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Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators


American Government

Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators

Larry W. Minor
Federal Motor Carrier Safety Administration
29 December 2017


[Federal Register Volume 82, Number 249 (Friday, December 29, 2017)]
[Notices]
[Pages 61812-61813]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-28127]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2017-0326]


Qualification of Drivers; Exemption Applications; Implantable 
Cardioverter Defibrillators

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of applications for exemption; request for comments.

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SUMMARY: FMCSA announces receipt of applications from six individuals 
for an exemption from the prohibition in the Federal Motor Carrier 
Safety Regulations (FMCSRs) against operation of a commercial motor 
vehicle (CMV) by persons with a current clinical diagnosis of 
myocardial infarction, angina pectoris, coronary insufficiency, 
thrombosis, or any other cardiovascular disease of a variety known to 
be accompanied by syncope, dyspnea, collapse, or congestive heart 
failure. If granted, the exemptions would enable these individuals with 
implantable cardioverter defibrillators (ICDs) to operate CMVs in 
interstate commerce.

DATES: Comments must be received on or before January 29, 2018.

ADDRESSES: You may submit comments bearing the Federal Docket 
Management System (FDMS) Docket ID FMCSA-2017-0326 using any of the 
following methods:
     Federal eRulemaking Portal: Go to http://www.regulations.gov. Follow the online instructions for submitting 
comments.
     Mail: Docket Management Facility; U.S. Department of 
Transportation, 1200 New Jersey Avenue SE, West Building Ground Floor, 
Room W12-140, Washington, DC 20590-0001.
     Hand Delivery: West Building Ground Floor, Room W12-140, 
1200 New Jersey Avenue SE, Washington, DC, between 9 a.m. and 5 p.m., 
e.t., Monday through Friday, except Federal Holidays.
     Fax: 1-202-493-2251.
    Instructions: Each submission must include the Agency name and the 
docket number for this notice. Note that all comments received will be 
posted without change to http://www.regulations.gov, including any 
personal information provided. Please see the Privacy Act heading below 
for further information.
    Docket: For access to the docket to read background documents or 
comments, go to http://www.regulations.gov, at any time or Room W12-140 
on the ground level of the West Building, 1200 New Jersey Avenue SE, 
Washington, DC, between 9 a.m. and 5 p.m., e.t., Monday through Friday, 
except Federal holidays. The FDMS is available 24 hours each day, 365 
days each year. If you want acknowledgment that we received your 
comments, please include a self-addressed, stamped envelope or postcard 
or print the acknowledgement page that appears after submitting 
comments online.
    Privacy Act: In accordance with 5 U.S.C. 553(c), DOT solicits 
comments from the public to better inform its rulemaking process. DOT 
posts these comments, without edit, including any personal information 
the commenter provides, to http://www.regulations.gov, as described in 
the system records notice (DOT/ALL-14 FDMS), which can be reviewed at 
http://www.dot.gov/privacy.

FOR FURTHER INFORMATION CONTACT: Ms. Christine A. Hydock, Chief, 
Medical Programs Division (202) 366-4001, fmcsamedical@dot.gov, FMCSA, 
Department of Transportation, 1200 New Jersey Avenue SE, Room W64-
224,Washington, DC 20590-0001. Office hours are from 8:30 a.m. to 5 
p.m., e.t., Monday through Friday, except Federal holidays. If you have 
questions regarding viewing or submitting material to the docket, 
contact Docket Services, telephone (202) 366-9826.

SUPPLEMENTARY INFORMATION:

I. Background

    Under 49 U.S.C. 31136(e) and 31315, FMCSA may grant an exemption 
from the FMCSRs for a five-year period if it finds ``such exemption 
would likely achieve a level of safety that is equivalent to or greater 
than the level that would be achieved absent such exemption.'' The 
statute also allows the Agency to renew exemptions at the end of the 
five-year period. FMCSA grants exemptions from the FMCSRs for a two-
year period to align with the maximum duration of a driver's medical 
certification.
    The six individuals listed in this notice have requested an 
exemption from 49 CFR 391.41(b)(4). Accordingly, the Agency will 
evaluate the qualifications of each applicant to determine whether 
granting the exemption will achieve the required level of safety 
mandated by statute.
    The physical qualification standard found in 49 CFR 391.41(b)(4) 
states that a person is physically qualified to drive a CMV if that 
person has no current clinical diagnosis of myocardial infarction, 
angina pectoris, coronary insufficiency, thrombosis, or any other 
cardiovascular disease of a variety known to be accompanied by syncope, 
dyspnea, collapse, or congestive cardiac failure.
    In addition to the regulations, FMCSA has published advisory 
criteria \1\ to assist Medical Examiners in determining whether drivers 
with certain medical conditions are qualified to operate a CMV in 
interstate

