Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators

Larry W. Minor
Federal Motor Carrier Safety Administration
27 February 2019

[Federal Register Volume 84, Number 39 (Wednesday, February 27, 2019)]
[Notices]
[Pages 6463-6464]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-03384]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2018-0403]


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 seven 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 March 29, 2019.

ADDRESSES: You may submit comments identified by the Federal Docket 
Management System (FDMS) Docket ID FMCSA-2018-0403 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., 
ET, Monday through Friday, except Federal Holidays.
     Fax: 1-202-493-2251.
    To avoid duplication, please use only one of these four methods. 
See the ``Public Participation'' portion of the SUPPLEMENTARY 
INFORMATION section for instructions on submitting comments.

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., 
ET, 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. Public Participation

A. Submitting Comments

    If you submit a comment, please include the docket number for this 
notice (Docket No. FMCSA-2018-0403), indicate the specific section of 
this document to which each comment applies, and provide a reason for 
each suggestion or recommendation. 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, 
put the docket number, FMCSA-2018-0403, in the keyword box, and click 
``Search.'' When the new screen appears, click on the ``Comment Now!'' 
button and type your comment into the text box on the following screen. 
Choose whether you are submitting your comment as an individual or on 
behalf of a third party and then submit.
    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.
    FMCSA will consider all comments and material received during the 
comment period.

B. Viewing Documents and Comments

    To view comments, as well as any documents mentioned in this notice 
as being available in the docket, go to http://www.regulations.gov. 
Insert the docket number, FMCSA-2018-0319, in the keyword box, and 
click ``Search.''

[[Page 6464]]

Next, click the ``Open Docket Folder'' button and choose the document 
to review. If you do not have access to the internet, you may view the 
docket online by visiting the Docket Management Facility in Room W12-
140 on the ground floor of the DOT West Building, 1200 New Jersey 
Avenue SE, Washington, DC 20590, between 9 a.m. and 5 p.m., ET, Monday 
through Friday, except Federal holidays.

C. 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 www.regulations.gov, as described in the system 
of records notice (DOT/ALL-14 FDMS), which can be reviewed at 
www.dot.gov/privacy.

II. 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 seven 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 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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III. Qualifications of Applicants

Mark Caviola

    Mr. Caviola is commercial motor vehicle driver who resides in New 
York and operates in Connecticut. A June 2018, Physician's Statement 
from his cardiologist to the New York State Department of Motor 
Vehicles states that his ICD was implanted in 2005 and during his ICD 
treatment has had no therapies, history of syncope, or loss of 
consciousness, with symptoms only limited to palpitations.

John J. Groff

    Mr. Groff is a Class A CDL holder in Pennsylvania. A November 2018, 
report from his cardiologist states that his CRT-D device was implanted 
in August of 2018, and following placement he showed likely improvement 
of his ejection fraction to the 40-45 percent range. His cardiologist 
reports that he has never had required device therapies.

Kevin L. Krueger

    Mr. Krueger is a commercial motor vehicle driver in Nebraska. 
August and December 2018 medical documentation from his cardiologist 
reports that a dual chamber ICD was implanted in 2009 and changed to a 
biventricular ICD in January of 2018. His report indicated ongoing 
monitoring of his device and that he is tolerating medical therapy.

Michael R. Miller

    Mr. Miller is a Class A CDL holder in California. A January 2019 
letter from his cardiologist reports that his ICD was implanted in 
September of 2018, and that he has not received any type of 
defibrillation since implantation, has not had cardiovascular 
complaints and is compliant with his current medical regime.

Anthony Saitta

    Mr. Saitta is a commercial motor vehicle driver in New York. An 
undated letter from his cardiologist reports that his ICD was implanted 
in 2007 and that since implantation the device deployed once in 2016 
inappropriately for atrial tachycardia with rapid ventricular rate. The 
letter states that Mr. Saitta reported no symptoms other than feeling 
the shock from the device, and that he did not lose consciousness. 
Prior to and since that event, the device has not deployed and he has 
maintained a stable cardiac status.

William Allan Spivey

    Mr. Spivey is a Class A CDL holder in North Carolina. A January 
2019, letter from his cardiologist reports that his ICD was implanted 
in March of 2018. His cardiologist reports that he has never received 
shocks from his device, at times has symptoms of shortness of breath 
and occasional fatigue after extended walking, and his current cardiac 
condition is stable.

Aaron J. Thomas

    Mr. Thomas is a commercial motor vehicle driver in Georgia. A 
December 2018, letter from his cardiologist reports that Mr. Thomas was 
implanted with an ICD in November of 2018, and is recovering well. He 
requires follow-up every six months for proper monitoring of his ICD 
and denies shortness of breath or chest pain.

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.

    Issued on: February 14, 2019.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2019-03384 Filed 2-26-19; 8:45 am]
 BILLING CODE 4910-EX-P