Driving test
Colorado officials navigate a fine line between privilege and responsibility in regulating drivers with medical conditions that could make them a danger behind the wheel .
L eon Hoschouer loved his cigars. For a 68-year-old Vietnam veteran in failing health, they offered rare pleasure that, on a Thursday afternoon in late May, would not wait.
Driving himself to the smoke shop to buy his favorites — four for 99 cents — was out of the question. Already debilitated by heart issues and only a fraction of one good lung, Hoschouer suffered from a seizure disorder that three years earlier had prompted family members to return his truck to the dealership and have his license revoked.
“He hated us for it,” recalls Jason Noble, Hoschouer’s great-nephew whose family took in the man they call Uncle Mack when his health began to slide.
And so, on this cool spring afternoon, Hoschouer set out on the only set of wheels at his disposal, his electric wheelchair, with oxygen tubes snaking to his nostrils beneath the bill of his veteran’s cap.
Noble’s 11-year-old son, Jericho, rode along on his bicycle as they made their way along East Alameda Avenue. When Hoschouer’s wheelchair got stuck along the way, Jericho freed it.
But when the old man turned cranky, the boy decided to head home.
Uncle Mack, driven by a stubborn streak in the absence of a driver’s license, continued rolling east down the sidewalk. The boy crossed Alameda at South Moline Street and pedaled away.
Moments later, Hoschouer lay lifeless on the ground, his wheelchair in pieces, after a car hopped the curb and plowed into him when a driver lost control while having a seizure. The issue of drivers’ fitness to get behind the wheel with potentially dangerous medical conditions surfaces intermittently. Usually, it happens in the wake of a tragedy that calls into question the means of navigating the fine line between privilege and responsibility.
In Colorado, that responsibility rests largely with the individual.
Applicants for a license are asked a single question: During the last two years, have you had any physical, mental or emotional conditions that would interfere with your ability to operate a motor vehicle safely including heart problems, diabetes, paralysis, epilepsy, seizures, lapses of consciousness or dizziness?
A “yes” response gets them a form that must be signed by their doctor stating they are medically cleared to drive. A seizure-related accident triggers no automatic suspension, but a re-exam is required in the case of fatal accidents. Failing the re-exam results in revocation or denial of a license.
In the recently ended 2015 fiscal year, the state canceled or denied 1,204 licenses — down slightly from the 1,311 in fiscal 2014.
Although requests for license cancellation, denial or re-examination can come from police, physicians, family members, court orders or motor vehicle personnel, Colorado has resisted efforts embraced by a handful of states to impose mandatory reporting requirements for physicians.
Motor vehicle crashes that lead to injury or death as a result of medical impairment remain a squishy statistical area in Colorado — and nationally, as well.
According to a state Department of Transportation database, which relies on responding officers to judge the factors involved, 2,088 incidents involving injuries — including 17 fatalities — were attributed in whole or part to medical conditions or illness over the last 10 years.
Sgt. Dave Hall, legislative liaison for the Colorado State Patrol, notes that those two criteria capture a wide variety of circumstances, from heart attacks to seizure disorders and even the flu.
Drunken and impaired drivers, along with distracted drivers, pose a far greater threat to safety than those with potentially problematic medical conditions, he says.
“We’re looking at the totality of things out there,” he says. “Once every four or five years, you hear of a highprofile seizure case. It’s important to take a step back and take a thoughtful look at the entirety of the situation.”
A study published in 2004 examined national statistics and found that the percentage of fatal driver crashes caused by seizures was only 0.2 percent — compared with 30 percent at- tributed to alcohol. Other studies have shown that the crash risk for people with epilepsy isn’t much higher than it is for people with other chronic medical conditions like heart disease or diabetes.
Dr. Allan Krumholz, professor of neurology at the University of Maryland and co-author of the 2004 study, says that examination of seizure-related accidents suffers from imprecise data — including his own commonly quoted 0.2 percent figure.
Consequently, he adds, policy tends to remain the object of debate.
“Solid evidence-based research is limited, partly because there are not good data systems to analyze this,” Krumholz says. “A lot of this is driven by anecdotes. It’s a policy issue, it’s a medical issue, it’s a social issue.”
Colorado is one of 13 states that does not have a medical advisory board to set policy and, in most instances, hear cases in which an individual’s ability to drive safely is challenged. Virtually all of the 37 states ruled by boards have an appeals process.
Six states require physicians to report at-risk drivers for certain conditions, according to the AAA Foundation for Traffic Safety. Krumholz notes that there is conflicting data on whether mandatory reporting improves public safety.
In any event, change can be a tricky proposition.
Families of victims express frustration that, in some cases, the drivers responsible for fatal accidents face no legal consequences. Individuals with medical conditions that might impair driving but who have had them under control fear unnecessary life-altering restrictions.
Physicians often shy away from laws that would put the burden on them to be medical watchdogs involved in state licensing functions. They also fear that mandatory reporting could make patients less likely to be completely honest about their symptoms.