[[Page 61813]]

commerce. [49 CFR part 391, APPENDIX A TO PART 391--MEDICAL ADVISORY 
CRITERIA, section D. Cardiovascular: Sec.  391.41(b)(4), paragraph 4.] 
The advisory criteria states that ICDs are disqualifying due to risk of 
syncope.
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    \1\ See http://www.ecfr.gov/cgi-bin/text-idx?SID=e47b48a9ea42dd67d999246e23d97970&mc=true&node=pt49.5.391&rgn=div5#ap49.5.391_171.a and https://www.gpo.gov/fdsys/pkg/CFR-2015-title49-vol5/pdf/CFR-2015-title49-vol5-part391-appA.pdf.
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II. Qualifications of Applicants

Frank D'Ercole

    Mr. D'Ercole is a 77 year old CDL holder in New Jersey. An October 
30, 2017 letter from his cardiologist states that his ICD was implanted 
in June 2017 and that since that time he has had no event on his AICD 
implant. His exercise test in May 2017 showed good exercise capacity.

Myles Goodwin

    Mr. Goodwin is a 54 year old driver in New Hampshire. A May 2017 
letter from his cardiologist states that his ICD was implanted in 
February 2015 and at the time of the letter had not deployed. As of 
February 2017, his cardiac issues were well controlled.

Cody Hairr

    Mr. Hairr is a 23 year old driver in North Carolina. Medical 
documentation from his cardiologist dated September 2017 and a 
cardiologist letter without a date indicates that his ICD was implanted 
in 2013 and has not discharged since it was implanted. The letter 
states that he has no dizziness, lightheadedness, palpitations, chest 
pain, undue shortness of breath, exercise intolerance or syncope since 
ICD placement. His cardiologist states that from a cardiac standpoint, 
we have not limited [him] from any activities or concerns related to 
syncope.

Dennis R. Pickett

    Mr. Pickett is a 78 year old Class A CDL holder in Indiana. An 
April 2017 letter from his cardiologist indicates that his permanent 
pacemaker was upgraded to a biventricular automatic implantable 
cardioverter defibrillator in February 2017 and has not deployed since 
that time. His cardiologist states that Mr. Pickett has not reported 
any syncopal episodes and that he plans to follow up visits for him 
every three months.

Terry Stephens

    Mr. Stephens is a 54 year old Class A CDL holder in Virginia. An 
August 2017 letter from his cardiologist states that his biventricular 
ICD was implanted in April 2015. The cardiologist's letter also states 
that Mr. Stephens does not have symptoms related to his underlying 
condition, has not had any episodes of loss of consciousness, has an 
ejection fraction of 45 per cent on echocardiogram, and is NYHA class I 
symptomatically.

Jeffrey A. Weiner

    Mr. Weiner is a 56 year old driver in Minnesota. A May 2017 letter 
from his cardiologist states that his ICD was implanted in July 2014, 
has not deployed since it was implanted, and is now asymptomatic. The 
letter states that his current underlying heart condition is well 
compensated.

III. Request for Comments

    In accordance with 49 U.S.C. 31136(e) and 31315, FMCSA requests 
public comment from all interested persons on the exemption petitions 
described in this notice. We will consider all comments received before 
the close of business on the closing date indicated in the dates 
section of the notice.

IV. Submitting Comments

    You may submit your comments and material online or by fax, mail, 
or hand delivery, but please use only one of these means. FMCSA 
recommends that you include your name and a mailing address, an email 
address, or a phone number in the body of your document so that FMCSA 
can contact you if there are questions regarding your submission.
    To submit your comment online, go to http://www.regulations.gov and 
in the search box insert the docket number FMCSA-2017-0326 and click 
the search button. When the new screen appears, click on the blue 
``Comment Now!'' button on the right hand side of the page. On the new 
page, enter information required including the specific section of this 
document to which each comment applies, and provide a reason for each 
suggestion or recommendation. If you submit your comments by mail or 
hand delivery, submit them in an unbound format, no larger than 8\1/2\ 
by 11 inches, suitable for copying and electronic filing. If you submit 
comments by mail and would like to know that they reached the facility, 
please enclose a stamped, self-addressed postcard or envelope.
    We will consider all comments and materials received during the 
comment period. FMCSA may issue a final determination any time after 
the close of the comment period.

V. Viewing Comments and Documents

    To view comments, as well as any documents mentioned in this 
preamble, go to http://www.regulations.gov and in the search box insert 
the docket number FMCSA-2017-0326 and click ``Search.'' Next, click 
``Open Docket Folder'' and you will find all documents and comments 
related to this notice.

    Issued on: December 22, 2017.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2017-28127 Filed 12-28-17; 8:45 am]
 BILLING CODE 4910-EX-P




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