[Federal Register Volume 77, Number 67 (Friday, April 6, 2012)]
[Notices]
[Pages 20873-20874]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-8372]


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 DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA--2012-0081]


Qualification of Drivers; Application for Exemptions; Implantable 
Cardioverter Defibrillators

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

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

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SUMMARY: FMCSA announces receipt of applications from four individuals 
for an exemption from the prohibition against persons with an 
implantable cardioverter defibrillator (ICD) in the Federal Motor 
Carrier Safety Regulations (FMCSRs), due to syncope or likelihood of 
causing any loss of ability to operate a commercial motor vehicle (CMV) 
safely. FMCSA requests public comments on these applications for an 
exemption. If granted, the exemption would enable these individuals 
with ICDs to operate CMVs in interstate commerce.

DATES: Comments must be received on or before May 7, 2012.

ADDRESSES: You may submit comments bearing the Federal Docket 
Management System (FDMS) Docket No. FMCSA-2011-(0081) using any of the 
following methods:
     Federal eRulemaking Portal: Go to http://www.regulations.gov. Follow the on-line 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.
    Instructions: Each submission must include the Agency name and the 
docket numbers 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., ET, 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 on-line.
    Privacy Act: Anyone may search the electronic form of all comments 
received into any of our dockets by the name of the individual 
submitting the comment (or of the person signing the comment, if 
submitted on behalf of an association, business, labor union, etc.). 
You may review DOT's Privacy Act Statement for the FDMS published in 
the Federal Register on January 17, 2008 (73 FR 3316), or you may visit 
http://edocket.access.gpo.gov/2008/pdf/E8-785.pdf.

FOR FURTHER INFORMATION CONTACT: Benisse Lester, M.D., Chief Medical 
Officer, (202) 366-4001, [email protected], FMCSA, Department of 
Transportation, 1200 New Jersey Avenue SE., Room W64-( ), Washington, 
DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m., Monday 
through Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION:

Background

    Section 4007 of the Transportation Equity Act for the 21st Century 
(TEA-21) [Pub. L. 105-178, June 9, 1998, 112 Stat. 107, 401] as amended 
49 U.S.C. 31315 and 31136(e) provides authority to grant exemptions 
from many of the Federal Motor Carrier Safety

[[Page 20874]]

Regulations (FMCSRs). On August 20, 2004, FMCSA published a final rule 
implementing section 4007 (69 FR 51589). Under this rule, FMCSA must 
publish a notice of each exemption request in the Federal Register (49 
CFR 381.315(a)). The Agency must provide the public with an opportunity 
to inspect the information relevant to the application, including any 
safety analyses that have been conducted. The Agency must also provide 
an opportunity for public comment on the request.
    The Agency reviews the safety analyses and the public comments and 
determines whether granting the exemption would likely achieve a level 
of safety equivalent to or greater than the level that would be 
achieved by the current regulation (49 CFR 381.305). The decision of 
the Agency must be published in the Federal Register (49 CFR 
381.315(b)). If the Agency denies the request, it must state the reason 
for doing so. If the decision is to grant the exemption, the notice 
must specify the person or class of persons receiving the exemption and 
the regulatory provision or provisions from which an exemption is 
granted. The notice must also specify the effective period of the 
exemption (up to 2 years) and explain the terms and conditions of the 
exemption. The exemption may be renewed (49 CFR 381.315(c) and 
381.300(b)). The four individuals listed in this notice have requested 
an exemption from the ICD prohibition in 49 CFR 391.41(b)(4), which 
applies to drivers who operate CMVs as defined in 49 CFR 390.5, in 
interstate commerce. Section 391.41(b)(4) states that a person is 
physically qualified to drive a commercial motor vehicle 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.
    FMCSA provides medical advisory criteria for use by medical 
examiners in determining whether drivers with certain medical 
conditions, procedures, and/or treatments should be certified to 
operate commercial motor vehicles in interstate commerce. The advisory 
criteria indicate that: The term ``has no current clinical diagnosis 
of'' (1) a current cardiovascular condition, or (2) a cardiovascular 
condition which has not fully stabilized regardless of the time limit. 
The term ``known to be accompanied by'' is designed to include a 
clinical diagnosis of a cardiovascular disease (1) which is accompanied 
by symptoms of syncope, dyspnea, collapse or congestive cardiac 
failure; and/or (2) which is likely to cause syncope, dyspnea, 
collapse, or congestive cardiac failure.
    It is the intent of the FMCSRs to render unqualified a driver who 
has a current cardiovascular disease which is accompanied by and/or 
likely to cause symptoms of syncope, dyspnea, collapse, or congestive 
cardiac failure. However, the subjective decision of whether the nature 
and severity of an individual's condition will likely cause symptoms of 
cardiovascular insufficiency rests with the medical examiner and the 
motor carrier.
    The advisory criteria states that implantable cardioverter 
defibrillators are disqualifying due to risk of syncope. The emphasis 
should be on the underlying medical condition(s) which require 
treatment and the general health of the driver.
    In the case of ICDs the underlying condition for which the device 
was placed may place the driver at risk for syncope or gradual or 
sudden incapacitation that may be likely to result in loss of ability 
to safely control a CMV. ICDs also may deploy inappropriately, which 
would result in loss of ability to safely control a CMV.

