81 FR 28119 - Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 89 (May 9, 2016)

Page Range		28119-28120
FR Document		2016-10875

FMCSA announces its decision to deny applications from 7 individuals seeking exemptions from the Federal cardiovascular standard applicable to interstate truck and bus drivers and discusses the reasons for the denials. The Agency reviewed the medical information of each the individuals who applied for an implantable cardioverter defibrillator (ICD) exemption. Based on a review of the applications and following an opportunity for public comment, FMCSA has concluded that the 7 individuals in the notice did not demonstrate they could achieve a level of safety that is equivalent to, or greater than, the level of safety that would be obtained by complying with the regulation.

Federal Register, Volume 81 Issue 89 (Monday, May 9, 2016)

[Federal Register Volume 81, Number 89 (Monday, May 9, 2016)]
[Notices]
[Pages 28119-28120]
From the Federal Register Online [www.thefederalregister.org]
[FR Doc No: 2016-10875]

[[Page 28119]]

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2015-0371]

Qualification of Drivers; Exemption Applications; Implantable
Cardioverter Defibrillators

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of denials of exemption applications.

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SUMMARY: FMCSA announces its decision to deny applications from 7
individuals seeking exemptions from the Federal cardiovascular standard
applicable to interstate truck and bus drivers and discusses the
reasons for the denials. The Agency reviewed the medical information of
each the individuals who applied for an implantable cardioverter
defibrillator (ICD) exemption. Based on a review of the applications
and following an opportunity for public comment, FMCSA has concluded
that the 7 individuals in the notice did not demonstrate they could
achieve a level of safety that is equivalent to, or greater than, the
level of safety that would be obtained by complying with the
regulation.

DATES: Denial letters were sent to each of the individuals listed in
this notice on March 1, 2016.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief Medical
Programs Division, 202-366-4001, U.S. Department of Transportation,
FMCSA, 1200 New Jersey Avenue SE., Room W64-224, Washington, DC 20590-
0001. Office hours are from 8:30 a.m. to 5 p.m. Monday through Friday,
except Federal holidays.

SUPPLEMENTARY INFORMATION:

Background

Under 49 U.S.C. 31136(e) and 31315, FMCSA may grant an exemption
from the Federal Motor Carrier Safety Regulations for up to five years
if it finds ``such exemption would likely achieve a level of safety
that is equivalent to or greater than the level that would be achieved
absent such exemption.'' FMCSA can renew exemptions for up to an
additional five years at the end of each five-year period.\1\
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\1\ 49 U.S.C. 31315(b), as amended by section 5206(a) of the
FAST Act, Pub. L. 114-94, div. A, title V, 129 Stat. 1537 (Dec. 4,
2015).
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On November 27, 2015, FMCSA published for public notice and
comment, FMCSA 2015-0371, listing 7 individuals seeking exemptions for
ICDs. Accordingly, the Agency has evaluated each applicant's request to
determine whether granting an exemption will achieve the required level
of safety mandated by statute.

Evaluation Criteria--Cardiovascular Medical Standard and Advisory
Criteria

The individuals included in this notice have requested an exemption
from the provisions of 49 CFR 391.41(b)(4), which applies to drivers
who operate CMVs in interstate commerce, as defined in 49 CFR 390.5.
Section 391.41(b)(4) states that:

A person is physically qualified to drive a commercial motor vehicle
if--
* * * * *
that person has no current clinical diagnosis of myocardial
infarction, angina pectoris, coronary insufficiency, thrombosis, or
any other cardiovascular disease of a variety known to be
accompanied by syncope [a temporary loss of consciousness due to a
sudden decline in blood flow to the brain], dyspnea [shortness of
breath], collapse, or congestive cardiac failure.

The FMCSA provides medical advisory criteria as recommendations for
use by medical examiners in determining whether drivers with certain
medical conditions and drivers who have undergone certain procedures
and/or treatments should be certified to operate CMVs in interstate
commerce in accordance with the various physical qualification
standards in 49 CFR part 391, subpart E. The advisory criteria are
currently set out in Appendix A to 49 CFR part 391. The advisory
criteria for section 391.41(b)(4) provide, in part, that:

The term ``has no current clinical diagnosis of'' is specifically
designed to encompass: ``a clinical diagnosis of'' (1) a current
cardiovascular condition, or (2) a cardiovascular condition which
has not fully stabilized regardless of the time limit. The term
``known to be accompanied by'' is designed to include a clinical
diagnosis of a cardiovascular disease (1) which is accompanied by
symptoms of syncope, dyspnea, collapse or congestive cardiac
failure; and/or (2) which is likely to cause syncope, dyspnea,
collapse, or congestive cardiac failure.
It is the intent of the Federal Motor Carrier Safety Regulations to
render unqualified, a driver who has a current cardiovascular
disease which is accompanied by and/or likely to cause symptoms of
syncope, dyspnea, collapse, or congestive cardiac failure. However,
the subjective decision of whether the nature and severity of an
individual's condition will likely cause symptoms of cardiovascular
insufficiency is on an individual basis and qualification rests with
the medical examiner and the motor carrier.

In the case of persons with ICDs, the underlying condition for
which the ICD was implanted places the individual at high risk for
syncope (a transient loss of consciousness) or other unpredictable
events known to result in gradual or sudden incapacitation. ICDs may
discharge, which could result in loss of ability to safely control a
CMV. See the Evidence Report on ``Cardiovascular Disease and Commercial
Motor Vehicle Driver Safety,'' April 2007.\2\ A focused research report
entitled ``Implantable Cardioverter Defibrillators and the Impact of a
Shock on a Patient When Deployed,'' completed for the FMCSA in December
2014, indicates that the available scientific data on persons with ICDs
and CMV driving does not support that persons with ICDs who operate
CMVs are able to meet an equal or greater level of safety and upholds
the findings of the April 2007 report. Copies of the April 2007 report
and the December 2014 report are included in the docket for this
notice.
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\2\ Now available at http://ntl.bts.gov/lib/30000/30100/30123/Final_CVD_Evidence_Report_v2.pdf.
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Discussion of Public Comments

On November 27, 2015, FMCSA published in a Federal Register Notice
the names of 7 individuals seeking ICD exemption and requested public
comment. The public comment period closed on December 28, 2015. A total
of 13 commenters responded to the notice. Each of the comments was
favorable towards the applicants continuing to drive CMV's with ICD's.
Commenters believed that the individuals seeking exemptions were
responsible drivers who had safe professional driving and work
histories and believed that their medical conditions did not present
safety concerns. One anonymous physician encouraged the FMCSA to
accommodate individuals with ICD's that have never deployed or that
have not deployed in many years by developing an exception to the
general rule that would still protect public safety.

FMCSA's Response

FMCSA acknowledges the commenters' reports of safe driving
histories and concerns for the driving careers of the applicants. Based
on the available medical literature cited above, however, FMCSA
believes that a driver with an ICD is at risk for incapacitation if the
device discharges. This risk is combined with the risks associated with
the underlying cardiovascular condition for which the ICD has been
implanted as a primary or secondary preventive measure.

[[Page 28120]]

Conclusion

FMCSA evaluated the 7 individual exemption requests on their
merits, available data from Evidence Reports and Medical Expert Panel
opinions on the impact of ICDs on Commercial Motor Vehicle driving, and
the public comments received. The Agency has determined that the
available medical literature and data does not support a conclusion
that granting these exemptions would achieve a level of safety
equivalent to or greater than the level of safety maintained without
the exemptions. Each applicant has, prior to this notice, received a
letter of final disposition on his/her exemption request. Those
decision letters fully outlined the basis for the denial and constitute
final Agency action. The list published today summarizes the Agency's
recent denials as required under 49 U.S.C. 31315(b)(4).
The following 7 applicants are denied exemptions from the
cardiovascular standard. Ellis James Benson, Jon Carey, Martin Carter,
Carl Jeglum, William Kastner, Mark Todd Smith, Andre Williams.

Issued on: April 28, 2016.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2016-10875 Filed 5-6-16; 8:45 am]
BILLING CODE 4910-EX-P

