Doctor: Do something about the dangers of e-scooters

People ride Lime scooters along Venice Beach on August 13 in Los Angeles, California.

Ford Vox is a physician specializing in rehabilitation medicine. He is also a journalist and medical analyst for National Public Radio affiliate WABE-FM 90.1 in Atlanta. He writes frequently for CNN Opinion. Follow him on Twitter @FordVox. The opinions expressed in this commentary are his. View more opinion articles on CNN.

(CNN)Electric scooter boards, zipping past with their often helmet-free riders balanced atop, are rolling into American cities -- like my hometown of Atlanta -- at breakneck speed. Really. You could break your neck on one.

The venture-funded companies behind this new business model are pushing out their web-based scooter rental networks in dozens of cities and college campuses -- in the same guerrilla fashion as Uber delivered its newfangled taxis years ago, miraculously drawing money forth from the regulatory void. And largely getting away with it.
Meanwhile, the accidents are piling up. I'm a doctor and this is a problem.
    It's a pattern regularly repeated with new consumer technology: sell it first, ask questions later. This is, of course, backwards. When health and safety is on the line, it is crucial that one company's legitimate right to come up with a handy new product (and money-making scheme) doesn't infringe on your right to move freely in public spaces without fear of serious injury.
    To wit: Consumer drones delivered similar problems. These remote-controlled flying blades will slice open human tissues on contact, yet despite that core safety failing, they exploded onto the marketplace without any rules. Accidents have abounded. An Iowa man recently incurred a paltry $160 fine after losing control of his drone, which proceeded to cut up a baby's face.
    And while the FAA now requires consumer drone registration, only commercial pilots are required to get licensed. Most importantly to people injured by drones, you don't have to get insurance if you want to fly one.
    Which brings us back to the electric scooters.
    Bird, the Los Angeles-based company that leads the market on e-scooters (its biggest competitors include Spin and Lime, both San-Francisco based), makes it clear you're on your own if you kiss the pavement (or an oncoming SUV) while riding Bird's tiny, flat black strip of metal suspended between two rubber tires. By renting a Bird, you're agreeing to "fully release, indemnify, and hold harmless" the company for injury, death, property damage and other losses.
    And as a Los Angeles woman who fractured her arm in two places recently learned after a Bird accident, neither your medical insurance nor car insurance may cover your medical bills; in her case, she told LA Times columnist Robin Abcarian, each insurer said the other should pay. Bird's rental agreement explicitly warns riders your automotive insurance may not cover your Bird accident.
    Doctors report seeing more people with injuries from electric scooters showing up in their ERs. While most come in with broken bones and road rash, some are deadly serious. Bird requires riders to be 18 or older, to wear a helmet, have a driver's license, stay off the sidewalk, and refrain from double riding. Many ignore this, with predictable outcomes.
    I recently treated such a rider at the Shepherd Center in Atlanta, where we focus on neurotraumas, like spinal cord injuries and traumatic brain injuries (TBI). My patient, who wasn't wearing a helmet, suffered a severe TBI in a collision with a car. While the driver of the car may well be to blame too, drivers are at a disadvantage when such devices take to city streets without any preparation: no effort to educate car owners that there is a new motorized vehicle to watch out for, no signage, no special street markings, and no coordination with the city.
    A human figure standing up on an e-scooter represents a smaller visual profile than a bicyclist, and -- out of the driver's peripheral vision -- may "read" as an upright individual walking or running, as in "I've got time to make this turn." It's easy to see how visual perceptual problems, key to traffic safety, can contribute to these accidents.
    I think my patient will ultimately be OK, but the injury will interrupt this patient's life for months, along with that of their entire family. It'll be a tough process getting back to independent living and work.
    Electric scooter companies aren't just allowing their renters to take their own lives into their hands; by introducing the gadgets to unprepared cities (other places you can find them include Memphis, San Francisco, Denver and Austin, among others) they're putting nonriders at risk, too.
    Likely sensing their vulnerability on the roadways, some scooter riders are zipping along the sidewalks at 15 mph, where they risk knocking down pedestrians and baby carriages. Bird tells its riders to follow the law in whatever town they're in. The problem is, riders don't always follow the traffic laws, and Bird knows that; all of us know that.
    What's more, company business models actually expect users to discard their spent scooters along sidewalks and roadsides, where gig economy workers collect them overnight for recharging. In the meantime, their mere presence in public rights of way is already affecting some citizens like James Curtis, a longtime volunteer at my hospital who says the scooters block the sidewalk for his wheelchair, making him "feel like a second-class citizen."
    Should cities ban them? Miami did, after, as the Washington Post reported, "their companies (were) sent packing by city attorneys with cease-and-desist letters in hand." Nashville seized the scooters once they blocked public rights of way and caused accidents soon after the uninvited rollout. How and whether to issue an ordinance regulating the scooters remains a matter of hot debate.
    San Diego started giving out tickets to riders not wearing a helmet, and San Francisco also put on the brakes, impounding the scooters and issuing a cease-and-desist order after Bird, Lime and Spin launched their services in the city without asking. Now transportation officials there are weighing permit applications from a dozen additional scooter services.
    There are alternatives here to the chaotic rollout of the scooter business -- although they may upend the companies' "disruptive" business models.
    Deep-pocketed e-scooter ventures should partner with cities to create scooter-enabled zones, with properly marked roadways and warning signage. They should learn their lessons there, and expand these zones as the safety track record warrants.
    The fact is, this technology absolutely could bring potential benefits to gridlocked cities like Atlanta, with the scooters' environmentally-friendly energy consumption, tiny physical footprint, and convenience.
    But these benefits have to be weighed alongside the interests of other citizens using the public byways. Instead, early this year Bird supported a bill in California aimed at ditching helmet laws, upping speeds to 20 mph and legally permitting scooters on sidewalks (something users are doing anyway, without the law on their side). A significantly revised version of the bill dumped most of the company's requests but still makes it legal to ride scooters without a helmet. The bill got through the state assembly and is up for a vote in the Senate.
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    I'm not holding my breath that e-scooter companies will step up to their responsibility: it's America and there's too much money to be made. What will control this e-scooter proliferation is waves of personal injury lawsuits (firms are already gearing up) that will regulate to some extent where dysfunctional city and state government have failed to do so.
      Meanwhile, I have a premonition I'll be writing something similar to this piece in 10 to 15 years, when rental jetpacks dumped on park benches start careening their customers into power lines and office towers. Could we try to get it right first, before that happens?
      Correction: An earlier version of this article incorrectly stated that the Iowa man who lost control of his drone and injured a baby was fined $190. He was fined $160.