Paul Grasso decided to rent a shared electric scooter through a startup called Lime, as he had many times before, and he expected it to be a routine trip.

It was mid-December, and the San Diego resident, near a park called Vacation Isle, wanted to pick up a few things from a store down the road. He saw a parked scooter—like so many around the city—and thought he’d have some fun and also speed up his errand.

Grasso launched the Lime app on his smartphone and scanned a code on the handlebars. The battery-powered scooter, which can travel up to 15 mph, was now his to use for a small fee. He didn’t have a helmet with him, and the scooters don’t come with one provided.

As he set out, Grasso noticed construction ahead and steered from the side of the street up onto the sidewalk. As he maneuvered, the scooter hit a bump, and he crashed head-first into the ground. “The whole unit just flipped forward and smashed my face into the cement walkway,” he said. 

More on Electric Scooters and Helmets

The 50-year-old spent the next four days in a hospital as he recovered from head injuries.

Grasso’s story is far from isolated. He’s one of an estimated 1,500 people across the country injured in an e-scooter-related crash since late 2017, according to a Consumer Reports spot tally from major hospitals and other public agencies, such as police departments, we contacted in recent weeks.

To better clarify how many scooter riders have been injured, CR contacted 110 hospitals and five agencies in 47 cities where at least one of the two biggest scooter companies, Bird or Lime, operates. CR asked how many patients they’ve treated for scooter-related injuries, and if they have the capability to track the injuries.

Several doctors at trauma centers told CR they’ve been treating serious injuries related to e-scooters since the ride-share fleets started showing up on some city streets about a year and a half ago. For example, the emergency chief at Grady Memorial Hospital in Atlanta estimated the emergency department has treated 360 people with injuries. Vanderbilt Hospital in Nashville has seen 250 people with injuries, according to the Medical Director of the Trauma ICU.

“We’ve had multiple concussions, nasal fractures, bilateral forearm fractures, and some people have required surgery,” says Beth Rupp, medical director at the Indiana University Health Center, in Bloomington, Ind., where ride-share e-scooters were introduced in September.

Experts told CR they’re concerned about the availability of helmets, especially when considering the nature of the ride-share business model, which allows anyone with a smartphone to rent a scooter from wherever the last rider leaves it, often from the side of the road.

“Who’s carrying a helmet with them?” says Oscar Guillamondegui, M.D., medical director of Vanderbilt University Medical Center’s trauma ICU. Guillamondegui estimates treating about 20 patients for scooter injuries. “I have only seen one person wearing a helmet. And that was my son, because I demanded it.”

California resident William Kairala, who was injured in a serious scooter crash last year, says that in his experience the ride-share business model promotes what he described as a split-second decision for riders.

“You can find the scooters, and you can just grab it and go,” he says. “In the spur of the moment.”

Cities Are Surprised

In some instances, companies have set up shop in cities without sufficiently meeting local requirements. And with few or no existing regulations in place for the battery-powered vehicles, communities have been left to figure out how to safely regulate them. Traditional transportation-for-hire-services, such as taxis or limousines, typically are regulated by state and local governments. But the advent of app-based ride-share services (Uber and Lyft paved the way) has challenged that traditional regulatory structure.

Lime and Bird started deploying their fleets in various cities in late 2017. Some cities welcomed them as sorely needed transportation options, and the companies have found a receptive audience in pitching their business as a way to combat climate change by reducing society’s reliance on gas-powered cars. In some cases, cities like Portland, Ore., and Baltimore launched e-scooter pilot programs to encourage their use.

But in other cities, the ride-share fleets arrived abruptly, and the rollout of the services was fraught with challenges. In some cases, basic questions were left unanswered, such as where scooters should be allowed to operate, and whether users should be required to wear helmets. Residents and officials in some cities also complained about scooters left on sidewalks, or anywhere out in public, for the next rider to rent.

