| Author | Affiliation |
|---|---|
| John Ashurst, DO, MSc | Conemaugh Memorial Medical Center, Department of Emergency Medicine, Johnstown, Pennsylvania |
| Benjamin Wagner, DO | Conemaugh Memorial Medical Center, Department of Emergency Medicine, Johnstown, Pennsylvania |
Introduction
Case report
Discussion
Conclusion
ABSTRACT
The Segway® self-balancing personal transporter has been used as a means of transport for sightseeing tourists, military, police and emergency medical personnel. Only recently have reports been published about serious injuries that have been sustained while operating this device. This case describes a 67-year-old male who sustained an oblique fracture of the shaft of the femur while using the Segway® for transportation around his community. We also present a review of the literature.
INTRODUCTION
In 2001, Dean Kamen developed a self-balancing, zero emissions personal transportation vehicle, known as the Segway® Personal Transporter (PT).1 The Segway’s® top speed is 12.5mph and was deemed safe for operation on urban pedestrian areas by the Centre for Electric Vehicle Experimentation in Quebec in 2006.1,2 However, several reports have been published that showed serious injuries to the “gliders” who operate these devices.3-6 This report adds to the growing literature of serious injury associated with the Segway® Personal Transporter.
CASE REPORT
A 67-year-old male presented to the emergency department with right leg pain after a fall from his Segway®. The patient reported that he used the personal transporter as his main means of transportation around the community and that evening had several alcoholic drinks and attempted to drive home. En route, he subsequently fell from the Segway® and injured his right leg. Past medical history was significant for diabetes and coronary artery disease.
Physical exam revealed a temperature of 36.6, pulse of 72 beats per minute, respirations of 14 and a blood pressure of 176/94mmHg. The patient’s Glasgow coma scale was 15 and he did not appear to have an alcohol smell on his breath. The only outward signs of trauma were located on his right lower extremity. A gross deformity was noted over the mid thigh with the entire lower extremity held in flexion and external rotation. Peripheral pulses were present in the extremity and no parasthesia was noted.
Radiograph of the right femur demonstrated an oblique fracture of the proximal shaft of the femur with severe displacement and angulation (Figure). Alcohol level was 0.024% and the remainder of the trauma studies were negative. The patient was subsequently admitted to the trauma service and underwent operative fixation the next day. He was discharged to a rehab facility five days post injury.
DISCUSSION
The U.S. Consumer Product Safety Commission is tasked in the United States with compiling data in the National Electronic Injury Surveillance System on injuries related to consumer products. Despite two separate recalls issued by the commission on the Segway® Personal Transporter, only 33 injuries were noted in the National Electronic Injury Surveillance System (NEISS) cases when searched with the key term “Segway”® from the year 2009 to 2013.7 Few injuries were identified because the National Electronic Injury Surveillance System does not have a specific code for this means of transportation but includes it with Scooters/Skateboards-powered under the code 5042.
When compared to published data from case reports and case series, none of the NEISS match the published literature. Most likely, the scarcity of literature is related to the under-reporting of the true number of accidents while using personal transporters. This is evidenced by the lack of an International Classification of Diseases 10 code as well as only a handful of reported cases.
After a review of Medline, we found four separate publications that noted significant injuries in relation to the Segway® Personal Transporter (Table 1). Of those reviewed, 16 patients required hospital admission due to significant traumatic injuries and seven were placed in an intensive care setting. Further examination showed that much like our patient, 81% of patients had a fracture with 38% occurring in the lower extremity. Although fractures are common, this classically differs from skateboard and scooter injuries in which the majority occur in the upper extremity.