And while the issue sporadically jars the public consciousness, Krumholz notes that the approaches to dealing with it remain fragmented by a variety of state laws.
“I think, if anything, it’s less resolved,” he says. “There needs to be a review and re-discussion of these issues. You can’t eliminate all the risk, but you want to make those risks acceptable. We don’t even have a standard for what’s an acceptable risk.”
Around the time Leon Hoschouer and Jericho set out down Alameda Avenue in search of the old man’s favorite cigars, DaVonne Cotton left work early from her job as a respiratory therapist at Presbyterian/St. Luke’s Medical Center in Denver.
She didn’t feel well, though the source of her malaise was difficult to describe. Later, the police report would relate that she felt “like her mind was there, but not.”
She started her black, mid-size 2010 Chrysler 300 and began her usual route home — east onto East 17th Avenue to Monaco Parkway or sometimes Quebec Street, then south to Alameda and then east again, toward Aurora.
Around 3:30 p.m., as she navigated the right lane in the routine flow of traffic approaching Moline Street, she felt her arms on the steering wheel suddenly veer right. She felt powerless to change course as her tires hit the curb.
And then, nothing.
Others described a horrifying spectacle. They saw the Chrysler driver’s head slump to the right as the car momentarily drifted, as if slowing to make a turn. But suddenly, the engine roared as the car hit the curb and accelerated onto the sidewalk — directly into a man in an electric wheelchair.
Onlookers saw the car continue forward, slam into a wooden pole and then spin clockwise back into the street, where it clipped another vehicle before coming to a stop.
Callers to 911 were overcome by confusion and distress as they tried to describe the broken condition of the victim. Others tended to the driver of the Chrysler, who appeared to be in the throes of a seizure.
“She’s not hurt from what I can see other than she’s out of it, convulsing. ...She’s not responding. ... Should I talk to her or not talk to her, ma’am? She looks like she’s falling asleep at this point …”
From immediate indications, the fatal accident appeared to be just that — an accident brought on by a medical condition. But many questions remained: Had the driver known she was susceptible to seizures? Had she had any previously? Did her doctors warn her of the possibility?
Could such a tragedy have been foreseen — and avoided?
In the last few years, a handful of cases has shifted attention to the issue in Colorado and underscored the factors in play when balancing concerns about medical conditions and driving safety.
One of the most prominent involved 42-year-old Christopher Booker, who appeared to have a seizure just before his vehicle struck a Denver police officer late last year as he and others attended to a student protest march moving down East Colfax Avenue. The officer needed several surgeries to address serious injuries that included crushed ribs, broken bones, a severed leg artery and a variety of other issues.
In February 2014, 34-year-old Carlos Bustillos, who had his teenage children in his pickup truck, appeared to have a seizure just before speeding into the side of a Longmont warehouse. He died in the crash, along with his dog, but the teens survived.
One month earlier, Theresa Marie O’Connor fatally injured a cyclist in a hit-and-run crash near Windsor that killed 46-year-old Ernesto Wiedenbrug. Her lawyer attributed her actions to a medical condition that made her dizzy. She pleaded guilty to leaving the scene of a crash and careless driving and got a year in jail with work release.
In 2010, Peter Wesley Lain crashed his Chevy pickup through a plate glass window and into an eyeglass store at the Greeley Mall when he suffered “an unforeseeable blackout due to an acute medical condition,” according to the Weld County district attorney’s office. A customer and an employee of the store were killed. Lain faced no charges.
Other incidents narrowly dodged disaster.
In November 2013, a woman believed to be having a seizure plowed her small sedan through a fence and onto the playground at a day care center in Durango. Christa Turnell jumped the curb and mowed down an electrical post before crashing through the fence and coming to a stop on the playground — which was unoccupied at the time. She was not cited.
The potential tragedy of a 2005 incident in Lafayette was overshadowed by the heroics of a 12-year-old boy whose mother blacked out from a seizure.
Her Mitsubishi Eclipse accelerated to over 60 mph in a Walmart parking lot and blew a front tire as it hopped a curb and roared toward an entrance to the store. Ryan Sullivan, despite having a cast and sling on his left arm, grabbed the steering wheel, swerved the vehicle through oncoming traffic and managed to stomp on the brake — leaving 82 feet of skid marks — and safely stop the car.
Lafayette police later presented him with a commendation letter for averting what the police chief calculated would have been multiple fatalities.
But the single most devastating crash — one that would trigger criminal charges and move a state legislator to seek a change in Colorado law — unfolded in 2011, when a speeding SUV went airborne during rush hour in Thornton and landed on a pickup truck, killing a family of five.
A 35-year-old woman reportedly suffered a seizure and accelerated her Ford Expedition into another car and then a median, which launched her at an estimated 68 mph into the truck containing five members of the Stollsteimer family — mom, dad and three kids.
The SUV driver, Monica Chavez, and her two children suffered minor injuries.
