What you don’t know won’t hurt you … but it can kill your kid.

So, you thought I was done with the wheelchair woes? Yes, we have a darn good wheelchair, after many attempts and fits and starts, the manufacturer came through. So, no, I am not complaining about Pearlsky’s chair. But I have another bug up my butt and many of our kids are in danger. Warning, reading this may really piss you off and may scare you …

Definitions:

Securement Point:

… the term securement point (or tiedown point) is reserved exclusively for those points or places on the wheelchair which are “grabbed” by the tiedown device or system in order to anchor or secure the wheelchair to the vehicle. Note that people don’t have securement points. Thus, a wheelchair may have four securement points for the case of a four-point tiedown system … ~SAE J2249: Wheelchair Tiedown and Occupant Restraint Systems

Transit Option: This consists of four securement points (metal loops that are attached to specific places on the wheelchair). It is to these loops that the straps from the floor of a transport vehicle (wheelchair van, etc.) are attached. If, and only if, these loops are used, the chair meets some federal safety standards for transport. Not all chairs come with securement points.

Background:

This story is true and was in an email to Sunrise Medical:

A wheelchair (Zippie TS) was sold without offering the transit option, customer never knew there was such a thing. It is the ONLY way the child is (can be) transported to or from school, doctors, etc. It was sold over two years ago (closer to four, I believe). Recently the chair tipped in a van and the driver blamed it on not knowing where to attach the tie downs. The owner then learned that there was a transit option, formally requested such, and was flatly turned down solely on the age of the chair, without knowledge of the condition of the chair (perfect). Now the customer knows that Sunrise medical warns of potential major or fatal injuries if the child is transported in the chair. There is no other way to transport the child (cannot get into a car seat without a lift, etc.) hence the child is homebound, cannot go to school or doctor, or anywhere without the risk of major or fatal injuries. Why is the only option to spend over $5000 out of pocket for a new chair since it is not time for insurance to pay? Also, specifically, why was the chair not delivered with a warning so she would have known right away, since your written company policy is “Only products that meet our safety requirements are released for distribution and each product is labeled with appropriate warnings to alert the customer of any inherent risk to using the product.” She learns four years later that she has subjected her son to potential, and Sunrise Medical known potential, risk. Specifically, what should she do? How does Sunrise Medical suggest, if any suggestion, that the child be transported for medical care or education?

I had two main concerns. The first is why would the manufacturer automatically not install the transit option if the chair was over two years old. The second, why do owners not know that a transit option is just that, an option.

What became of the email? A conference call with the in house transit option expert. I must say that they do care about the issue and are very knowledgeable and are committed to safety.

Explanations:

The two year drop dead no flexibility rule really had me riled.

I must say the explanation I was given does have some credibility and I do understand why the rule is in place …

It turns out that if you use wheelchair tiedowns but they attach to the frame, and not to specific securement points, over time the frame is damaged. The manufacturer did many studies and learned that the frame actually gets damaged and the timeframe appears to be two years. There are many liability issues involved with the transit options, and there was much testing done on the transit options when attached to a new chair. If attached to a chair over two years old, that has sustained damage to the frame, the liability and even the reliability of the system changes. Hence the two year rule.

There are some holes in the argument here and possible fixes, but the point is that it is not liability-wise sound, nor potentially safety-wise sound, so the option is not available. It would make sense to have the option include key parts of the frame, but then you are basically replacing a significant part of the chair.

So why isn’t every chair sold with the transit option?

I find it hard to believe that anyone in one of these chairs would NEVER be transported in a vehicle. Even if not typically transported, there is never going to be an emergency? The actual cost of materials is trivial (maybe $20 on a $5000 chair). I did not really understand the answer to this question, it had to do with cost of research and design and testing. I would think spreading that cost among all the chairs would be cost effective. Also, why are there some wheelchairs where the option is NOT available? And why are these the lower cost chairs, thus if you are going to transport, you must upgrade? I cannot conceive of selling a wheelchair, especially to our population of kids, in a condition where transporting that child in the chair knowingly endangers him or her. I was told they are looking at integrating the securement on future frames.

Okay, it is an option. There are some insurance companies who will not pay for the option. That in its one right is outrageous. I am further told that DME’s (the ones that sell you the chair) who know that the option is not paid for will, at times, not tell the customer (you, your kid) that there is a transport option! I am told that if they “know” you can not get it via insurance, they don’t mention it! I find this outrageous but this explanation was mentioned several times. The parents in the story above were NEVER told by their RTS (the one who works for the DME) that such an option existed.

