title: Failure of the legal system to enforce drunk driving legislation effectively.
abstract: OBJECTIVE
  To evaluate the investigation and prosecution of drunk drivers and identify reasons for system failure.
  
  
  METHODS
  Prospective data collection on all drivers with an elevated blood alcohol level who were treated at a Level I trauma center between January 1 and June 30, 1991.
  
  
  METHODS
  Level I trauma center/university medical center serving a population of 1.8 million.
  
  
  METHODS
  Prospective data collection, interviewing ambulance squad members, investigating police, and results of prosecution.
  
  
  RESULTS
  Of 321 drivers, 78 had ethanol levels of more than 100 mg/dL; nine were between 50 and 100 mg/dL. All drivers had rapid transport to a trauma center for severe injury or high-risk injury mechanism. Police reports were accessible for 84 of 87 drivers; all drivers were believed to be at fault. The crashes resulted in five deaths and 74 other victims requiring hospitalization. Six of the intoxicated drivers died. Police requests for blood alcohol levels were made for 28 drivers, one of whom died. The remaining 59 drivers had no legal blood alcohol level drawn. Although the greater the distance from our center (more rural), the less likely were requests for ethanol levels, but there were many "no requests" from nearby cities. Of the 28 drivers on whom legal alcohol levels were drawn, eight escaped central registration with the highway safety commission, which records any and every traffic violation within New Jersey. Of the remaining 20, eight were not prosecuted (excluding one death), including one repeat offender. One committed a later "driving while intoxicated" offense and was then prosecuted. The remaining 11 were all convicted; five were repeat offenders.
  
  
  CONCLUSIONS
  Reasonable cause is required for legal blood alcohol requests. Our data demonstrated that this is difficult when the driver is unavailable for questioning. However, once legal blood alcohol levels have been obtained, inadequate legal follow-up leads to nonprosecution. Once officially charged, conviction appears certain, but even this punishment and re-education fail to change behavior in many of these drivers.
authors.affiliation: Cooper Hospital/University Medical Center, UMDNJ/Robert Wood Johnson Medical School, Camden.
authors.forename: C G
authors.initials: CG
authors.lastname: Rehm
authors.forename: J
authors.initials: J
authors.lastname: Nelson
authors.forename: D
authors.initials: D
authors.lastname: MacKenzie
authors.forename: S E
authors.initials: SE
authors.lastname: Ross
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000097:blood* / Q000150:complications*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D011446:Prospective Studies; D014193:Trauma Centers