First Ever Court Ordered Sleep Study
Greyhound bus lines recently reached an out of court settlement with 5 passengers injured in a 2013 accident in Monroe Ohio.
The case will be interesting to sleep medicine in that this case may be the first court ordered post accident sleep study. Often the National Transportation Safety Board will obtain post accident sleep studies. But these are obtained under investigative authority of the NTSB.
In this case the driver had gotten a normal DOT medical exam about a month before the crash. At the DOT exam the examiner felt the driver was high risk for sleep apnea and issued a normal 90 day conditional certification pending completion of a sleep study. While waiting to schedule the study, the driver was involved in the crash where his falling asleep at the wheel was an allegation of the plaintiff. The driver and Greyhound claimed he choked on some coffee.
Originally the defense attorneys attempted to block having the driver submit for a sleep study. The trial court and a later appeals court upheld the order for the driver to undergo a sleep study. The driver was positive for moderate to severe sleep apnea. The exact AHI is not released.
At this time other facts about the case are in dispute and may be clarified later.
The concern of many in trucking and other CMV operations is that insurance carriers may not be willing to risk the exposure created by this case in allowing drivers screened high risk but waiting to schedule sleep studies to continue to work.
This may result in a much higher rate of “stat” sleep study requests.
Whether or not a driver screened high risk for sleep apnea should be allowed to drive while waiting for sleep studies is a question posed in the DOT ANPRM discussed elsewhere here on Sleep Scholar.
This case will complicate discussions about testing and treatment of CMV operators. Before HST became the norm for CMV operators often PSG contracts required MD interpretation before 9:00 AM the morning after the study. The intent of these contract requirements was to have the driver pick up a CPAP as per the interpreting MD orders before leaving the sleep lab in the morning.
Sleep medicine professionals should consider comments on the ANPRM about the logistical and managerial issues around executing large numbers of “stat” sleep study interpretations.