The Honorable Carol J. Carmody
Remarks for the Public Meeting on Motorcoach Safety
National Highway Traffic Safety Administration
Washington, D.C.
April 30, 2002


Good morning. Thank you for inviting me to participate in this important public meeting on motorcoach safety. I am delighted to be here, and I am pleased that we could make our Boardroom available for this discussion.

The NTSB and the NHTSA enjoy a unique partnership. We share the same objective - - ensuring the safety of our fellow citizens as they travel on our nation's highways.

For more than 30 years, the Safety Board's mission has been to prevent accidents. We conduct thorough, independent, and objective investigations and issue recommendations to correct the problems we discover. Our small agency of less than 500 employees has investigated thousands of aviation, railroad, marine, highway, and pipeline accidents.

I want to thank those here today for your continuing efforts to improve motorcoach passenger safety on our roadways. It has certainly paid off. In the past five years, more than 219,000 people were killed on our nation's highways. During that same time, there were 56 motorcoach occupant fatalities. Last year, only three individuals were killed in motorcoach accidents. These are remarkable statistics - - especially considering that motorcoaches log an average of 28 billion passenger miles annually.

Even though our efforts have been successful - - we cannot become complacent. We must continue to reduce the number of accidents to the lowest level possible. Just last week, on April 24th, in Kinder, Louisiana, a motorcoach driver apparently became medically incapacitated; the bus traveled off of the road, and struck a telephone pole. The driver died and four passengers were injured. We are all here today to do our best to make sure that accidents - -such this one - - are prevented.

The NTSB has investigated every major motorcoach accident in our nation since 1968, and the Board has made numerous recommendations to improve motorcoach operator oversight, driver training, licensing, medical certifications, vehicle crashworthiness, restraints, and collision warning technologies.

Thanks to the efforts of Congress, DOT, the industry and others, we have seen significant improvements in the overall operation of motorcoaches ranging from driver licensing requirements, to vehicle improvements such as automatic slack adjustors. However, there are still several NTSB safety recommendations regarding vehicle crashworthiness, collision warning technologies, and driver medical certification that have yet to be implemented. While Mr. Osterman, the Director of the Board's Office of Highway Safety, will review the crashworthiness and collision warning technology issues a little later in the program, I will focus the remainder of my remarks on the issue of driver medical certification.

The Safety Board is concerned about driver qualifications and qualifications for commercial driver examiners. The NTSB's recent report on the 1999 New Orleans bus crash that killed 22 people and injured 22 others highlights the importance of ensuring that fitness examinations for commercial drivers are properly conducted and adequately evaluate an individual's condition. This accident was the fourth deadliest bus crash in U.S. history. A 55-passenger motorcoach enroute to Bay St. Louis, Mississippi, ran off the highway into a grassy side slope, crashed through a guardrail and a chain-link fence, vaulted over a paved golf cart path, and collided with a dirt embankment before finally coming to rest.

The NTSB investigation revealed that two years before the crash, the 46-year-old driver had been diagnosed with a terminal heart condition and suffered symptoms including impaired heart function, an enlarged heart, and congestive heart failure. The driver had been hospitalized several times for congestive heart failure. In July 1998, the driver was diagnosed with advanced kidney failure. By December 1998, he was receiving kidney dialysis three times a week.

Clearly, this individual should not have been driving a commercial motorcoach. Yet, he was still able to obtain a valid commercial driver's license and pass a commercial driver's fitness examination in August 1998. As shocking as this situation is - - it is not unique. In fact, over the years, the Safety Board has examined many crashes involving drivers who did not meet the medical qualifications specified in the Code of Federal Regulations or who were unfit to drive commercial vehicles.

The data uncovered during our investigation led the Board to conclude that the medical certification process for commercial drivers is ineffective and inadequate. Consequently, we recommended that the Federal Motor Carrier Safety Administration (FMCSA) develop a comprehensive medical oversight program to revitalize and improve the program.

