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The Cost of Irresponsibility
Apneic Trucker Who Killed Tennessee
Trooper Owes Family $5 Million
Just where is that dividing line between providing
for your family and being irresponsible? For Clifford Engum, that line
has been made clear by his actions, or rather, his lack of action.
Engum, you see, used to drive big rigs down the highways
of the United States. He did that until he was sent to prison for killing
a Tennessee state trooper. Let's back up just a minute here and look
at the many events that led to Engun being used as a classic example
of irresponsibility behind the wheel of a vehicle — and his work
vehicle being an 18-wheeler.
In terms of coming into the public spotlight, Engum's
story begins in July 1997 when he was involved in an accident and injured
two state trooper in Utah. In that accident, the patrol car was parked
in the roadway to prevent other vehicles from running into a pile of
gravel which had been spilled in the roadway. Engum plowed into the
patrol car, with his tractor-semitrailer, seriously injuring two troopers.
Seven months before this accident, in December 1996,
however, Engum had been hospitalized for an infection in his legs. While
hospitalized, Engum was warned by his physician at the VA hospital that
he likely had sleep apnea and should undergo a sleep study to determine
if he did, in fact, have apnea, and determine its severity.
Being the upstanding pillar of the community that
history now shows Engum to have been, he told the doctors he would take
part in the strongly suggested sleep study “promptly.” He
explained he didn't have time to have a sleep study performed in December
1996, according to medical records released by the National Transportation
Safety Board (NTSB). According to the medical records, he told the doctors
at the VA hospital he had to return to work.
For Engum, promptly getting a sleep study meant going
for the study in August 1997 — one month after careening his truck
into the patrol car in Utah, injuring the two state troopers. Bear in mind,
this accident occurred more than seven months after being told by doctors at the
VA hospital that he likely suffered from obstructive sleep apnea.
After his sleep study, Engum was told that he did,
in fact, have sleep apnea, and required a CPAP machine to treat the
condition. After receiving his CPAP in September 1997, Engum decided
he could not tolerate the machine, and instead, opted for a surgical
fix. Now, since there is no surgery available that effectively cures sleep
apnea, he likely had a procedure which either eliminated his snoring,
which may have helped reduce the number of
apneas he suffered per hour while sleeping, but even that isn't clear. It seems there were some post-operative complications, including swelling of the neck, which resulted in
difficulty swallowing and anxiety for Engum. Despite the problems, Engum failed to keep a
post-operative appointment, and then failed to have a follow-up sleep study to see if
the surgery had lessened the severity of his apnea or even the total number of apneas he suffered per hour.
Then, more than 42 months later, Engum killed a Tennessee
state trooper when he fell asleep at the wheel of the tractor-semitrailer he was
driving for Eck Miller Transportation Co.
According to medical information released by the NTSB,
Engum should have been disqualified from having a commercial driver's license (CDL)
for several reasons -- one being that he suffered from untreated sleep apnea.
Had Engum been disqualified from having a CDL, and possibly even a regular
driver's license, the Tennessee trooper would be alive today.
The role of apnea in this case: extreme.
The role of non-compliance in this case: extreme.
The role of CPAP or BiPAP in this case: none (Engum was non-compliant)
Online Files Regarding This Accident
National
Transportation Safety Board's Highway Accident Report
National
Transportation Safety Board's Press Release
National
Transportation Safety Board's Abstract of the Highway Accident Report
For more information on adjusting
to CPAP or BiPAP, the use of CPAP or BiPAP, or issues related to sleep apnea or other
sleep disorders, .
=====
$5 million judgment goes to dead trooper's family
By The Associated Press (September 23, 2002)
JACKSON, Tenn. (AP) - A jury awarded more than $5
million to the three children of a state trooper killed when a truck
crashed into his patrol car along an Interstate 40 construction zone.
The ex-wife of Trooper Lynn Ross, Diane, filed the wrongful death suit
against Idaho truck driver Clifford Engum, the now defunct Eck Miller
Transportation Corp., and Dement Construction Co. The compensatory damages were
awarded on Friday.
On the morning of July 26, 2000, Ross was one of two troopers whose patrol
cars were blocking the right lane of eastbound I-40, protecting a construction
crew installing rumble strips on the shoulder. Engum's 18-wheeler, going 65
miles per hour, struck Ross' patrol car, which caught fire and went into the
median.
The family contends Eck Miller Transportation knew Engum had a substandard
driving record and suffered from sleep apnea, which is a condition marked by
interrupted sleep, slower reflexes and lapses into sleep during the day. Dement
was included in the suit for not adequately marking the work zone.