How important does the manufacturer think the transit option is? Quotes from the owner’s manual:

5. Use only with Wheelchair Tie down and Occupant Restraint Systems (WTORS) that have been installed in accordance with the manufacturer’s instructions and SAE J2249.

6. Attach WTORS to securement points in accordance with the manufacturer’s instructions and SAE J2249.

If you fail to heed these warnings damage to your chair, a fall, tip-over or loss of control may occur and cause severe injury to the rider or others.

So, no securements, no WTORS attached to said missing securements, hence “severe injury.” You read that quote in the manual, right? The one with 46 Warnings and instructions on how to assemble the chair (including bolt torques), but does not tell you how to use the brakes.

What I want to know is how many families would knowingly opt out of the transit option if told “Please realize that without this option, if you ever have your child in the chair in a vehicle, you are risking severe injury, or death, and that the chair is completely unfit for such use.” Even if insurance would not come up with the money, I am sure the family would.

So my friend in the story above never knew. Now let’s look at the official Business Code of Conduct from the manufacturer, found here. Page 8, under Product Safety & Standards:

Only products that meet our safety requirements are released for distribution and each product is labeled with appropriate warnings to alert the customer of any inherent risk to using the product.

So, I would think that if a chair is delivered without the transit option, it would be “labeled with appropriate warnings” because there is an “inherent risk to using the product,” that being putting it in a vehicle with a kid. That makes sense.

The chairs are not delivered with any label on the chair warning of such. Let’s say it was. Let’s say you ordered a chair and it did not have the transit option, no securements. The first time you put it in a vehicle and went to attach tiedowns you see a bright yellow and red sticker that says “WARNING: Using this chair in a moving vehicle without the $150 transit option puts the occupant at risk of severe injury or death.” Even if you ignored the “appropriate warning label” you would have been warned. The odds are that with the chair being a week old, you would have called the company and they would install the transit option.

But nooooo, there is no such label. I asked why. I was told that the “appropriate warnings” are in the owner’s manual (8 pages in, after 43 other warnings). This does not meet the requirements of the company’s own Code of Business Ethics. Then I was told that the front of the owner’s manual has a checkbox that says “with transit option” and one that says “without transit option.” Turns out that on the two manuals I have here (from the multiple chairs received in the last four months) NO checkbox is checked. Furthermore, how many of us know what the heck a “transit option” is anyway?

My friend was sold a chair and never told by the salesman (RTS) that there was a transit option nor that there was an issue. Remember that the RTS (the salesperson from the DME) has his /her own code of ethics that includes:

1. Provide competent, timely, high-quality equipment and services to meet the physiological and functional needs, as well as the goals, of the consumer.

3. Present the consumer with complete information on the choices of available equipment, pricing, funding options, and the consumer’s financial responsibility.

My friend’s chair was delivered without any caution labels on it. The owner’s manual (decidedly NOT a user’s manual) was in a sealed plastic bag obscured by registration forms and ads and stuff, and admittedly not read, since it’s presence was not even known. One hundred percent of the manuals I received with the last four chair deliveries did not even note if the transit option was installed.

So we have TWO written codes of ethics, that of the manufacturer and that of the sales person violated. And the result is a child subjected to conditions that can cause “severe injury” or fatal injury, WITHOUT KNOWLEDGE of the parent.

Summary:

I do not understand how an RTS can sell a chair without CLEARLY explaining said option.

I do not understand why the manufacturer does not, to use their words, label “each product” … “with appropriate warnings to alert the customer of any inherent risk to using the product.”

I do understand why Sunrise Medical does not put the transit option on chairs older than two years. It sort of makes sense.

Solutions:

Simply put a very visible label, one that cannot be missed, on chairs that do not have transit options that states clearly the “inherent risk” in using the chair in a moving vehicle. The cost of the label would be about fifty cents. Hell, I will donate them. The label would head off any liability law suits pertaining to lack of the transit option.

You want to know when they DO put a label on the chair? When there IS a transit option. Get this, when the transit option IS installed, the label on the transit option says “Use of [something besides the transit option] … could result in increased risk of severe injury or death in a vehicular mishap.” In other words, use what we put on your chair, or your kid can die. But if we don’t put it on the chair, and hence, in their words, there is an “increased risk of severe injury or death in a vehicular mishap,” well, we don’t clearly tell you. Wow.

Click on the image to see the label … again, it is only there if the transit option is there.

Sunrise Medical has done a lot for wheelchair safety, working with committees, doing testing, etc. and they have a strong commitment to safety. But they need to heed their own code of ethics and put a fifty cent label on every chair without securements. Fifty cents!

Well, that’s my two cents …