Reporting Disorders Characterized by Lapses of Conciousness

 
Reporting Disorders Characterized by Lapses of Consciousness

What to Report:

State law requires physicians to report certain patients who are diagnosed as having a disorder characterized by lapses of consciousness. This includes some conditions* that affect alertness, sensory motor functions used to operate a motor vehicle, and the ability to perform activities of daily living. Examples are Alzheimer's disease and related disorders, seizure disorders, brain tumors, narcolepsy, sleep apnea, and abnormal metabolic states including hypo- and hyperglycemia associated with diabetes. In addition, if a physician reasonably and in good faith believes that reporting will serve the public interest, he or she may report a patient’s condition even if not required by law. Note that it is only necessary to report patients age 14 years or older and there are exceptions to the reporting requirements.**

How to Report:

Reports of lapses of consciousness (LOC) must be submitted within 7 calendar days to the local health officer (i.e., the health department) in the jurisdiction where the patient resides.

  • Los Angeles County:  Complete the Physician Report Form and fax it to the Los Angeles County Department of Public Health at 888-397-3778 or 213-482-5508.  For questions, call 888-397-3993.
  • Long Beach Health and Human Services: complete this form and fax to 562-570-4374 or call 562-570-4302.
  • Pasadena Public Health Department: complete this form and fax to 626-744-6115 or call 626-744-6043.
  • Other local health jurisdictions in California: See contact list.

Overview of the Lapses of Consciousness Reporting Process in LA County

PHASE 1: Physician submits report to Local Health Officer who sends information to DMV Flow chart - Phase 1 of Reporting Process

PHASE 2: DMV Evaluates Driver Safety4 Flow chart - Phase 2 of Reporting Process

  1. See below for definitions and exceptions to reporting.
  2. Report Pasadena or Long Beach residents to their local health department.
  3. The form for LA County can be downloaded here.
  4. The Local Health Officer has no role in phase 2 and cannot advise physicians about the process or which DMV forms to use. This might not be the same physician who reported in phase 1.

On receipt of the physician's report, the local health officer submits the patient's identity to the Department of Motor Vehicles (DMV).  If DMV needs more information they will instruct the patient to complete page 1 of the Driver Medical Evaluation Form (DS 326), which includes a medical release, and give the form to the medical professional who is most familiar with their health history and current medical condition. The health professional completes pages 2 and 3 of the form and submits it to the DMV. The local health officer is not involved in this process.

Definitions and Exceptions:

*Pertinent definitions: 17 CCR §§ 2800, 2802, 2804, 2806
Definition of Disorders Characterized by Lapses of Consciousness
(a) “Disorders characterized by lapses of consciousness” means those medical conditions that involve:
      (1) a loss of consciousness or a marked reduction of alertness or responsiveness to external stimuli; and
      (2) the inability to perform one or more activities of daily living; and
      (3) the impairment of the sensory motor functions used to operate a motor vehicle.
(b) Examples of medical conditions that do not always, but may progress to the level of functional severity described in subsection (a) of this section include Alzheimer's disease and related disorders, seizure disorders, brain tumors, narcolepsy, sleep apnea, and abnormal metabolic states, including hypo- and hyperglycemia associated with diabetes.  

**Exceptions to reporting: 17CCR § 2812
A physician and surgeon shall not be required to notify the local health officer of a patient with a disorder characterized by lapses of consciousness if:
(a) The patient's sensory motor functions are impaired to the extent that the patient is unable to ever operate a motor vehicle, or
(b) The patient states that he or she does not drive and states that he or she never intends to drive, and the physician and surgeon believes these statements made by the patient are true, or
(c) The physician and surgeon previously reported the diagnosis and, since that report, the physician and surgeon believes the patient has not operated a motor vehicle, or
(d) There is documentation in the patient's medical record that another physician and surgeon reported the diagnosis and, since that report, the physician and surgeon believes the patient has not operated a motor vehicle.  

California Law:

Statute requiring lapse of consciousness reporting: H&S § 103900

Reporting requirements: 17CCR § 2810

(a) Except as provided in Section 2812, a physician and surgeon shall notify the local health officer within seven (7) calendar days of every patient 14 years of age or older, when a physician and surgeon has diagnosed a disorder characterized by lapses of consciousness (as defined in Section 2806) in a patient.
(b) The report prepared pursuant to subsection (a) of this section shall include:
      (1) The name, address, date of birth, and diagnosis of the patient; and
      (2) The name, address, and phone number of the physician and surgeon making the report.  

More information:

Medical Board of California Newsletter Summer 2015, p. 10: Reporting Lapses of Consciousness -- What is Your Legal Responsibility?

California DMV: Medical conditions and driving

NHTSA: Driver Fitness Medical Guidelines, Sept. 2009

 

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