Interpretation ID: nht87-1.83

TYPE: INTERPRETATION-NHTSA

DATE: 06/03/87

FROM: AUTHOR UNAVAILABLE; Erika Z. Jones; NHTSA

TO: Ms. Sadako Vargas

TITLE: FMVSS INTERPRETATION

TEXT:

Ms. Sadako Vargas, MA, OTR Children's Specialized Hospital New Providence Road Mountainside, NJ 07091

Dear Ms. Vargas:

Thank you for your recent letter to Steve Kratzke of my staff, requesting approval to adapt a car seat for use by patients that are Siamese twins. You explained that these patients are connected at the waist, and have two trunks, two sets of arms, and on e pair of legs. You would like to modify an existing car seat by adding another harness and perhaps adding extra foam cushions to support their heads and offer added comfort. hope the following explanation of our statute and regulatory requirements will be helpful to you.

The National Traffic and Motor Vehicle Safety Act (15 U.S.C. 1381 et seq.) authorizes this agency to issue Federal motor vehicle safety standards that establish performance requirements for new motor vehicles and items of motor vehicle equipment. We have used this authority to issue Federal Motor Vehicle Safety Standard No. 213, Child Restraint Systems (49 CFR S571.213. Manufacturers of child restraint systems must certify that each new child restraint they produce conforms to Standard No. 213 before th e child restraint is offered for sale.

However, the Safety Act provide; that child restraint systems are only required to comply with Standard No. 213 until "after the first purchase of it in good faith for purposes other than resale;" 15 U.S.C. 1397(b)(1). When your hospital purchases child restraint systems, that is the first purchase in good faith for purposes other than resale. Once your hospital has made such a purchase, the Safety Act does not require that the child restraint system continue to conform with Standard No. 213.

The only restriction the Safety Act imposes on child restraint systems after the first purchase in good faith for purposes other than resale is that no manufacturer, distributor, dealer, or motor vehicle repair business can "render inoperative" any devic e or element of design installed on or in the child restraint system in compliance with Standard No. 213; 15 U.S.C. 1397(a)(1)(A). Note that there is no statutory prohibition against the owner of the child restraint system rendering inoperative a device or element of design installed on the child restraint in compliance with Standard No. 213. We conclude that a hospital modifying child restraints for use by physically handicapped children is not a manufacturer, distributor, dealer, or motor vehicle repa ir business. This conclusion means there is no statutory restriction on the type or modifications your hospital can make to child restraints it has acquired. Accordingly, the hospital does not need any approval from this agency to modify child restraint systems to accommodate the particular needs of physically handicapped children.

You also asked for our advice as to what kind of car seat your hospital can provide these siamese twins when they outgrow the commercially available car seat you are proposing to modify for them. I doubt that there are commercially available child restra int systems that, without modification, can accommodate the Siamese twins. If you are asking which child restraint you should select for modification or are seeking advice on how to best perform any modifications, I recommend that you contact Ms. Kathlee n Weber, who is associated with the Transportation Research Institute of the University of Michigan. She has experience in testing child restraints designed specifically for use by physically handicapped children and could provide you with information ab out such testing. Her telephone number is (313) 764-4722.

I hope this information is helpful for you. If you have any further questions on this topic, please feel free to contact Mr. Kratzke at this address or by telephone at (202) 366-2992.

Sincerely, Erika Z. Jones Chief Counsel

Mr. Steve Kratzki Advisor to Chief Council National Highway Traffic Safety Administration 400 Seventh Street S.W. - Room 5219 Washington, D. C. 20590 April 6, 1987

Dear Mr. Kratzki:

This is to request approval for the use of an adapted car seat for particular patients, in regard to the phone conversation you had with Dr. Elena Zarafu, Medical Director of Children's Specialized Hospital.

The patients in question are siamese twins, 2, months old at the present time. They are connected from the waist up, have two separate trucks, two sets of arms, and one pair of legs. Their approximate weight is 6.6. lbs. and the height is presently. 45 i nches.

We are considering adapting a Britan care seat. The upper parts of the existing harness passes over the inner shoulders of both twins. The lower part of the existing harness secures the twins' hips. An extra harness will be attached across the chests of both the harness. The harness will be about 2 inches wide, padded with soft foam, and wrapped around the back of the car seat (secured to the back of the car seat with velcro). Extra foam cushions or pillows may be necessary to support their heads and ad d comfort.

The twins, at present, fit in the Britan car seat together. However, there is no other car seat large enough to accommodate them when they grow more. I would appreciate your advice as to what kind of the seat we can provide them when they no longer fit i n the commercially available care seat.

Thank you very much. Sadako Vargas, MA, OTR SV/bp