| Age | Injuries | Admission |
|---|---|---|
| 72 | Multiple brain contusions, radial head fracture, subarachnoid hemorrhage, subdural hematoma, comminuted nasal bone fracture, mandibular fracture | ICU |
| 57 | Subarachnoid hemorrhage | ICU |
| 61 | Elbow laceration, pneumothorax, rib fracture | |
| 40 | Comminuted intra-articular fracture of the tibial plateau with impaction, comminuted intra-articular fracture of the proximal fibula, partial tear of the Achilles tendon. | |
| 62 | Comminuted fracture of the proximal humerus, inferiorly displaced comminuted fracture of the right orbital floor, displaced comminuted fracture of the anterior medial and lateral maxillary sinus walls, subarachnoid hemorrhage | ICU |
| 52 | Closed head injury without loss of consciousness | ICU |
| 25 | Trimalleolar fracture | |
| 45 | Displaced fractures of the superior pubic ramus and inferior pubic ramus | |
| 33 | Non-displaced fracture of the anterior column of the left acetabulum, non-displaced fracture of the left inferior pubic ramus | |
| 73 | Mandibular fractures, comminuted and displaced fractures of the anterolateral and posterolateral walls of the left maxillary sinus, displaced fracture of the zygomatic arch, fracture of the left orbital floor, comminuted fracture of the lateral wall of the left orbit, angulated fracture of the left nasal bone, fracture of the lateral pterygoid plate. | |
| 73 | Comminuted transverse fracture of the left anterior column of the acetabular cup with femoral head displacement | |
| 59 | Femoral neck fracture | |
| 58 | Right pneumothorax, second, third and eighth rib fracture, right pulmonary contusion, right acetabular fracture, respiratory failure | ICU |
| 55 | Open distal fibula fracture | |
| 57 | Subarachnoid hemorrhage, Intraparenchymal contusion | ICU |
| 55 | Respiratory failure, right subdural hematoma, and basilar skull fracture | ICU |
ICU, intensive care unit
More alarmingly, however, is the age of those sustaining injuries. Based upon reported data in the literature and from the NEISS, the average age of those injured is 46.07 years old (Table 2) on a personal transporter. Also, 44% of those reported injuries on personal transporters had significant head trauma that required an intensive care admission. It is difficult to ascertain the reason for this trend but could be related to personal transporters being used more by tourists as compared to other modes of transportation.
| Age | Diagnosis |
|---|---|
| 72 | Tib/fib fracture |
| 12 | Fractured elbow |
| 56 | Right shoulder contusion |
| 62 | Left shoulder sprain |
| 51 | Intertrochanteric hip fracture |
| 74 | Abrasions |
| 35 | Humeral fracture |
| 59 | Fibular fracture |
| 48 | Wrist fracture |
| 56 | Pubic ramus fracture |
| 12 | Concussion |
| 20 | Abrasions |
| 87 | Nasal fracture |
| 61 | Radial head fracture, wrist fracture |
| 45 | Shoulder fracture |
| 65 | Leg hematoma |
| 61 | Closed head injury |
| 13 | Neck pain |
| 86 | Sprained knee |
| 55 | Sprained ankle |
| 56 | Fibular fracture |
| 37 | Lip laceration |
| 59 | Hand fracture |
| 67 | Wrist fracture |
| 55 | Elbow fracture |
| 54 | Hand laceration |
| 22 | Knee abrasions |
| 43 | Laceration |
| 46 | Back contusion |
| 63 | Ankle fracture |
| 56 | Facial laceration |
| 86 | Concussion |
| 75 | Abrasions |
No deaths caused by Segway® use could be found in the published medical literature or within the NEISS over the time period selected. Ironically, however, a subsequent owner of the Segway® company perished after his personal transporter rolled off a 30-foot cliff and into the water in the United Kingdom.8
CONCLUSION
Based upon a literature review, injuries from the Segway® Personal Transporter are likely under-reported but those that are reported are significant in nature. Emergency physicians and the Consumer Product Safety Commission should continue to monitor the number of injuries that present in the United States, and further studies regarding the personal transporter’s safety should be undertaken.
Footnotes
Section Editor: Rick A. McPheeters, DO
Full text available through open access at http://escholarship.org/uc/uciem_westjem
Address for Correspondence: John Ashurst, DO, MSc, Conemaugh Memorial Medical Center, 1086 Franklin Street, Department of Emergency Medicine, Johnstown, PA 15905. Email: ashurst.john.32.research@gmail.com. 9 / 2015; 16:693 – 695
Submission history: Revision received April 20, 2015; Accepted July 9, 2015
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none. Authors have no relation with the manufacturer of Segway.
REFERENCES
1. About Segway. Segway Inc. The Leader in Personal, Green Transportation. Available at: http://www.segway.com/about-segway/. Accessed Sept 4, 2014.
2. Pilot Project for Evaluating the Segway HT Motorized Personal Transportation Device in Real Conditions. 2006. Available at: http://www.segway.com/segway-resources/downloads/pdfs/14567e.pdf.
3. Boniface K, McKay MP, Lucas R, et al. Serious injuries related to the Segway personal transporter: A case series. Ann Emerg Med. 2011;57:370-4.
4. Vincent K, Block E, Black J. Traumatic injuries associated with Segways and personal transporters. Am Surg. 2009;75:722-4.
5. Mikkelsen R, Petersen A, Hvolris J. Two cases of associated hip fractures after falls from the Segway Personal Transporter. Emerg Med. 2014;179.
6. Barnes J, Webb M, Holland J. The quickest way to A&E maybe via the Segway. BMJ Case Rep. 2013.
7. Available at: http://www.cpsc.gov/en/Research–Statistics/NEISS-Injury-Data/. Accessed Apr 18, 2015.
8. Williams S. Segway Owner Dies in Segway Crash. Wheels Segway Owner Dies in Segway Crash Comments. 2010 Accessed Apr 18, 2015.
