The National Transportation Safety Board, wrapping up its investigation into a fatal 1999 bus crash, is recommending tougher physicals and procedures for prospective employers to find out about drug problems.

On Mother's Day 1999, a motorcoach crashed outside New Orleans, killing 22 passengers. Driver Frank Bedell was discovered to be in extremely poor health, with heart disease and kidney failure, and tested positive for marijuana after the crash. The resulting NTSB investigation highlighted how truck and bus drivers like Bedell, who had a valid DOT medical card, can slip through cracks in the commercial driver oversight system.
During a public meeting Tuesday, the board said that among the major safety issues identified in the accident were the inadequacy of the medical certification process and the absence of a way to identify drivers who have tested positive for drugs.
The board called "the failure of the medical certification process to remove unfit drivers … a systemic, not an isolated, problem." Among the problems:

• Those who perform medical examinations - doctors, chiropractors, nurse practitioners and physician's assistants - may not have the knowledge of commercial driving needed to determine whether a medical condition poses a danger. Although there are information sources available to help, many practitioners don't know about them.

• Regulations on medical certification don't reflect current medical knowledge and can be ambiguous regarding conditions that call for disqualification.

• There is no process for driver medical examination forms to be reviewed; drivers must carry the card, but the form is simply filed away.

• There is no way to track medical certification exams. That lets drivers "doctor shop" - keep trying different doctors until they find one who will pass them.

• There is no way for enforcement authorities to know if a medical card is valid during an inspection.

The board did say that a new medical certification form recently introduced is a substantial improvement over the old one and should help with some of these issues.
The board also noted that results of tests for controlled substances, performed under federal Department of Transportation requirements, are often not available to prospective employers, making it difficult for them to make well-informed hiring decisions. It also believes that drug testing regulations cannot adequately identify owner-operators who abuse drugs.
The NTSB recommended that the Federal Motor Carrier Safety Administration develop a comprehensive medical oversight program for interstate commercial drivers. They said the program should make sure that those who are performing the medical exams are qualified to do so and are educated about occupational issues for drivers. The board would like to see a tracking mechanism for medical certification applications and a way for enforcement officials to know if a medical certificate is valid.
It also recommended that states develop similar programs for intrastate commercial drivers.
The board recommended that FMCSA develop a system that records all positive drug and alcohol test results and refusals. It wants to require prospective employers to query the system before making a hiring decision, and require those doing medical exams to query the system before issuing a medical certificate.

Related story: See "NTSB Hearing: Holes In Medical Certification Program," 1/21/2000.