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Jan. 25, 2019 -- Nearly 250 patients were treated at two Los Angeles emergency departments in one year because of mishaps on electric scooters, a new study has found.

The scooters -- those shareable two-wheeled vehicles you can pick up spontaneously on a street corner and drop off almost wherever you wish -- are touted as a cheap way to get around.

But the trend comes with a price: injury risk.

Most of the 249 patients in the JAMA Network Open study were discharged after being patched up, but 15 people had to be hospitalized, including two with severe head injuries.

"One third actually arrived by ambulance," says lead study author Tarak Trivedi, MD, a research fellow at the National Clinician Scholars Program at UCLA. 

Most patients were riders, but 21 non-riders were injured as bystanders or by such mishaps as falling over parked scooters.

The report was published not to condemn the use of the scooters, says Frederick Rivara, MD, editor of JAMA Network Open, who wrote a commentary to accompany the study. The scooters are here to stay, he says.

"We just need to figure out how to make these things safer," says Rivara, professor of pediatrics, founding director, and investigator at the Harborview Injury Prevention and Research Center at the University of Washington in Seattle.

Among the companies now offering the scooters across the country are Lime, Bird, Jump (Uber), and Lyft. Users download an app, enter credit card information, and use the app to find a scooter. Fees and specifics vary, but the scooters are inexpensive. Lime, for instance, charges $1 to start and 15 cents a mile. Its scooters can travel about 20 miles. Speeds can reach about 15 mph.

Injury Report

Trivedi and his colleagues reviewed the medical records of patients coming to two urban emergency departments -- Ronald Reagan UCLA Medical Center and UCLA Medical Center in Santa Monica -- between Sept. 1, 2017, and Aug. 31, 2018. Electric scooters were first available in the United States in this area, showing up in September 2017, Trivedi says.

The average age of the patients treated was about 34, but ranged from 8 to 89. Falls were the most common way people got injured, accounting for more than 80% of the accidents. Next was collision, affecting 11%. Nearly 9% of riders were hit by a moving vehicle or other object.

Head injury was most common, followed by fractures and then bruises, sprains, and cuts. While 95 patients had a minor head injury, five had bleeding in the skull.

Only 10 riders were documented as wearing helmets. Most accidents happened from 3 to 11 p.m. Twelve riders were intoxicated. Trivedi says they did not gather information on which of the many scooter models were involved in the accidents.

Besides reviewing the medical records, the researchers also watched 193 scooter riders during three sessions in the area. They found 94% did not wear helmets, nearly 8% had more than one person on a scooter, and more than 9% didn't obey traffic laws. More than a quarter of riders were seen on the sidewalk, which is not allowed.

Expert Perspective

The injuries reported in the UCLA study mirror what Robert Glatter, MD, an emergency doctor at Lenox Hill Hospital in New York City, also sees. The risk is not only for riders, he says, but pedestrians.

"I have witnessed scooter riders nearly collide with baby carriages, runners, bicyclists, along with pedestrians on sidewalks," he says. "I feel these scooters represent a new public health threat."

"While traveling 15 mph while helmetless may not seem very fast, it packs enough of a punch to cause a traumatic brain injury, broken bones, and land you in the ICU," he says.

Company Response

WebMD reached out to Lime and Bird for comment. Paul Steely White, Bird’s director of safety policy and advocacy, says the company is “committed to partnering with cities, organizations and community members to safely and responsibly embrace e-scooters as an alternative to cars.”

White points out what he calls a limitation of the study: It did not take into account the total number of scooter trips taken in the time period studied, so the number of accidents would amount to a fraction of total rides taken.

Mary Caroline Pruitt, communications manager for Lime, says "the safety of our riders and the community is our number one priority." The company has recently led several safety initiatives, including the launch of the Lime Gen 3 scooter with enhanced safety features. The company is working with local governments to support dedicated bike lanes and paths. Lime also supports recommendations to innovate helmet design, Pruitt says. 

Boosting Scooter Safety

To make scooters safer, Rivara suggests that the Consumer Product Safety Commission test different helmets for the various scooters and ''label them according to the vehicle in which their use is appropriate.'' Helmet makers should come up with models for use with the scooters, he says. And the companies, which encourage helmet use, should go a step further and provide them, he says.

On company websites, scooter companies encourage helmet use and include safety tips.

On its website, Lime says it will distribute 250,000 helmets worldwide as part of its Respect the Ride program.

Cities, which sign contracts with the scooter companies, should make the companies provide helmets as part of the deal, Rivara says.

Those who ride should respect the fact that the scooter ''is a fast-moving piece of technology that has to be treated with caution," says Trivedi, who says he rides the scooters and finds them useful but recommends safety measures. He urges people to wear a helmet and learn how to operate the scooters before jumping on. The companies might consider requiring people to watch an instructional video before scooter use, he says.

Besides wearing a properly fitted helmet, Glatter suggest riders wear padding and gear to protect against fractures and ''road rash."

The study and its authors were funded and supported by the UCLA National Clinician Scholars Program, David Geffen School of Medicine, UCLA; the VA Office of Academic Affiliations through the VA/National Clinician Scholars Program; and a grant from the Korein Foundation.

Clatification: A statistic in the first section of this story was changed to reflect that one third of patients with injuries from electric scooters included in the study arrived at emergency departments in an ambulance. 

Show Sources

Tarak Trivedi, MD, research fellow, National Clinician Scholars Program, UCLA.

Frederick Rivara, MD, professor of pediatrics and founding director and investigator, Harborview Injury Prevention and Research Center, University of Washington, Seattle; editor, JAMA Network Open.

JAMA Network Open, Jan. 25, 2019.

Robert Glatter, MD, emergency doctor, Lenox Hill Hospital, New York City.

Paul Steely White, director of safety policy and advocacy, Bird scooters.

Mary Caroline Pruitt, communications manager, Lime scooters.

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