Soon after the vehicles appeared, so did injuries linked to them: broken bones, fractures, blunt head trauma, even brain injuries.

"I don't think anybody in their wildest dreams just expected we were going to have hundreds of these devices deployed, essentially overnight and all over the place," said Julian Gold, mayor of Beverly Hills, Calif., who is also a medical doctor.

In July, the Beverly Hills City Council approved a temporary e-scooter ban. Bird later sued the city to overturn it, and the case remains pending.

A new California law that went into effect last month eliminated the state’s helmet requirement for e-scooter riders older than 18. The law was supported by Bird, and signed by then-Gov. Jerry Brown, a Democrat. Bird did not respond to CR’s question about why the company supported the law.

Whatever the benefits of e-scooters, Gold says, “they are currently outweighed by the risks. . . . And the risks are both in terms of public safety and in terms of public clutter.”

Rider Safety

Lime and Bird, plus a handful of other smaller players, portray scooters as a “last-mile” solution that helps ease congestion on already-packed roads. They’re affordable, too. Bird, for example, usually charges $1 per use, plus 15 cents per minute the ride lasts—and they’re aimed at being accessible.

The terms of service contract and payment operate through an app on your smartphone. And because the vehicles are dockless, users can leave them anywhere they please for the next rider to use. At night, the companies deploy a fleet of workers to pick up the vehicles—which they track using GPS technology—and recharge them for the next day.

We contacted Lime and Bird for this article and asked them a series of questions, including the number of injuries and crashes associated with their e-scooters, how they promote helmet use, and details about their public education and deployment strategies. Both Bird and Lime say safety is paramount and that they’re eager to work with cities to safely deploy scooters.

Neither company provided injury or crash figures. But CR did obtain records from the city of Portland, Ore., showing that by July 2018, Bird and Lime had tallied 470 injuries combined across the U.S., before each had expanded into dozens of additional markets across the U.S. and beyond.

In a statement, Lime tells CR the company’s deployment strategy is driven in part by a desire to address climate change, which it called “the issue of our time.” 

“Moving rapidly to reduce carbon emissions in transportation is one of the reasons we feel the need to move so fast,” the company says. The majority of Lime’s 26 million rides have happened safely, the statement adds, and the company uses numerous tools to educate riders about safety. To date, the company says it has distributed 75,000 free helmets to riders around the world.

“Rider safety remains Lime's top priority, which is why we provide riders with free helmets and recommend the use of helmets in our app and on pictures on our actual scooters,” the statement says. “In order to unlock a Lime scooter for the first time, all riders must first complete in-app tutorials that provide guidelines on helmet safety.”

The company also says it researches local regulations in every city before it launches its services to ensure that vehicles are compliant and that city officials are notified ahead of time. But it, like Bird, has faced regulatory challenges from cities, such as Indianapolis, for operating without needed permits.

“As this is an emerging and evolving industry, there have been occasional differences in regulatory interpretation, which have been eventually resolved,” Lime says in its written statement. “We are committed to working with cities to ensure that our operations follow the rules, and are in compliance in every jurisdiction where we operate.”

A Bird spokesperson told CR in an email that it’s “committed to partnering with cities to ensure that the community, and its visitors, safely embrace our affordable, environmentally friendly transportation option. We strive to improve and enhance the well-being of our riders and communities through concrete action, including: requiring riders to upload a driver’s license and confirm they are 18 or older, providing an in-app tutorial on how to ride a Bird and how to park it, and posting clear safety instructions on each Bird.”

The spokesperson says that Bird recommends that users report any damaged scooters or incidents involving its scooters and “strongly encourage[s] all riders to wear helmets.” The email notes Bird has given away more than 65,000 free helmets.

An Urban Transportation Solution?

The market for scooters grew rapidly in 2018, and today, they’re available in dozens of cities across the U.S. Spurred by Bird and Lime, other startups such as Spin, Skip, Lyft (which also owns scooters), and Uber-owned Jump, are angling for a piece of the market.

