From the WebMD Archives

Editors note: This story was updated on Sept. 25, 2018, with new data on injuries from Salt Lake City. 

Aug. 30, 2018 -- On a recent midweek afternoon, during Atlanta’s unforgiving rush hour, two boys zip down a sidewalk on a Lime-brand motorized electric scooter. The smaller of the two stands in front, his hands close to the center of the handlebars. The taller boy reaches around him to control the scooter’s hand accelerator and brake. Neither wears a helmet. They don’t appear old enough to meet the dockless scooter-share program’s requirement that riders be at least 18 years old.

In the last few months, scenes like this -- along with far more death-defying ones -- have become part of the urban landscape in Atlanta and dozens of other U.S. cities, including Seattle, Salt Lake City, Miami, New York City, San Antonio, Chicago, and Los Angeles.

Following bicycle-share programs that have swept the nation, dockless scooter shares, including Lime, Bird and Spin, seemed to descend on many locales under the cover of night. The companies planted the battery-powered scooters, lined up and leaning on kickstands, outside parks, shopping centers, coffee shops, and other high-foot-traffic areas in city centers. Riders can unlock a scooter with an app -- after releasing the company of all liability for any injury they incur -- and complete the last mile of their commute from train station to office, gym or happy hour. When riders finish with a dockless scooter, they can park them almost anywhere, rather than check them back into a designated rack like a shared bike.

City dwellers woke up one morning to this mostly unregulated new mode of transportation they’d need to learn to navigate, or navigate around. In this brave new world of hop-on, hop-off shared personal vehicles, accidents are inevitable.

Since Birds landed in Atlanta, “We’ve seen a variety of injuries,” says Hany Atallah, a doctor and chief of emergency medicine at Grady Memorial Hospital, Atlanta’s most comprehensive trauma center. “From scrapes, bumps and bruises, upper extremity [arm] injuries caused by falling and trying to catch yourself, to serious head injuries with bleeding in the brain that get sent to ICU, and everything in between.”

Atlantans have reported e-scooters on the crowded interstate that runs through downtown and going the wrong way on congested streets during rush hour. Earlier this month, the city saw its first scooter-related death when a police officer ran a red light without using his emergency lights and hit a rider. Keeping riders safe will require that companies, the cities in which they operate (nearly 30 for Bird and more than 50 predominantly California towns for Lime), and riders each take action and responsibility.

For its part, Bird announced earlier this month its Save Our Sidewalks pledge to set aside some of its profits to create protected bike lanes for scooters in its partner cities. The company also launched a global advisory board to spearhead safety campaigns. Lime did not respond to requests for comment on its safety initiatives.

From Broken Bones to Brain Injuries

Emergency health care providers from Oakland to Baltimore describe mostly broken arms and wrists and a few head traumas among the injuries their emergency departments have seen in the short time since the e-scooters rolled into their towns.

“In the past 2 or 3 months, we’ve seen six or eight scooter injuries,” says Alex Stempel, an Oakland-based physician assistant at Alta Bates Summit Medical Center in the San Francisco Bay Area. Besides broken arms and wrists, he’s seen a shattered elbow.

In Atlanta, an electric scooter incident sidelined Georgia Tech sophomore linebacker Bruce Jordan-Swilling before the team’s first game. “I don’t think he’ll play. He got hurt on a scooter -- the ones that you ride with no helmet, that you fly down the road just kind of waiting for it to happen,” said head coach Paul Johnson. Jordan-Swilling was injured on his personal scooter, not a shared one, a teammate told The Atlanta Journal-Constitution newspaper.

But it’s not only riders who stand to get hurt. “I saw a lady who was sideswiped by a scooter that was weaving in and out of a crowd on the sidewalk,” says Leigh Vinocur, a doctor who runs the urgent care division at MedStar Health in Baltimore. The cut on the woman’s ankle required stitches. Vinocur also described incidents in which people leaving bars in the wee hours trip over scooters left in the middle of the sidewalk.

In Salt Lake City, officials at the University of Utah Health’s emergency department say that scooter-related injuries this summer have increased 161% over the same time period in 2017, The Washington Post reported. Those injuries included fractures or dislocations of ankles, wrists, elbows, and shoulders. Several patients also had head injuries, the newspaper says. 

