic event during his sleep on April 30, 2018. We make these findings of fact.
b. Is the appellant’s physical condition, if any, likely to significantly interfere with his ability to drive safely?
13Having found that the appellant suffers from Type 1 diabetes and experienced an extreme hypoglycemic event, we now must consider whether this condition is likely to significantly affect his ability to drive safely.
14The Registrar has the burden to establish how the appellant’s medical condition will interfere with his ability to drive safely. The Registrar did not lead any evidence linking the appellant’s Type 1 diabetes to his ability to drive safely but did refer to Section 7.6.4 of the CCMTA Standards.
15As stated above, the CCMTA Standards are not binding on the Tribunal. However, these standards can provide helpful guideposts as to whether the appellant is able to drive safely. Section 7.6.4 of the CCMTA Standards provides, among other things, that non-commercial drivers are eligible for a licence following an extreme hypoglycemic event if the treating physician indicates that stable glycemic control has been re-established and no further severe hypoglycemic episodes while awake or asleep have occurred within the past six months.
16Concurrent with the suspension of the appellant’s driver’s licence, the Registrar requested that the Epilepsy and Seizure form and the Diabetes Assessment form be completed by the appellant’s physicians. These were completed and submitted. The Epilepsy and Seizure form, completed by the appellant’s family doctor, confirmed that the seizure suffered by the appellant as part of the extreme hypoglycemic event was provoked by the insulin medication. The Registrar indicated that it is satisfied that the condition of seizure is no longer a concern.
17The Diabetes Assessment form was completed on May 9, 2018 by the appellant’s endocrinologist. It confirmed that the appellant has Type 1 Diabetes that is treated by insulin. This form also confirmed a number of other matters in relation to the appellant’s management of his disease, as follows:
a. That his most recent A1C (being a marker that reveals how well diabetes is being controlled by drugs or insulin) results are under 7% and that these results are consistent with his glucose logs;
b. That he has an adequate understanding of his disease and that he is compliant with treatment with respect to diet, lifestyle, exercise, rest and attendance at medical appointments;
c. That he has awareness of and experiences early symptoms of hypoglycemia and that he has not experienced any episodes of hypoglycemic unawareness in the past three months or reported any such incidents in the past 12 months;
d. That there have not been other incidents of severe hypoglycemia in the past six months;
e. That the appellant has regained adequate glycemic control; and
f. That the appellant is adherent to the prescribed treatment regimen and that there has been no pattern of non-adherence or misuse of medication.
18We are satisfied that the information in the Diabetes Assessment form confirms that the appellant has re-established stable glycemic control as is required by Section 7.6.4 of the CCMTA Standards. Therefore, we must decide whether it is necessary to adhere to the requirement in the CCMTA Standards that no hypoglycemic episodes have been experienced for a period of six months. This six month period will end on October 31, 2018, about 40 days after the date of the hearing.
19In this respect, the testimony of the appellant is helpful. He indicated that he was diagnosed with Type 1 diabetes at the age of 10 and that he has been managing the condition for the majority of his life. He further indicated that he managed the condition on his own, without the assistance of his parents, from about age 16. He also testified that at the outset he was required to figure out much on his own, owing to his parents’ limited ability with the English language.
20The appellant discussed fluently his treatment regime, including the times he tests his blood sugar, his dosages of different types of insulin and noting special situations (such as before and after gym workouts or if he has a substantial snack) for which he will check his blood sugar.
21He had an appointment with his endocrinologist on the day prior to the hearing and indicated that his Hb AIC was again at 7%. He also reported that he had ordered a “free style sensor”, a device that will provide continuous monitoring of his blood sugar level without the need of pricking a finger. This device will enhance his ability to manage the disease.
22The appellant described the evening of the incident. He had arrived home from the gym at about 11 p.m., took insulin, ate a pizza and went to bed. He did not notice the early signs of hypoglycemia because he was asleep. He testified that he had never experienced an extreme hypoglycemic event before and that he keeps “dex-glucose” tablets with him at all times, to treat an episode of hypoglycemia, should he begin to feel any early signs.
23The appellant does not suffer from any other medical conditions, and does not smoke or use recreational drugs. He acknowledged drinking alcohol occasionally, usually about two to three beers at a time. He went on to state that he is aware that alcohol interferes with insulin and that drinking causes complications with diabetes management.
24We find that the appellant is very knowledgeable about his diabetes, has good insight and awareness into the condition, takes good care of himself, maintains a healthy lifestyle and has good control of his blood sugar levels. In short, he takes his condition seriously and we believe that he is now able to drive safely and no further degree of safety be achieved by requiring the appellant to wait out the remainder of the six month period recommended by the CCMTA Standards.
25After considering the evidence and submissions of the parties, we find on a balance of probabilities that the appellant does not suffer from a physical condition that is likely to interfere significantly with his ability to drive a motor vehicle safely.
E. ORDER:
26For the reasons set out above, pursuant to subsection 50(2) of the Act, the Registrar’s decision to suspend the Appellant’s driver’s licence is set aside.
LICENCE APPEAL TRIBUNAL
____________________________
Dr. Dimitri Louvish
____________________________
Joanne E. Foot
Released: October 16, 2018