Medical professionals and researchers are scrambling to make sense of the transportation trend’s public health impact, but they’re having to do so on the fly: A study published in late January by researchers at the University of California, Los Angeles, found that 249 people were injured in e-scooter-related crashes, but the findings were limited to two hospitals in Southern California. No national data on e-scooter crashes currently exist.

“Electric scooters are a promising new transportation option, but safety always must come first,” says William Wallace, a senior policy analyst for Consumer Reports.

A total of 60 medical facilities and other entities responded to our inquiries as of Jan. 31. Of those, 23—which include one police department, a city transportation department, a city emergency medical services provider, and a smaller medical clinic—reported treating 1,545 patients for scooter-involved injuries over the past year. The other 37, or about 62 percent, say they either don’t track scooter injuries, lack the capability entirely, or had no reports of injuries on file.

Outside of our tally, at least four fatalities have been confirmed to date, after Austin, Texas, police reported a 21-year-old male riding a Lime scooter died in a collision this past weekend.

For this report, CR also reviewed court records, and spoke with a dozen medical professionals, safety experts, and crash victims, to capture what appears to be the most comprehensive look at e-scooters and safety to date.

CR’s analysis is limited, to be sure. Without average trip lengths in each city, for example, it’s impossible to calculate the rate of incidents. A recent study from Portland’s Bureau of Transportation found the city’s injury rate to be 2.2 per 10,000 miles traveled and 2.5 per 10,000 e-scooter trips taken. The study noted that figure “may not be related to rental e-­scooters, so the actual rate is likely lower.”

Nationally, recent data from the National Highway Traffic Safety Administration found the injury rate to be .05 per 10,000 vehicle miles traveled for motorcycles and 0.1 per 10,000 miles travelled for cars. And a previous study by the Mineta Transportation Institute at San Jose University found the average rate of the Washington, D.C., bikeshare program to be .04 per 10,000 trips taken. However, there’s still no established way to calculate injury rates for e-scooters, making comparisons with other modes of transportation difficult.

Some hospitals were only able to provide CR a count of how many emergency department medical record entries contained the word “scooter,” meaning a few incidents involving personally owned seated-scooters or Vespas could be roped in. Several doctors and spokespeople, however, said most of their incidents are attributed to the newer battery-powered e-scooters. Other counts from our tally were simply educated estimates from hospital medical directors of patients treated at their facilities. Several, though, have kept detailed records of e-scooter accidents to better understand the trend.

Many of the medical professionals and officials who spoke to CR for this story say the total number of injuries is unquestionably higher because so many hospitals don’t have the medical record capability yet to accurately track specific scooter-related injuries.

“That’s the one thing we’ve been able to show over and over again is that all of our datasets are incomplete,” says Christopher Ziebell, M.D., emergency department medical director for the Dell Seton Medical Center at the University of Texas in Austin. Ziebell’s staff has counted 53 injuries  stemming from e-scooter accidents since the rental fleets arrived in Austin last May, including 16 head injuries, or about 30 percent of the total.

The Centers for Disease Control and Prevention is working on a study about the health risks associated with e-scooters by examining injuries to riders in Austin. A spokesperson for the CDC tells CR that the analysis is ongoing and a report should be finalized in the spring.

Helmets Rarely Seen

The lack of helmets among riders in the incidents he observed stands out to Austin Badeau, M.D., a doctor at the University of Utah Health, who recently analyzed 50 emergency room visits over a five-month period in 2018 from scooter-related injuries.

Badeau, 32, says he traveled to California shortly after e-scooters launched in cities across the state, and realized quickly they were likely to proliferate. They arrived in Salt Lake City last summer.

“I just started noticing a few of these injuries coming in,” Badeau says, “and it certainly seemed like it would be something timely to study.”