28120 Federal Register / Vol. 81, No. 89 / Monday, May 9, 2016 / Notices

Conclusion on-line instructions for submitting period if it finds ‘‘such exemption
FMCSA evaluated the 7 individual comments. would likely achieve a level of safety
exemption requests on their merits, • Mail: Docket Management Facility; that is equivalent to or greater than the
available data from Evidence Reports U.S. Department of Transportation, 1200 level that would be achieved absent
and Medical Expert Panel opinions on New Jersey Avenue SE., West Building such exemption.’’ The statute also
the impact of ICDs on Commercial Ground Floor, Room W12–140, allows the Agency to renew exemptions
Motor Vehicle driving, and the public Washington, DC 20590–0001. at the end of the 2-year period. The 30
comments received. The Agency has • Hand Delivery: West Building individuals listed in this notice have
determined that the available medical Ground Floor, Room W12–140, 1200 recently requested such an exemption
literature and data does not support a New Jersey Avenue SE., Washington, from the hearing requirement in 49 CFR
conclusion that granting these DC, between 9 a.m. and 5 p.m., Monday 391.41(b)(11), which applies to drivers
exemptions would achieve a level of through Friday, except Federal of CMVs in interstate commerce.
safety equivalent to or greater than the Holidays. Accordingly, the Agency will evaluate
level of safety maintained without the • Fax: 1–202–493–2251. the qualifications of each applicant to
exemptions. Each applicant has, prior to Instructions: Each submission must determine whether granting the
this notice, received a letter of final include the Agency name and the exemption will achieve the required
disposition on his/her exemption docket numbers for this notice. Note level of safety mandated by statute.
request. Those decision letters fully that all comments received will be The physical qualification standard
outlined the basis for the denial and posted without change to http:// for drivers regarding hearing found in
constitute final Agency action. The list www.regulations.gov, including any 49 CFR 391.41(b)(11) states that a
published today summarizes the personal information provided. Please person is physically qualified to drive a
Agency’s recent denials as required see the Privacy Act heading below for CMV if that person
under 49 U.S.C. 31315(b)(4). further information.
First perceives a forced whispered voice in
The following 7 applicants are denied Docket: For access to the docket to the better ear at not less than 5 feet with or
exemptions from the cardiovascular read background documents or without the use of a hearing aid or, if tested
standard. Ellis James Benson, Jon Carey, comments, go to http:// by use of an audiometric device, does not
Martin Carter, Carl Jeglum, William www.regulations.gov at any time or have an average hearing loss in the better ear
Kastner, Mark Todd Smith, Andre Room W12–140 on the ground level of greater than 40 decibels at 500 Hz, 1,000 Hz,
Williams. the West Building, 1200 New Jersey and 2,000 Hz with or without a hearing aid
Avenue SE., Washington, DC, between 9 when the audiometric device is calibrated to
Issued on: April 28, 2016. American National Standard (formerly ASA
a.m. and 5 p.m., Monday through
Larry W. Minor, Friday, except Federal holidays. The Standard) Z24.5—1951.
Associate Administrator for Policy. Federal Docket Management System This standard was adopted in 1970
[FR Doc. 2016–10875 Filed 5–6–16; 8:45 am] (FDMS) is available 24 hours each day, and was revised in 1971 to allow drivers
BILLING CODE 4910–EX–P 365 days each year. If you want to be qualified under this standard
acknowledgment that we received your while wearing a hearing aid, 35 FR
comments, please include a self- 6458, 6463 (April 22, 1970) and 36 FR
DEPARTMENT OF TRANSPORTATION addressed, stamped envelope or 12857 (July 3, 1971).
postcard or print the acknowledgement
Federal Motor Carrier Safety page that appears after submitting II. Qualifications of Applicants
Administration comments on-line. James E. Adams
[Docket No. FMCSA–2015–0329] Privacy Act: In accordance with 5
U.S.C. 553(c), DOT solicits comments Mr. Adams, age 44, holds an
Qualification of Drivers; Application for from the public to better inform its operator’s license in Georgia.
Exemptions; Hearing rulemaking process. DOT posts these Ronald Bagby
AGENCY: Federal Motor Carrier Safety comments, without edit, including any
Administration (FMCSA), Department personal information the commenter Mr. Bagby, age 66, holds an operator’s
of Transportation. provides, to www.regulations.gov, as license in Missouri.
described in the system of records Robert Barnett
ACTION: Notice of applications for
notice (DOT/ALL–14 FDMS), which can
exemptions; request for comments.
be reviewed at www.dot.gov/privacy. Mr. Barnett, age 66, holds an
SUMMARY: FMCSA announces receipt of FOR FURTHER INFORMATION CONTACT: operator’s license in Michigan.
applications from 30 individuals for an Christine A. Hydock, Chief, Medical Jason A. Beutal
exemption from the hearing requirement Programs Division, (202) 366–4001,
to operate commercial motor vehicles fmcsamedical@dot.gov, FMCSA, Mr. Beutal, age 39, holds an operator’s
(CMVs) in interstate commerce. If Department of Transportation, 1200 license in Wisconsin.
granted, the exemptions would enable New Jersey Avenue SE., Room W64– Benjamin Bottoms
these individuals to operate CMVs in 113, Washington, DC 20590–0001.
interstate commerce. Office hours are 8:30 a.m. to 5 p.m., e.t., Mr. Bottoms, age 37, holds an
DATES: Comments must be received on Monday through Friday, except Federal operator’s license in Virginia.
or before June 8, 2016. holidays.
mstockstill on DSK3G9T082PROD with NOTICES

Edward Broeker
ADDRESSES: You may submit comments SUPPLEMENTARY INFORMATION:
bearing the Federal Docket Management Mr. Broeker, age 54, holds an
I. Background operator’s license in California.
System (FDMS) Docket No. FMCSA–
2015–0329 using any of the following Under 49 U.S.C. 31136(e) and 31315, John Brown
methods: FMCSA may grant an exemption from
• Federal eRulemaking Portal: Go to the Federal Motor Carrier Safety Mr. Brown, age 59, holds a class A
http://www.regulations.gov. Follow the Regulations (FMCSRs) for a 2-year CDL in Minnesota.

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Document Created: 2018-02-07 14:50:20
Document Modified: 2018-02-07 14:50:20

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice of denials of exemption applications.
Dates		Denial letters were sent to each of the individuals listed in this notice on March 1, 2016.
Contact		Ms. Christine A. Hydock, Chief Medical Programs Division, 202-366-4001, U.S. Department of Transportation, FMCSA, 1200 New Jersey Avenue SE., Room W64-224, Washington, DC 20590- 0001. Office hours are from 8:30 a.m. to 5 p.m. Monday through Friday, except Federal holidays.
FR Citation		81 FR 28119

81 FR 28119 - Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators

DEPARTMENT OF TRANSPORTATIONFederal Motor Carrier Safety Administration

Federal Register Volume 81, Issue 89 (May 9, 2016)

DEPARTMENT OF TRANSPORTATION
Federal Motor Carrier Safety Administration