Qualification of Drivers; Exemption Applications; Implantable Cardioverter Defibrillators

Larry W. Minor
Federal Motor Carrier Safety Administration
5 November 2019

[Federal Register Volume 84, Number 214 (Tuesday, November 5, 2019)]
[Notices]
[Pages 59672-59673]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-24101]


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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-2019-0230]


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 (transient loss of consciousness), dyspnea 
(shortness of breath), 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 December 5, 2019.

ADDRESSES: You may submit comments identified by the Federal Docket 
Management System (FDMS) Docket ID FMCSA-2019-0230 using any of the 
following methods:
     Federal eRulemaking Portal: Go to http://www.regulations.gov/docket?D=FMCSA-2019-0230. 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: (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 Operations, (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-2019-0230), 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 http://www.regulations.gov/docket?D=FMCSA-2019-0230. 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/docket?D=FMCSA-2019-0230 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(b), FMCSA may grant an exemption 
from the FMCSRs for no longer than a 5-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 5-year period. FMCSA grants medical exemptions from the 
FMCSRs for a 2-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 Sec.  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

[[Page 59673]]

conditions are qualified to operate a CMV in interstate commerce. The 
advisory criteria states that ICDs are disqualifying due to risk of 
syncope.
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    \1\ These criteria may be found in 49 CFR part 391, APPENDIX A 
TO PART 391--MEDICAL ADVISORY CRITERIA, section D. Cardiovascular: 
Sec.  391.41(b)(4), paragraph 4, which is available on the internet 
at 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

John Gittenmeier

    Mr. Gittenmeier is a commercial motor vehicle driver in Missouri. 
An August 2019, letter from Mr. Gittenmeier's cardiologist reports that 
his ICD was implanted in May of 2018, and that he denies any symptoms 
of palpitations, rapid heartbeat, shortness of breath, chest pains, 
syncope, or edema. His cardiologist reports that his most recent 
ejection fraction in 2018, was 40 percent.

Charles Huff

    Mr. Huff is a commercial motor vehicle driver in Ohio. A July 2019, 
letter from his cardiologist reports that his ICD was implanted in 
2012. Mr. Huff's cardiologist reports that he has episodes of non-
sustained ventricular arrhythmia but has no countershock, that he had 
ATPs, (antitachycardia pacing) and that his ejection fraction is around 
40 percent. Mr. Huff has an ``Intrastate Only'' Ohio Public Utilities 
Medical Examiner's Provisional Certificate that expires December 8, 
2019. Mr. Huff seeks to operate a CMV in interstate commerce into the 
States of Indiana, Pennsylvania, and Michigan, for a distance of no 
more than 50 miles for a two-year period for each of the three States.

Brian Hullopeter

    Mr. Hullopeter is a commercial motor vehicle driver in Minnesota. A 
July 2019, letter from his cardiologists reports that Mr. Hullopeter's 
ICD device was implanted in May of 2017, and has not deployed. His last 
echocardiogram showed normal left ventricular size and function.

Gaetano Letizia

    Mr. Letizia is commercial driver in New Jersey. Letters dated July 
2019, from his cardiologists report that Mr. Gaetano's CRT-ICD was 
implanted in September 2017, and over the past year he has not received 
any shocks or therapies from the defibrillator. His most recent June 
2019, ejection fraction was measured between 35 and 40 percent. His 
cardiologist's letter reports that he is stable from a cardiac 
standpoint.

Corey Tugwell

    Mr. Tugwell is a Class A CDL holder in Oklahoma. A September 2019, 
letter from Mr. Tugwell's cardiologist reports that his initial ICD 
implantation was in July of 2011. His cardiologist reports that Mr. 
Tugwell has not had syncope for many years, and he has never 
demonstrated any life-threatening arrhythmias or received appropriate 
ICD shocks since initial implantation, that he has an ejection fraction 
of 50-55 percent, and his cardiomyopathy has resolved and his current 
risk of life-threatening arrhythmias or ICD shocks appears to be very 
low.

Thomas Daniel Worsley

    Mr. Worsley is a commercial motor vehicle driver in Virginia. A 
July 2019, letter from Mr. Worsley's cardiologist reports that his 
biventricular pacemaker/ICD was implanted in October 2018, his ejection 
fraction is 52 percent, he is asymptomatic and physically very active. 
Mr. Worsley's cardiologist reports that he is at extremely low risk for 
any sudden cardiac death as he now has a normal ejection fraction and 
an implantable defibrillator which he states that by recent studies has 
been shown to work 99 percent of the time.

Request for Comments

    In accordance with 49 U.S.C. 31136(e) and 31315(b), 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 under the DATES 
section of the notice.

    Issued on: October 30, 2019.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2019-24101 Filed 11-4-19; 8:45 am]
BILLING CODE 4910-EX-P