title: Traffic collisions between electric mobility devices (wheelchairs) and motor vehicles: Accidents, hubris, or self-destructive behavior?
abstract: OBJECTIVE
  This study had its genesis in a personally observed collision between a motor vehicle and a motorized wheelchair (electric mobility device) on a busy street in the middle of the block at an unmarked crossing. To the observer, at the time, this appeared to be a suicidal act. This investigation was initiated to both delineate the number of these crashes nationally and understand this phenomena as a potentially planned act of self-destruction.
  
  
  METHODS
  An initial survey of police reports was immediately frustrated by an inability to separate motor vehicle and electric mobility device collisions from the much larger group that involved ambulatory citizens because both types were classified together as "pedestrian" accidents. Instead, the search engine NexisLexis was used to identify 107 newspaper articles each of which described a motor vehicle and electric mobility device accident.
  
  
  RESULTS
  In the motor vehicle and electric mobility device collisions, men predominated women (3:1 ratio) with an average age of 56 yrs. Sixty of these accidents were fatal. Ninety-four percent involved an electric mobility device and 6% a manual wheelchair. In 50% of the cases, the motor vehicle was a truck, van, or sport utility vehicle. Fifty percent occurred at dusk or dawn or at night. The electric mobility device occupant was cited as the guilty party in 39% of the cases and the driver of the motor vehicle in 27%. Twenty percent were unwitnessed hit-and-run accidents, whereas "no fault" was found in 8% of the cases.
  
  
  CONCLUSIONS
  Although many accidents do happen by chance, when an electric mobility device operator openly challenges busy traffic by attempting to traverse it in the middle of the block at an unmarked crossing, predisposing psychosocial factors must also be considered. Hubris or premeditated self-destructive behavior or both need to be explored as preeminent issues with reference to the prodromal of the "accident process."
authors.affiliation: Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
authors.forename: Myron M
authors.initials: MM
authors.lastname: LaBan
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Nabity
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000523:psychology / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000523:psychology; D002423:Cause of Death; D003430:Cross-Sectional Studies; D004560:Electricity; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000706:statistics & numerical data; D018570:Risk Assessment; D012309:Risk-Taking; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology*; D017678:Sex Distribution; D016019:Survival Analysis; D014910:Wheelchairs / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult