Ontario Ombudsman André Marin has urged the province to ensure safer roads by fixing “numerous flaws” in its systems for monitoring drivers with potentially dangerous medical conditions.
In the report released April 30, “Better Safe Than Sorry,” Marin outlines the case of Allan Maki. He caused a triple-fatal car crash in 2009 while experiencing severe uncontrolled hypoglycemia due to diabetes.
The Ombudsman’s probe revealed inconsistencies, errors and bureaucratic failures in the province’s system for reporting and monitoring drivers with potentially dangerous medical conditions.
Process Break-Down Questioned
“In Mr. Maki’s case, the system clearly broke down,” Marin writes in the report.
It took the Ministry almost two years after the crash to suspend his licence, even after his case was flagged by police and a physician. Ontario requires medical professionals to report to the Ministry drivers who have uncontrolled hypoglycemia.
That case raised questions about the Ministry of Transportation’s process of obtaining information about drivers with uncontrolled hypoglycemia and taking action when warranted.
Among the issues flagged in the Ombudsman’s report:
- Maki was given an outdated form to renew his driver’s licence in 2007 that did not refer specifically to needing insulin to control his diabetes, so it was never flagged for medical review
- Although physicians must report patients with medical conditions that might make it unsafe for them to drive, the forms and instructions given to them for reporting these conditions are unclear
- After the 2009 accident, the emergency room doctor made a report noting Maki’s uncontrolled hypoglycemia, but the Ministry had no record of it
- A Hamilton Police officer said he sent a letter to the Ministry in July 2009, asking for Maki’s licence to be suspended, but it was never received
- Some Ministry staff are uncertain about the medical standards currently in use for assessing driver safety
- The Ministry rarely follows up to ensure suspended drivers undergo “diabetes education” as required, and the safe-driving curriculum offered is inconsistent across the province
Reportable Condition in Other Provinces
Roughly one million Ontarians live with diabetes. According to some studies, up to 25% of those being treated with insulin could potentially experience hypoglycemic unawareness – the inability to recognize the warning signs of low blood sugar and potential impairment.
“Although most drivers who have diabetes are perfectly safe, the condition of uncontrolled hypoglycemia was deemed serious enough that Ontario and other provinces made it a reportable condition,” Marin said.
The Ministry has agreed to implement all 19 recommendations in the Ombudsman’s report, including working with the medical community and stakeholders such as the Canadian Diabetes Association, to develop a public guide to driving responsibly with diabetes.
Marin also calls on the government to educate the public about the need for responsible monitoring of medical conditions, similar to what has been done to discourage drinking and driving.
The Ombudsman is an independent officer of the Legislature who investigates complaints from the public about Ontario government services.
André Marin has been the Ombudsman since 2005 and his investigations have sparked numerous government reforms. The office has conducted dozens of investigations into broad systemic problems, and resolved thousands of individual complaints about provincial government services each year.