The Safety Board is also concerned that the commercial driver examiners may not be qualified to evaluate the medical conditions of drivers and their medicines. Currently, examiners can be members of many different medical professions including medical doctors, advanced practice nurses, and chiropractors. Regardless of their credentials, none of the examiners is required to attend standardized training courses that would address specific fitness concerns for commercial drivers. As a result, the Safety Board recommended that - - as part of FMCSA's medical oversight program - - individuals performing commercial driver medical exams must be educated on driver occupational issues and must have access to specific information relating to commercial drivers and transportation.

Furthermore, the Safety Board believes that without additional guidance, examiners will not read or fully understand the new eight-page examination form mandated by the FMCSA. The new form contains significantly more health history and will provide more information to health examiners, but our investigations have indicated that previous two-page examination forms were often misunderstood or not read at all. We believe more training is needed for examiners.

We are also concerned by the lack of federal requirements for the review and tracking of completed examination forms by state licensing authorities. In the case of the New Orleans bus driver, discussed a few minutes ago - - the driver indicated on his medical form that he did not have a heart condition, despite the fact that that he listed several well known heart medicines he was currently taking. Although the examiner asked about this glaring discrepancy, she eventually provided the driver with a new medical certificate after - - somehow - - concluding he did not have a current heart condition.

Unfortunately, even if the examiner had declared the driver unfit for duty, he could very well still operate a commercial vehicle. Current regulations do not require either the driver or the examiner to inform anyone of a fitness exam failure. The driver could have taken a second fitness exam with a different medical examiner or he could have ordered the form from a vendor or downloaded it off the Internet and completed it himself. Actually, the Safety Board has investigated crashes where drivers have done just that.

If examiners were required to forward all completed examination forms to state licensing agencies for tracking and review, unqualified drivers could be identified. In the New Orleans case, a tracking and review process may have subjected the driver to further scrutiny. Some states already require such review and tracking of commercial driver examination forms and certificates and have merged the medical exam with the commercial driver's license exam. We have recommended that FMCSA include a review process, as part of their medical oversight program, that prevents, or identifies and corrects, the inappropriate issuance of medical certificates.

Law enforcement officials must also be given the necessary tools to identify unfit drivers. In most states, law enforcement officials determine driver fitness solely by a driver's possession of a current medical certificate or by perceived compliance with a certificate's restrictions. Some states have gone further, such as California and Arizona, and have instituted systems that provide a mechanism to determine during routine traffic stops if a driver has a current medical certificate. As we recommended in our report, more must be done to identify whether commercial drivers are actually fit to operate their vehicles.

Another issue is the medical community's willingness to intercede in cases involving fitness examinations. One of the most frustrating aspects of the New Orleans situation was the number of doctors and nurses who knew that the driver was very ill, but made no effort to notify anyone who could have prevented him from operating a bus. We must do more to encourage healthcare providers to report such cases. In fact, we need to ensure that there is a mechanism in place that facilitates their reporting, and we have recommended that FMCSA incorporate such a mechanism into its oversight program.

The New Orleans bus crash brought attention to numerous deficiencies in the commercial driver medical certification program. These deficiencies endanger the traveling public and jeopardize those individuals working in surface transportation. The Safety Board has proposed significant changes to the medical certification program. There are successful examples of each of our proposals already in place in several states and at the Federal Aviation Administration (FAA). FAA medical examiners are required to attend a training course, given a handbook of examination procedures, and regularly advised of regulatory changes. In addition, the FAA reviews and tracks all pilot examination forms. Our fellow citizens deserve a system that protects them on the highways as well. I urge each of you to work with the FMCSA, your associations and representatives, and the states to ensure that these recommendations are implemented.

Working together, the NTSB, DOT, associations and the industry can bolster the safety of our transportation system, and specifically our motorcoach operations, and ensure the safe travel of our fellow citizens.

Thank you.