Engum and Eck Miller Transportation are responsible for 65 percent of the
amount, which was at nearly $8 million before attorneys agreed upon the lower
sum. Dement Construction must pay 35 percent.
Engum pleaded guilty in February to vehicular homicide and aggravated assault
and was sentenced to a year in jail.
(source:
http://www.knoxnews.com/kns/state/article/0,1406,KNS_348_1433919,00.html
or http://tinyurl.com/1lc2
=====
FOR
IMMEDIATE RELEASE: May 14, 2002 SB-02-13
INCAPACITATED TRUCK DRIVER, POOR PLANNING
BY STATE
AUTHORITIES LED TO FATAL WORK ZONE CRASH
IN TENNESSEE
- -----------------------------------------------------------
WASHINGTON, D.C. - The National Transportation Safety Board today adopted a
final report on its investigation into a fatal highway crash in a work zone in
Jackson, Tennessee, citing the truck driver’s incapacitation and a flawed
medical certification process as the probable cause. Poor coordination and
planning for the work zone project by the Tennessee Department of
Transportation, the Tennessee Highway Patrol and the construction contractor
were found to be contributing factors in the crash.
On July 26, 2000, an eastbound tractor semitrailer traveling at a
driver-estimated speed of 65 miles an hour entered a 55 m.p.h. work zone and
collided with a Tennessee Highway Patrol (THP) vehicle protecting the work zone.
Witnesses reported that the patrol car exploded and caught fire at impact. The
patrol car was pushed approximately 192 feet before it came to rest on the
median. The truck continued through the median and into the westbound lanes,
where it collided with another vehicle. The State Trooper in the patrol car was
killed in the crash. Witnesses saw the truck drifting out of its lane before the
accident.
The medical oversight issues presented by this crash were similar to those
dealt with by the Safety Board in its investigation of a fatal tour bus crash in
New Orleans the previous year. The truck driver in the Tennessee crash had
previously been diagnosed with sleep apnea and hypothyroidism, and had a similar
crash in 1997, when he struck the rear of a patrol car in Utah.
Although neither condition is specifically disqualifying for a commercial
driver’s license, the Safety Board believes that had a comprehensive medical
oversight program been in place at the time of the accident, this driver, with
known and potentially incapacitating medical conditions, would have been less
likely to have been operating a commercial vehicle. This accident, the Board
said, “demonstrates how easily unfit drivers are able to take advantage of the
inadequacies of the current medical system, resulting in potentially fatal
consequences.” The Board urged the Federal Motor Carrier Safety Administration
and the American Association of Motor Vehicle Administrators to act quickly to
develop a comprehensive medical oversight plan for commercial drivers.
Motorists had complained about the design of the work zone before the
accident. The signage was poor and drivers were unsure which lane was closed.
The Safety Board said that the traffic control and safety aspects of the work
zone operation would have been improved had the construction contract
incorporated traffic control plans for all aspects of the work zone operation
and had it assigned specific responsibilities to each party. In fact, the Board
noted, the traffic control configuration for this work zone did not meet federal
guidelines for a lane closure on a divided highway. In addition, the Board
stated that had the Tennessee Highway Patrol officers received work zone traffic
control training, they may have asked for clarification on the traffic control
strategy to be used that day, and would have realized the hazards of positioning
their vehicles in the lane behind the highway construction vehicles.
Work zone fatalities have increased 52 percent over the latest five-year
period recorded, from 717 in 1996 to 1,093 in 2000.
Commercial vehicles, which account for 7 percent of all vehicle miles driven,
are involved in 20 percent of all fatal work zone accidents.
It is impossible to assess whether the increase in work zone deaths is due
simply to increased traffic patterns or to other reasons because no adequate
exposure data is available. The Safety Board continues to wait for a positive
response to its decade-old recommendation to the Federal Highway Administration
to collect work zone exposure data.
As a result of this investigation, the Board issued four safety
recommendations to the Federal Highway Administration, the National Highway
Traffic Safety Administration, the Tennessee Department of Transportation, and
several associations to develop a model training program for law enforcement
personnel that addresses traffic control strategies for work zones. The Board
also recommended that FHWA review and revise the Manual for Uniform Traffic
Control Devices to provide guidance on coordination with law enforcement
personnel used in highway work zone traffic control.
A synopsis of the Safety Board’s report can be found on its web site under
Publications. The full report will be available on the web site in several
weeks.
NTSB Press Contact: Ted Lopatkiewicz, Director, Public Affairs (202)
314-6100
- 30 -
=====
FINDINGS OF THE NATIONAL TRANSPORTATION SAFETY BOARD IN THE ACCIDENT
(copied
verbatim from the report)
Title: Highway Accident Report: Collision in a Work Zone on Interstate
Highway 40 (I-40), Jackson, Tennessee, July 26, 2000 NTSB Report Number:
HAR-02-01, adopted on 5/14/2002 NTIS Report Number: PB2002-916201"
Driver Medical Information
The investigation revealed that the 50-year-old tractor-semitrailer
driver
was involved in a similar accident in July 1997, when he struck a stopped
highway patrol car in Utah, seriously injuring two troopers. The patrol car had
been parked on the roadway to prevent other vehicles from running into a load of
spilled gravel.9 After the Jackson, Tennessee, accident, the driver stated to
the THP that he might have fallen asleep immediately before the accident.
The tractor-semitrailer driver's medical records from a Denver Veteran's
Administration hospital indicated that in December 1996, during in-patient
treatment for a severe infection of his legs, he was evaluated as possibly
having obstructive sleep apnea. His physician recommended that he take part in a
formal sleep study; the driver stated that he needed to return to work and would
follow up promptly when he returned to Boise, Idaho. He did not formally undergo
a sleep study until August 1997, the month following his involvement in the
motor vehicle accident that seriously injured two troopers. He was diagnosed
with obstructive sleep apnea and given a device10 to treat his condition. He
was not able to tolerate the device and, in September 1997, underwent surgery to
try to correct the disorder. His hospital records indicated that he suffered
complications11 from the surgery. He failed to keep a postsurgery
(sic) appointment
in the pulmonary clinic and never scheduled a followup (sic) sleep study. The driver
did not indicate that he had been diagnosed or treated for obstructive sleep
apnea on any of his commercial driver medical examination forms.
In September 1998, the driver was diagnosed with
hypothyroidism12 and placed on replacement thyroid hormone. He noted this condition on his
October 1998 commercial driver medical examination form and was found by the
physician performing the examination to have markedly diminished deep tendon
reflexes.13 The physician noted that the driver had just begun replacement
therapy but did not limit or deny the medical certificate.
On his August 1999 commercial driver medical examination form, the driver
made no mention of hypothyroidism or his history of sleep apnea. Although he had
been prescribed medication for his hypothyroidism, he indicated that he was not
on any medication.
Following the accident, a pill bottle was found in the driver's truck cab.
The bottle contained 85 of 90 pills of levothyroxine, a thyroid hormone
replacement. The prescription date was 1998, with an expiration date of December
1999. The labeling noted that the prescription was the first of four available
for refill of the medication. A blood test performed by the THP following this
accident indicated that his thyroid hormone level was markedly low. Symptoms of
untreated hypothyroidism may include fatigue, lethargy, constipation, cold
intolerance, stiffness and cramping of the muscles, carpal tunnel syndrome, and,
over time, a slowing of intellectual and motor activity, a decrease in appetite,
and an increase in weight. Obstructive sleep apnea is also associated with
untreated hypothyroidism.14
Neither obstructive sleep apnea nor hypothyroidism is specifically
disqualifying for commercial drivers, although nonbinding Federal Motor Carrier
Safety Administration (FMCSA) advisory criteria note that "there are many
conditions that interfere with oxygen exchange ... including ... sleep apnea. If
the medical examiner detects a respiratory dysfunction that in any way is likely
to interfere with the driver's ability to safely control and drive a commercial
motor vehicle, the driver must be referred to a specialist for further
evaluation or therapy."15 No FMCSA guidelines address
hypothyroidism.
Citations
9 The driver was charged with a misdemeanor and fined.
10 A continuous positive air pressure mask that holds the airway open and
keeps oxygen flowing freely during sleep.
11 Postoperative swelling of the neck, resulting in difficulty swallowing and
anxiety.
12 A condition of decreased activity of the thyroid gland.
13 Diminished cognitive and motor functions are typical symptoms of
hypothyroidism.
14 Leonard
Wartofsky, "Diseases of the Thyroid," eds. Kurt J. Isselbacher, Eugene
Braunwald, and Jean D. Wilson, et. al., Harrison's
Principles of Internal Medicine, 13th edition (New York: McGraw Hill, Inc., 1994) 1931-1953.
15 For further information, see
http://www.fmcsa.dot.gov/rulesregs/fmcsr/medical.htm
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