The injuries he observed in the 50 patients ran the gamut: cuts and bruises, musculoskeletal injuries, major head injuries. None of the patients reported wearing a helmet at the time of their injury, he says. (The count may have included incidents involving personally owned scooters, but Badeau says the accidents coincided with the arrival of rental e-scooters in town.)

Part of the reason for the low helmet use, some medical experts suggest, is that riding a scooter is a decision made in a flash, whereas riding a bike is more deliberative. A study published last December on Seattle’s bikeshare program found 90 percent of cyclists wore helmets when riding their personal bikes; only 20 percent of bike share riders did the same.

The American Medical Association recommends that scooter riders wear helmets. “The AMA encourages all Americans to adopt preventive measures to stay safe and healthy,” the medical organization told CR. “For riders of scooters, the AMA recommends the use of full protective gear, including certified helmets, elbow and knee pads and closed-toe shoes. Rider[s] should take appropriate safety measures to prevent scooter injuries.”

Kairala, the California resident who was injured, doesn’t believe that scooter companies are doing enough to promote helmet use. Last June, the 63-year-old dropped his bicycle off at a shop in Santa Monica, Calif., for repair, and decided to head home on a Bird scooter parked out front. He had no helmet at the time.

He rode a few blocks, and then arrived at an intersection with a number of bicyclists idling, waiting for the red light to change. When it turned green, Kairala says, “We all took off, and that’s all I remember.”

A police officer who responded to the scene reported that he discovered Kairala “bleeding from the right side of his head,” according to an incident report. He woke up in the emergency room at Ronald Reagan UCLA Medical Center, having suffered a skull fracture.

Kairala told police he doesn’t know how he wound up injured. But the effects of the crash continue to linger. “I have to stop watching TV because the image will start crossing,” he says.

Kairala says he regrets not wearing a helmet, but he says the ubiquity of scooters in some cities leaves them in arm’s reach of helmet-free consumers to rent on a moment’s notice.

Other riders have alleged defects in the scooters themselves. Lime previously recognized safety concerns in 2018 related to some of its scooters, but Bird hasn’t been without complaints either. A potential class-action lawsuit filed Jan. 8 in Los Angeles County Superior Court by rider Emily Duker alleges that Bird scooters "contain defective electronics, brakes, battery charge indicators, wheels and tires, internal power tubes and accelerators, and do not contain adequate instructions and/or warnings regarding these hazards and dangers."

Duker was injured last July, the suit claims, after the throttle of a Bird scooter she was riding "stuck," before the "brakes failed, and the wheels of the scooter gave way," causing Duker's head and body to "violently crash into the scooter and asphalt." (Reached by phone, Duker deferred to her attorney, who declined to comment.)

Duker, the lawsuit says, "sustained serious injuries to her head and body and was taken to a hospital and thereafter her teeth were wired and bonded shut forcing her to eat and drink through a straw."

Bird did not respond specifically to a written question from CR asking for comment about the lawsuit.

Lessons Learned

Scooter companies and cities could take cues from bike-share programs for ways to potentially increase helmet use. Seattle, for example, tried out helmet kiosks, says Elliot Martin, Ph.D., a research and development engineer at the University of California, Berkeley’s Transportation Sustainability Research Center.

“Maybe it’s a heavy cost, maybe it’s not as effective as we’d like,” he says, “but the system is at least trying to provide access to helmets.”

Experts also suggested that companies could connect with hotels and cities to voluntarily provide helmets for scooter use.

But, for now, the best advice that experts, including CR, had for riders was to wear a helmet.

“Right now, a stunning number of e-scooter users are getting seriously hurt, including with head injuries,” Wallace, the CR analyst, says. “Consumers, scooter companies, cities, helmet makers, and safety regulators must work together now to improve the safety of these products.”

Scooter Safety 101

Scooters are an affordable—and fun—means of transportation, but there are some important things you need to know. On the "Consumer 101" TV show, Consumer Reports expert Ryan Felton offers tips for keeping safe while using a scooter.