MCSAC-MRB Votes to Approve
Medical Examiners & Employers/Municipalities/Motor Carriers May be Liable
It’s amazing to me to still get emails like this one:
I’ve recently implemented sleep apnea screening on DOT exam patients. Today I was informed by the local municipality that we provide workers comp services to that it will pull its DOT patients if we continue sleep apnea screening if its not a Federal Mandate. As far as I can tell, sleep apnea screening is a best practices guideline not a mandate… correct?Dr A.
This is unfortunate. There are some folks who want to just keep their head in the sand regarding sleep apnea on DOT exams but it is misguided. Just because there is no official rule does not mean you should ignore serious medical conditions. The medical examiner and the motor carrier or municipality could be held liable for wrongful death and other liability by ignoring such responsibility.
Medical Examiner Responsible to Identify and Manage Sleep Apnea
As the medical examiner it is your responsibility to use not only regulations, but current best practices and whatever other guidance is available from FMCSA, Medical expert panel reports, MCSAC-MRB recommendations and the medical literature in general.
When you look at sleep apnea certification for DOT exams this way, there is no way you can not screen and refer for testing those drivers who fall in to risk categories again recommended this week by the MCSAC-MRB meetings held Oct 24, 25, 2016 with these recommendations:
Among the board’s recommendations was a set of guidelines for when a truck driver should be required to have a sleep test. The board suggested mandatory sleep apnea screening for any truck driver with a body mass index of 40 or above, with admitted fatigue or sleeping during wakeful periods, or for any drivers who have been involved in a sleep-related motor vehicle accident.
Based on the review board’s recommendations, sleep apnea screening could also be mandatory for drivers who possess a BMI of at least 33 and have at least three of the following factors:
- Untreated hypertension
- Type 2 diabetes
- Loud snoring
- Witness apneas
- Small airway/Mallampati score
- A neck size of 17 inches or more for males and 15.5 or more for females
- Age 42 or older
- Male or post-menopausal female
- Untreated hypothyroidism
- Stroke, coronary or artery disease
- Micrognathia or retrognathia
If you do not follow these guidelines for sleep apnea on DOT exams, you are placing yourself at risk of liability. You should make your client aware of these responsibilities and stick to your guns, insisting that you are obligated to do so by being a certified medical examiner.
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