ST. PAUL, Alta. — An Alberta judge says the province should require doctors to report unfit drivers following a deadly crash at a small-town school.
Provincial court Judge Karl Wilberg says in his fatality inquiry report, released Thursday, that the tragedy four years ago could have been prevented if such a policy had been in place.
"Long-standing institutional failures, deadly in their impact, that lead to avoidable injury and death should not be ordinary occurrences," Wilberg wrote.
"These failures are still with us today and lives remain at risk."
Richard Benson, a man who suffered seizures for a decade but rarely took his prescribed medication, continued to drive although he wasn't supposed to. He concealed his health condition when filling out his driver's licence and vehicle insurance documents.
On the morning of Oct. 25, 2012, the 46-year-old had a seizure behind the wheel of his minivan in St. Paul, east of Edmonton. The van bolted at about 80 km/h and crossed five streets before it plowed through a fence and into a lower-level classroom at Racette Junior High School.
The van sent students and mangled desks flying as it spun around and pinned three girls underneath it.
It was a nightmarish scene, wrote Wilberg.
Megan Wolitski, 11, died in hospital the next day. Classmate Maddie Guitard was left in a vegetative state and died last year.
The third girl, Angelina Luce, suffered a serious brain injury and continues to have speech, vision and emotional problems.
Benson pleaded guilty in 2013 to charges of criminal negligence causing death and criminal negligence causing bodily harm. He was sentenced to 11 1/2 months jail and banned from driving for life.
Wilberg said Benson had eight documented interactions with doctors and hospital over the 10 years he shouldn't have been driving. No one reported him.
"Mr. Benson wasn't going to report that he was unsafe to drive," wrote the judge. "His physicians and health-care providers didn't report him either. Even Mr. Benson's family was concerned about the risk he posed by continuing to drive, but they too did nothing."
The judge said there is widespread confusion over whether doctors should report unfit drivers.
The Canadian Medical Association's code of ethics requires physicians to disclose patient health information to third parties if there is a significant risk of harm to others. But the Alberta College of Physicians and Surgeons tells its members that reporting is not mandatory.
The inquiry heard that doctors are reluctant to report because it might jeopardize their relationships with patients. There's also a myth that reporting is discretionary, said Wilberg.
The judge said a standardized test to identify dangerous health conditions might help doctors feel more comfortable with reporting. As well, they could be compensated for the extra work.
Court heard that there was low compliance by doctors after Ontario made reporting mandatory in 1968. The rate increased after doctors were reimbursed.
Dr. Lyle Mittelsteadt, with the Alberta Medical Association, said the issue of reporting has been discussed with transportation officials for years. He said if it's implemented, the province should make it clear when a doctor should report, since medical conditions change over time.
"I do think that most physicians take patient safety very seriously and they do want to report when a patient is unsafe."
Wilberg further recommended that a computer system used by pharmacists be programmed to notify the registrar of motor vehicles when people receive anti-seizure or dementia medications.
An official with Alberta Transportation told the inquiry that the move was considered at one time but met with intense bureaucratic opposition.
"This resistance is irrational and dangerous," said Wilberg.
Transportation Minister Brian Mason said he will be reviewing the report and discussing it with health officials, as well as looking at how reporting systems are working in other provinces. Along with Alberta, Nova Scotia and Quebec also don't require reporting, he said.
"We do take the judge's recommendations seriously. We're studying it but we're not yet in a position to make a determination on policy."
— By Chris Purdy in Edmonton
The Canadian Press