Emergency medical providers tend to chalk the accidents up to a few common causes.

For starters, riders don’t need any prior experience to operate the little vehicles. They might not know that the tiny wheels can’t take cracks and potholes the way bicycle tires can, which makes tipping over a risk. Riders might not understand electric vehicles either. “Anything that’s electric accelerates to full force immediately,” says Vinocur. “It’s not like combustion engines that take a minute to rev up.” An unwitting rider could get thrown right off the back when the scooter starts to move.

“If you’re a beginner, get a sense of how it moves and accelerates before you get going,” says Stempel.

He should know. Stempel hops on scooters to get to the gym, to cruise around nearby Lake Merritt, and to go downtown to meet his friends for drinks. “Then, if I drink too much to scoot, I can just Uber back,” he says.

In most accidents, riders aren’t wearing helmets, health care providers say. Yet, research shows they can make brain injuries much less likely. In a study that compared bicycle accidents in the Netherlands, where helmets are not required, with similar accidents in Australia, where helmets are law, accidents in the Netherlands were nearly four times more likely to result in a brain injury.

Perhaps unsurprisingly, phones play a role in scooter mishaps, too. “Trying to use your phone while riding a scooter is a hard thing to do,” says Stempel. “I admit it, I’ve tried.” 

Wild, Wild West

E-scooters join a sharing economy -- including players like Lyft, Uber, and Airbnb -- that has established itself as a modern-day Wild West. Bird and its competitors jumped into markets including Tempe, AZ; Minneapolis; Columbus, OH; Oklahoma City; and San Jose, CA, with no warning.

Since the scooters’ unannounced arrivals, some locations, including Milwaukee, WI, Charleston, SC, parts of greater Los Angeles, and a handful of college campuses, have banned them. Most scooter cities that responded to requests for comment, including Denver, Charlotte, NC, and Portland, OR, have instead established pilot programs that reserve their city’s right to place new rules on scooter companies and riders or banish the vehicles altogether based on what the pilot studies find.

“In San Jose, we had no regulation to permit or prohibit these scooters,” says Colin Heyne, public information manager for the local Department of Transportation. San Jose and many others are now scrambling to regulate an industry that simply didn’t exist a year ago.

In Scottsdale, AZ, and San Diego, riders can get ticketed for violating laws. Other cities put the onus on companies to ensure their riders follow local road rules and reserve the right to revoke operating permits if they don’t. “We have open lines of communication with these companies, and they’ve been good about addressing some of our concerns,” says Heyne.

Most locales treat scooters like bikes, expecting riders to use bike lanes where available and obey local helmet laws.

Helmets can be tricky though. The draw of e-scooters is that riders can hop on them spontaneously when they’d otherwise be walking. “You don’t always have a helmet with you,” says Stempel, who admits to riding bare-headed. “Maybe if they could have one attached,” he offers. Bird, for its part, offers free helmets to users through the app for $1.99 shipping. Still, riders must have the helmet with them to reap the benefits.

“Use common sense,” says Atlanta’s Atallah. “Wear a helmet, knee pads, and elbow pads if you can, and don’t ride on the interstate.”

Cities are also catching on that they need to be explicit about where to leave the scooters: out of the way of pedestrians. San Jose requires riders to take a photo of the parked scooter once they finish their ride.

While cities work out the kinks in this brand new mode of transportation, they can’t deny the scooters’ popularity. During the first three weeks of Portland’s pilot, riders took 96,255 trips of about 1.7 miles each to cover a total distance of more than 163,000 miles. So now the cities are pressed to make the scooters safe for everyone.

“We don’t want to shut anyone down,” says San Jose’s Heyne. “We want to encourage car-free mobility and innovation.”

WebMD Health News


Hany Atallah, MD, chief of emergency medicine, Grady Memorial Hospital, Atlanta.

Alex Stempel, physician assistant, Alta Bates Summit Medical Center, Oakland, CA.

Leigh Vinocur, MD, medical director, PromptCare, MedStar Health, Baltimore.

Colin Heyne, public information manager, Department of Transportation, San Jose, CA.

The Washington Post: "Hospital ER reports 161 percent spike in visits involving electric scooters."

The Atlanta Journal-Constitution: "Georgia Tech’s Bruce Jordan-Swilling in scooter accident."


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