Culpability and Accountability of Hospitalized Injured Alcohol-Impaired Drivers

Maull, Kimball I.

doi:10.1001/jama.1984.03350140026019

Cited by 57 publications

(5 citation statements)

References 2 publications

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“…One solution would be mandatory reporting by the ED physician/nurse providing care. This issue has been previously suggested and eloquently argued 4,5,7,9,11,13. Currently, substantial variation in mandatory reporting laws exists across the U.S. Perhaps most supportive of the concept of mandatory reporting of intoxicated drivers is a 1990 survey of 1,041 emergency physicians, of whom 78% supported the practice 20.…”

Section: Discussionmentioning

confidence: 80%

Successful Conviction of Intoxicated Drivers at a Level I Trauma Center

Holmes¹,

Adams²,

Rogers³

et al. 2014

WestJEM

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IntroductionConviction rates for drivers driving under the influence (DUI) and in motor vehicle collisions (MVC) presenting to trauma centers are based primarily on data from the 1990s. Our goal was to identify DUI conviction rates of intoxicated drivers in MVCs presenting to a trauma center and to identify factors associated with the failure to obtain a DUI conviction.MethodsRetrospective study of adults (>18 years) presenting to a trauma center emergency department (ED) in 2007. Eligible subjects were drivers involved in a MVC with an ED blood alcohol level (BAL) ≥ 80mg/dL. Subjects were matched to their Department of Motor Vehicle (DMV) records to identify DUI convictions from the collision, the legal blood alcohol concentration (BAC), and arresting officer’s impression of the driver’s sobriety. We entered potential variables predictive of failure to obtain a DUI conviction into a regression model.ResultsThe 241 included subjects had a mean age of 34.1 ± 12.8 years, and 185 (77%) were male. Successful DUI convictions occurred in 142/241 (58.9%, 95% CI 52.4, 65.2%) subjects. In a regression model, Injury Severity Score > 15 (odds ratio = 2.70 (95% CI 1.06, 6.85)) and a lower ED BAL from 80 to 200mg/dL (odds ratio = 5.03 (95% CI 1.69, 14.9) were independently associated with a failure to obtain a DUI conviction.ConclusionSlightly more than half of drivers who present to an ED after a MVC receive a DUI conviction. The most severely injured subjects and those with lower BALs are least likely to be convicted of a DUI.

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Section: Discussionmentioning

confidence: 80%

Successful Conviction of Intoxicated Drivers at a Level I Trauma Center

Holmes¹,

Adams²,

Rogers³

et al. 2014

WestJEM

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“…Those who are intoxicated run great risks to themselves and are extremely dangerous to others. Excess alcohol is associated with more severe injury and more complications during treatment (Raffle, 1989;Colquitt, Fielding & Cronan, 1987;Maull, Kinning & Hickman, 1984).…”

Section: W H O Suffers Road Accidents?mentioning

confidence: 99%

Psychiatric aspects of road traffic accidents

Mayou

1992

International Review of Psychiatry

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The psychiatry of road traffic accidents has been neglected. Psychiatn'c factors especially alcohol and drug abuse are important causes. Psychiatric consequences are common and include post-traumatic stress disorder and phobic travel anxiety. Legal and compensation issues and whiplash neck inju ry are discussed. Clinical implications are outlined.Int Rev Psychiatry Downloaded from informahealthcare.com by Nyu Medical Center on 06/13/15 For personal use only. Int Rev Psychiatry Downloaded from informahealthcare.com by Nyu Medical Center on 06/13/15 For personal use only.

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“…The contribution of alcohol to motor vehicle crash risk has long been recognized (Maull et al 1984 ; Soderstrom et al 1993 ; Quinlan et al 2005 ), but the mechanisms through which various drugs and drug combinations contribute to serious MV crash are less well understood. The prevalence of non-alcohol drug use by drivers has increased in the last few decades with marijuana becoming the leading drug detected in fatal crashes (Brady and Li 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Restraint use and risky driving behaviors across drug types and drug and alcohol combinations for drivers involved in a fatal motor vehicle collision on U.S. roadways

2016

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BackgroundWhile driving impaired is a well-recognized risk factor for motor vehicle (MV) crash, recent trends in recreational drug use and abuse may pose increased threats to occupant safety. This study examines mechanisms through which drug and/or alcohol combinations contribute to fatal MV crash.MethodsThe Fatality Analysis Reporting System (FARS) for 2008–2013 was used to examine drugs, alcohol, driver restraint use, driver violations/errors and other behaviors of drivers of passenger vehicles who were tested for both alcohol and drugs (n = 79,932). Statistical analysis was based on Chi-square tests and multivariable logistic regression. Associations of restraint use and other outcomes with alcohol and drug use were measured by estimated odds ratios (ORs) and 95 % confidence intervals (95 % CIs).ResultsMore than half (54.8 %) of the study population were positive for drugs or alcohol at the time of crash. Approximately half of drivers were belted, but this varied from 67.1 % (unimpaired) to 33.0 % (drugs plus alcohol). Compared to the unimpaired, the odds of a driver being unbelted varied: alcohol and cannabis (OR 3.70, 95 % CI 3.44–3.97), alcohol only (3.50,3.36–3.65), stimulants (2.13,1.91–2.38), depressants (2.09,1.89–2.31), narcotics (1.84,1.67–2.02) and cannabis only (1.55,1.43–1.67). Compared to belted drivers, unbelted drivers were over 4 times more likely to die. Driving violations varied across drug/drug alcohol combinations. Speed-related violations were higher for drivers positive for stimulants, alcohol, cannabis, and cannabis plus alcohol, with a more than two fold increase for alcohol and cannabis (2.36, 2.05, 2.71).ConclusionsMechanisms through which drugs, alcohol and substance combinations produce increased risks to occupant safety include lowered restraint use and increases in risky driving behaviors, including speeding, lane, passing, turning and signal/sign violations.

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Culpability and Accountability of Hospitalized Injured Alcohol-Impaired Drivers

Cited by 57 publications

References 2 publications

Successful Conviction of Intoxicated Drivers at a Level I Trauma Center

Successful Conviction of Intoxicated Drivers at a Level I Trauma Center

Psychiatric aspects of road traffic accidents

Restraint use and risky driving behaviors across drug types and drug and alcohol combinations for drivers involved in a fatal motor vehicle collision on U.S. roadways

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