Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, May 10, 1990 TAG: 9005100033
SECTION: EXTRA PAGE: E-1 EDITION: METRO
SOURCE: JOE KENNEDY STAFF WRITER
DATELINE: LENGTH: Long
My wife and son had been in a head-on automobile collision. They were hurt. Could I get there as quickly as possible?
I drove the two miles to the site of the wreck and found Sharon cut, bleeding and saying she thought her ankle was broken. Michael, ashen, lay in the rear seat with his eyes closed.
County rescue workers were cutting off my wife's coat to remove her from the car. I spoke with her briefly and asked about Michael.
"He's all right," a rescue worker said. "Come back and talk to him."
I went over, leaned through the open rear door and spoke to him. He opened his eyes and answered my questions in a faint voice. He didn't look all right to me, but in a situation like that, you listen for the good news and ignore evidence to the contrary.
At the Roanoke Memorial emergency room, the scene was much the same. Sharon had obvious, painful injuries that eventually required plastic surgery and a cast. Michael, who is 6, showed only an abrasion across his abdomen from the lap belt he'd been wearing in the back seat.
"We'll probably admit him for observation overnight," someone told me. "But we'll wait to hear from the surgeon."
A few hours later, trauma surgeon Howard Nabors arrived. By then, Michael had thrown up once, and his color had not improved. Nabors barked a series of questions to the residents and nurses and ordered them to get Michael ready for a CAT scan and X-rays. He displayed more alarm than I expected.
Perhaps 40 minutes later, he took me into a room and told me he thought he should operate. The pictures had shown an abnormality in the intestine. The procedure would be exploratory, and maybe nothing was wrong, he said. But he thought he ought to look.
In the operating room, Nabors found and repaired tears in Michael's duodenum and colon, damage that he later called life-threatening.
Michael also had a fractured bone in his lower back.
A thought troubled me then, and it troubles me now: Rather than protect him, the lap belt in the back seat had injured my son.
An `unexplored problem'
Under Virginia law, children under age 4 or weighing less than 40 pounds traveling in cars must ride in what the state code book calls "a child restraint device of a type which meets the standards adopted by the United States Department of Transportation" - an approved child safety seat.
Children older than 4, or weighing more than 40 pounds, should use standard auto seatbelts or approved booster seats, though neither is required by law if they are in the back seat.
Standard rear-seat seatbelts, especially the lap-only type, are often not well-suited for children in the 40- to 70-pound category, said Benjamin Kelley, who is president of the Injury Reduction Institute in Maryland, a non-profit organization of lawyers involved in personal injury litigation.
"Certain manufacturers have been very inattentive to the needs of children . . . in their restraint system design," Kelley said.
"Lap belts in the rear seat . . . are an anachronism. They're hazardous because they concentrate so much force in the middle area, and this can give rise to abdominal and spinal cord injury from the swinging forward of the body."
Such belts can be dangerous to anyone in a frontal crash. But children and small adults especially are at risk, because the belts often don't fit them over the pelvic bones, as they should. They can ride up onto the abdomen and expose the internal organs to injury. Even when properly placed on children, they direct energy from the crash onto the pelvis, which is not sufficiently developed to accept it.
Only since last December has the government required auto manufacturers to install lap and shoulder belts in the rear seats of their cars.
The injury institute estimates that there are 140 million cars on the road with lap-only rear seatbelts. It estimates that 1,000 children are killed or seriously hurt by these belts in crashes each year.
The group has called on manufacturers, safety groups and federal highway safety officials to publicize the hazards of rear-seat lap-only belts, especially to children, and to encourage people to install lap and shoulder belts in cars that lack them.
Government action may be slow in coming.
The administrator of the National Highway Traffic Safety Administration, a federal goverment agency that provides research and recommendations on auto safety, has said problems with rear seat lap belts were "small potatoes" compared with the 340,000 annual accidents involving front seat passengers, particularly those not wearing seatbelts.
Russell Shew of the Center for Auto Safety in Washington, a non-profit group founded by Ralph Nader, disagrees.
"We think this is one of the major, unexplored problems" in auto safety, he said. "We think the government ought to look into the issue of what to do for children" weighing between 40 and 70 pounds.
In at least one case, the automotive industry has acknowledged the problem.
Much litigation to come?
In April, the Ford Motor Co. agreed to pay $6 million to a California couple who sued after one of their twin 11-year-old sons was killed and the other was left a paraplegic in a crash in November 1988.
They were passengers in a Ford Escort who wore lap-only rear seatbelts, according to the Wall Street Journal. The parents' lawsuit charged Ford with negligence for equipping older Escorts with lap-only belts in the rear instead of lap-and-shoulder systems. They said Ford did it to save money. Ford said the benefits of three-point belts in the rear weren't clear at that time, the Journal reported.
A Ford spokesman said the company agreed to the settlement because the tragic nature of the case might cause a jury to reach a verdict unfavorable to it.
Kelley of the Injury Reduction Institute predicted that the rear lap belt issue would become "one of the biggest sources of automotive litigation in history."
He predicted that such lawsuits against all auto manufacturers, estimated at 500 now, could reach 1,200 per year.
The Journal said such suits usually allege either that car manufacturers have known for some time that lap-only belts are not as good as three-point belts, or that sometimes, wearing such belts is worse than wearing no seatbelt at all, because of the internal injuries that can occur.
Despite the potential hazards, the December 1989 issue of Consultant, a magazine for primary care physicians, said the injuries sometimes caused by seatbelts - even lap-only belts - do not negate their benefits. Seatbelts cut the death and major injury rate in crashes by half compared with occupants who go unbelted.
I believe that Michael was better off with his lap belt than he would have been had he worn no seatbelt at all. The thought of him flying, unrestrained, through the car after the impact gives me chills.
But a 1986 study by the National Transportation Safety Board showed that lap-only belts, and particularly those in the rear seat, performed poorly in 26 frontal crashes.
The board said that in many cases, the belts induced severe injuries and deaths that might not have occurred if no belts had been worn.
Though that finding caused an outcry at the time, the NTSB has not retracted it.
Tim Hurd, chief of public affairs for the National Highway Traffic Safety Administration, disagreed strongly with the NTSB study.
"If a lap belt is in the car, you should use it," he said. "It will keep you in the car, for one thing. If you're in a rollover, you have four times as great a chance of being killed without it."
The article in Consultant noted that motor vehicle crashes are the leading cause of death in this country for people between ages 5 and 34, as well as the most costly source of disability.
Lap and shoulder belts are rated far more safe for those big enough to wear them, but they are not without hazards to children. The shoulder portion of the belt may, for example, cross a child's face or neck. The parents may place the shoulder portion behind the child, in effect creating a more dangerous lap belt. Traffic safety experts advise parents to put their children in federally approved booster seats after they've outgrown their child safety seats. But booster seats are not required under Virginia law, and children often dislike using them.
Michael used a booster seat until he noticed his schoolmates riding without them. When he protested, we let him use the seatbelt.
As a consequence, he spent two difficult weeks in the hospital. But so far, the story has had a happy ending.
As Howard Nabors, the surgeon, said on the day my son came home, "We dodged a bullet."
Sharon and Michael are doing well. He is back at school, bearing no evidence of his trauma except for the long scar that snakes up his belly.
Our replacement car has lap and shoulder belts in the rear, but Michael rides in the back in a booster seat. We plan for him to use it for a long time to come.
by CNB