“My whole family was killed by a woman who claimed she had a seizure,” says Chris Stollsteimer, who lost his son Randy, daughter-in-law Crystaldawn and three grandchildren. “We went to court for it, and I didn’t like the outcome. They set her free, said it was just a horrible accident.”
Untangling the back story of an accident looms key to determining whether a driver suffering from a medical condition was simply a victim of cruel circumstance or a perpetrator of criminal negligence.
Take the case that critically injured the Denver cop.
At first, the news conjured an image of unavoidable tragedy: A driver suffering from a medical condition lost control of his black Mercedes and slammed into Officer John Adsit, dragging him beneath the vehicle and leaving him with life-threatening injuries.
Weeks later, the tale took a twist: After close examination of medical records, Denver prosecutors filed multiple felony charges against the driver. Authorities alleged that Christopher Booker had a history of seizures but failed to disclose that when he applied for his driver’s license.
“It is our position that he operated a motor vehicle knowing that he suffered from a medical condition that made him unsafe to drive and therefore showing universal malice,” DA Mitch Morrissey said at a news conference announcing the charges.
Booker awaits arraignment on Aug. 13.
In Adams County, prosecutors went after Monica Chavez for the five deaths in Thornton. They sought criminally negligent homicide convictions based on the argument that an emergency room doctor told her in 2006 to see a neurologist to be cleared to drive.
But that order didn’t make it onto her discharge papers. About four years passed before Chavez had another episode, but she didn’t see a doctor on that occasion.
Months later, her car flew through the air and hit the Stollsteimers’ pickup truck. A jury acquitted her of all charges. “I sat and cried for a long time,” says Bob Stollsteimer, recalling the aftermath of the court proceedings. “What we saw through the process of the trial that ended in a not-guilty verdict was weaknesses in the laws. We hoped we could put forward some kind of bill that would protect people from these type of accidents.”
He contacted his state representative in Montrose, Republican Don Coram, and made a pitch that found a sympathetic ear in a legislator who considers the self-reporting aspect of Colorado’s driver’s licensing law woefully inadequate.
“It’s the honor system in Colorado, basically,” Coram says. “If you have a problem with seizures, it’s up to you to notify the Department of Revenue. Frankly, they don’t do that.”
The Thornton accident moved him to sponsor legislation in 2014 that initially mandated that doctors report patients who lose consciousness or motor function to the Department of Revenue, which would cancel the individual’s license pending an appeal.
But even after amendments significantly revised Coram’s bill to move the onus for medical disclosure to license applicants, it died in committee without a single vote in support after testimony from opponents.
Among them was Dr. Tamaan Osbourne-Roberts, president of the Colorado Medical Society, who says that the medical decision-making around lapses in consciousness can be “remarkably complicated and take a while to figure out, and is something that is best articulated through the physician-patient relationship as opposed to a legislative fix.”
Bruce Brown, district attorney for Colorado’s 5th Judicial District that includes four mountain counties, maintains that prosecutors have sufficient tools to address people who fail to seek or follow medical advice and don’t drive responsibly. He adds that depriving more people of licenses puts an unnecessary strain on the current system.
Coram says that until there’s a broader consensus, he’s not going to pursue a mandatory reporting law any further.
“Do I think it needs to be done? Absolutely,” he says. “Several other states have done this, and the sky didn’t fall because of it. I think without a doubt we’re missing the boat. It’s a very serious problem no one wants to take seriously.”
In the wake of the crash that took Leon Hoschouer’s life, Aurora police launched an investigation to determine whether DaVonne Cotton knew beforehand that she could pose a danger behind the wheel.
The probe found that she had never been under driving restraints and did not have a seizure disorder prior to the crash on Alameda Avenue.
She wasn’t charged in the case, and she says that even now the accident “is not something that was very clear.”
She won’t be able to drive for at least three months from the time of the accident, pending a retest.
“I’ve been in the medical field all my life,” says the respiratory therapist. “I’ve saved lives. Then this happens.”
Hoschouer was buried at Fort Logan National Cemetery in Denver. He had run a plumbing business upon returning from his combat tour in Vietnam, but more recently failing health slowed him down.
Heart trouble, a pacemaker, deterioration of his lungs, memory that faded in and out — and then the seizures, which a few years ago led relatives to ensure that he wouldn’t drive anymore. But he could be stubborn.
For all his difficulties, Hoschouer still asked about getting his driver’s license back.
“We just had to tell him, ‘You could kill somebody doing this,’ ” Noble recalls. “The reason why we did it was because of stuff like this. He couldn’t drive because he had seizures, and what happened? Coincidence — she had a seizure, jumped the curb and hit him.”
The tragedy could have been doubled if Noble’s young son hadn’t peeled off from Uncle Mack just before Moline Street. Noble finds that no small blessing, and one that makes it easier to accept that the seizure-induced crash carried no criminal consequence.
“It’s one of those things,” he says. “I mean, she has to live with it the rest of her life. It happens, I’m sorry to say. I’m not going to hold it against her.
“It’s an accident.”