Protecting People With Special Needs From the Dangers of Being Left Unattended in Vehicles

This toolkit focuses on a serious hazard that may endanger adults and children who, due to their disability, may be particularly susceptible to the risks of being unsafely left unattended in a vehicle. The Justice Center’s 24-hour abuse and neglect hotline has received numerous reports of adults and children who needed assistance to exit a vehicle, but were inadvertently left behind in vehicles operated by provider agencies. Whether you are a driver, transportation aide, service provider, agency, individual, self-advocate, or family member -- you have a role to play in preventing a needless tragedy from happening. The information provided in this toolkit will help raise awareness of the dangers of leaving people unsafely unattended in vehicles and provides common-sense tips to reduce risk.

Heat stroke, hypothermia and other medical complications related to dangerously high or low temperatures in the vehicle infants and young children, elderly adults, people who are overweight or who have chronic medical conditions including those taking medications such as psychotropic medications and diuretics are at a higher risk for heat stroke, hypothermia and other medical complications related to extremely high or low body temperatures.

Accidents and other emergencies lack of caregiver attention to a person who requires supervision and support can lead to many dangerous situations, including neglect of an individual’s personal care and medical needs, prevention of high risk behaviors and accidents.

This case study, involving a fictitious victim, represents a collection of facts identified from multiple case investigations and is used for illustrative purposes only.

A Close Call

Ann-Marie is an adult who lives with a significant intellectual disability. She resides in a group home in upstate New York and requires supervision and support from her caregivers to ensure her safety. Ann-Marie regularly attends a day habilitation program. She and her peers are transported to the program in a 12-passenger van. One morning last July, Ann-Marie was accidentally left behind in the closed van for an hour in the program’s parking lot. The temperature outside was almost 76 degrees. Despite rising temperatures inside the vehicle, staff found Ann-Marie before she suffered any harm.

The Mistake: Ann-Marie is left behind in the van: 8:50 AM

The driver was distracted by a change in routine and allowed the group to separate. Upon arriving at the day program, the driver, the only staff member assigned to the group, failed to keep the group together or to make sure all of the individuals safely exited the vehicle. It was raining hard that morning, so instead of parking the van and going to the building as a group, the driver pulled up to the program entrance and directed his passengers to exit the van there so they would remain dry. Without ever leaving the vehicle, the driver casually observed the individuals file out of the van and run inside. The van appeared empty from the rear-view mirror. No formal head-count, seat check, or other steps were taken to ensure that everyone had disembarked at the entrance. The driver parked and locked the van -- leaving behind Ann-Marie who was lying down and asleep on the farthest backseat, out of view.

The 1st Missed Opportunity to Find Ann-Marie: 8:50-8:55 AM

Program staff had become complacent about their duty to take attendance. When the van pulled up to the program entrance, a staff member inside the building marked Ann-Marie and her housemates as “present” on the attendance sheet, based solely on seeing the van arrive at the entrance. This staff member did not verify that Ann-Marie and her peers entered the building. It was later learned that this was a common practice.

The 2nd Missed Opportunity to Find Ann-Marie: 8:55-9:00 AM

The driver relied on faulty judgment (an assumption that no one was still in the van) instead of following good practices (conducting a full back-to-front vehicle inspection to check for any remaining passengers). The driver sat in the van and documented various required post-trip information, which included a notation that everyone had safely disembarked. However, she failed to follow the agency’s required post-trip inspection policy to check for remaining passengers. She relied instead on her informal observations and judgment when completing the report.

The 3rd Missed Opportunity to Find Ann-Marie: 9:00-9:40 AM

Program staff had developed bad habits surrounding Ann-Marie’s supervision plan. The staff member assigned to Ann-Marie did not attend to her supervision plan that morning (Ann-Marie required eyes-on supervision and at least 15-minute documented well-being checks). It was well known that Ann-Marie had a habit of not going directly to her classroom in the morning. She often sat on a bench at the entrance of the building where she would informally engage with other program staff for as long as an hour before she would agree to go to her classroom. The classroom staffperson assigned to Ann-Marie did not consider her absence to be of concern. As a result, Ann-Marie’s absence was not questioned until 9:40 a.m. when staff went to encourage her to join the group and she was nowhere to be found.

A Delay in Finding Ann-Marie: 9:40-9:50 AM

The agency's missing person protocol did not direct staff to conduct a methodical search of high-risk locations first. Valuable time was lost when staff searched the entire building before someone thought to check the van. Ann-Marie was finally located at 9:50 a.m. in the locked, parked vehicle, a full hour after she was believed to have exited the vehicle. She was found asleep and unharmed.

Additional information about lessons learned from this case study as well as vehicle inspection safety tips are available in the Toolkit below.