Individual Applications for Exemption--Qualifications

Donald Hively

    Mr. Hively is a 52 year old commercial motor vehicle (CMV) driver 
who holds a class A commercial drivers license (CDL) from the state of 
Pennsylvania. Mr. Hively has driven a truck for 36 years. He had an ICD 
placed due to ventricular tachycardia and a low ejection fraction which 
improved. The device has deployed several times, most recently due to 
ventricular tachycardia in October 2011. Mr. Hively would like to 
continue to drive a truck in interstate commerce, if he is granted an 
exemption.

Richard Tadsen

    Mr. Tadsen is a 72 year old CMV driver who holds a class B and 
class D CDL from the state of Iowa. Mr. Tadsen had an ICD placed in 
2009, with a history that includes cardiomyopathy, low ejection 
fraction which has improved, and hypertension. He would like to obtain 
a CDL and drive a CMV in interstate commerce, if granted an exemption.

Richard Freund

    Mr. Freund is a 59 year old CMV driver who holds a class C and 
class D CDL from the state of New Jersey. Mr. Freund had an ICD placed 
due to a congenital heart condition. His driving history has a Driving 
Under the Influence of Alcohol or Drugs (DUI) in 1988. He would like to 
obtain a CDL and drive a CMV in interstate commerce, as a courier 
transporting small packages for distances that are usually less than 
100 miles, if granted an exemption.

Richard Rusk

    Mr. Rusk is a 53 year old CMV driver who holds a class A CDL in 
Illinois. Mr. Rusk had an ICD placed in 2010 as part of a clinical 
trial for sarcoidosis. He has had no episode of syncope. The ICD has 
never deployed. His physician states that Mr. Rusk is at the lower risk 
end of persons with ICDs. Mr. Rusk would like to obtain a CDL and drive 
a CMV in interstate commerce, if granted an exemption.

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. The Agency will consider all comments 
received before the close of business May 7, 2012. Comments will be 
available for examination in the docket at the location listed under 
the ADDRESSES section of this notice. The Agency will file comments 
received after the comment closing date in the public docket, and will 
consider them to the extent practicable. In addition to late comments, 
FMCSA will also continue to file, in the public docket, relevant 
information that becomes available after the comment closing date. 
Interested persons should monitor the public docket for new material.

    Issued on: March 29, 2012.
Larry W. Minor,
Associate Administrator for Policy.
[FR Doc. 2012-8372 Filed 4-5-12; 8:45 am]
BILLING CODE 4910-EX-P