Out of Control In Texas, the cost of one crash

Out of Control In Texas, the cost of one crash

Last in an occasional series

The thrum of rumble strips jolted David Jacob Anzaldua awake in time to see his truck headed toward a roadside ditch. He jerked the steering wheel, hoping to guide the blue Chevrolet Silverado back onto U.S. 79 in Jewett.

Instead, the Crosby native careened across the rural road about 120 miles north of Houston and hit a metal gate outside Leon High School, sending his pickup rolling side over side into a tree.

"My hands immediately fell off the steering wheel," the curly-haired 19-year-old recalled from a hospital bed in Houston months after the May 6 crash. "And I knew there was something wrong."

The impact fractured the C4 vertebra halfway down his neck. Now paralyzed from the chest down, Alzaldua will pay for those drowsy seconds for the rest of his life.

His medical bills will take longer.

They already have reached above $1 million, and will climb higher still.

David Jacob Anzaldua, or "D.J.," is kissed by his grandmother, Hilda Anzaldua, as he is being released from Memorial Hermann Hospital in July. Anzaldua, 19, fell asleep while driving his blue Chevy Silverado home in Jewett, Texas. The crash caused a C4 spinal cord injury that left him paralyzed from the chest down. less David Jacob Anzaldua, or "D.J.," is kissed by his grandmother, Hilda Anzaldua, as he is being released from Memorial Hermann Hospital in July. Anzaldua, 19, fell asleep while driving his blue Chevy Silverado ... more Photo: Godofredo A. Vasquez/Staff Photographer Photo: Godofredo A. Vasquez/Staff Photographer Image 1 of / 11 Caption Close Out of Control: In Texas, the cost of one car crash 1 / 11 Back to Gallery

Motor vehicle crashes, from the routine fender benders that happen every 80 seconds across the Lone Star State to the serious injury accidents such as Anzaldua's, cost Texans billions in medical bills, roadway repairs and emergency response. Factoring in years of lost wages and other costs brings 2017's tally to $38.4 billion, a Houston Chronicle analysis shows, an 86 percent increase in the cost of crashes since 2007.

OUT OF CONTROL: Read our whole series here

Crashes similar to Anzaldua's take a heavy toll on the Houston region, the most deadly major metro area in the nation for drivers, passengers and people in their path, a Chronicle investigation found earlier this year. All told, the region's 697 roadway deaths and 3,198 serious injuries last year produced a total economic loss of at least $7.19 billion, or roughly 1.5 percent of the metro area's gross domestic product.

When drivers crash, everyone pays, whether in the form of higher insurance premiums, more expensive automobiles with added safety features, higher taxes for emergency response and cleanup, car repairs, and millions in lost wages or productivity due to hours spent in idling traffic.

"There is a huge economic toll," said Kara Macek, with the Governors Highway Safety Association. "Property damage is just the tip of the iceberg."

As Anzaldua's crash shows, the far larger and costlier effects from crashes are medical bills that mount for serious injuries. Nationally, of the $1.14 million direct cost for crashes involving severe injury, $837,182, or more than 73 percent, is from medical bills and lost wages.

Factoring all economic losses — deaths, years of recovery and treatment from serious injuries, insurance, property damage and police time — the National Center for Statistics and Analysis set the annual national cost of roadway crashes at $242 billion, or 1.6 percent of the nation's 2015 GDP.

Put another way, the cumulative toll of the crashes that take place across the nation every year ends up costing every American $784 a year. The only ways to save that money are make medicine cheaper and materials less expensive to replace, or reduce the number of crashes.

"One of those two things have to go down," said Robert Wunderlich, director of Center for Transportation Safety at the Texas A&M Transportation Institute. "There is no magic. There is no other way around it."

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Regionally, transportation officials have called it a public health issue, noting that the nearly $4.9 billion in direct crash costs in Texas is about one ninth of the nation's $44 billion in direct costs from crashes.

"We have people dying and being injured and that very definitely has a cost," said Maggi Gunnels, acting regional administrator for the National Highway Traffic Safety Administration in Texas and surrounding states. "It's the same everywhere, but especially in this region."

A slow, costly recovery

In the eight months since Anzaldua crashed into that tree, his medical and rehabilitation expenses have topped $1.1 million.

After firefighters extricated Anzaldua from his mangled truck, he was flown by helicopter to Baylor Scott and White Medical Center, 70 miles away in Temple. The flight alone cost $55,000.

Five days later, doctors moved him to the Texas Medical Center in Houston, where he could receive more advanced care and be closer to his family.

Another helicopter ride: $80,000.

He spent weeks in Memorial Hermann Hospital's intensive care unit.

For Anzaldua, of course, the costs for his momentary lapse behind the wheel go far beyond the financial. They have cost him a lifetime of dreams.

Before the crash, Anzaldua ranged across the Texas countryside on hunting and fishing trips, and loved playing football and baseball. At Tyler Junior College, the teen known as "D.J." — for David Jacob — was considering a career in athletic training or physical therapy. Now, he was the patient, struggling to regain enough strength and muscle function to be independent.

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The crash injured Anzaldua so badly that he initially could not speak or breathe on his own. The only sound he could make to communicate with his doctors was to click his tongue.

"It's like being a baby again, almost," he said later. "Except you can't move. Everybody has to do everything for you. They got to change you, feed you, help you to try and learn to talk again."

It was weeks before he could swallow on his own. He spent almost two months at TIRR Memorial Hermann, one of the premier rehabilitation facilities in the country.

The day he checked out, July 19, he wheeled into a $41,000 modified Honda Odyssey his caregivers, Lance and Julie Jackson, had purchased — with proceeds from a fundraiser to help pay for Anzaldua's considerable medical bills — to take him to and from therapy appointments.

The Jacksons — Anzaldua calls them "Mr. Lance" and "Ms. Julie" — drove him 30 miles northeast to their home in Crosby. They have known Anzaldua since he was a child, when he and their daughter became best friends, and they agreed to care for him after his crash. It made more sense than living with his father 80 miles from a hospital in Jewett. And his care was too complex for his mother, who was raising his younger brother and had to work so Anzaldua could have health insurance.

As they neared the Jacksons' home, a long line of black, red and blue waist-high letters came into view on the couple's lawn: "Welcome home Anzaldua! #AnzalduaStrong"

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The relief of the moment did not last. Four days later, he was back in the hospital with a urinary tract infection, a common affliction for those with spinal cord injuries. The bill for that was $4,722.

Another infection in October led to a short stint at St. Joseph's Hospital, for which his insurance was billed more than $20,000.

Though he is covered by his mother's insurance, Anzaldua still is liable for nearly $150,000 in medical bills.

That does not count the $450 to $600 a week his caregivers pay in private nursing care — and which already has topped at least $11,000. Nor does it include the money spent on pads and diapers and boxes of sterile gloves needed to maintain his hygiene and daily bowel regimens.

"He needs 24-hour care," Julie Jackson said. "That's a big pill to swallow."

Climbing Costs David Anzaldua was paralyzed from the chest down in a May crash. His hospitalization, recovery and care has cost insurers, family and friends a combined more than $1.1 million, a figure sure to climb by the hundreds of thousands of dollars over the decades he is expected to live. Here’s just some of the expenses, ranging from emergency medical care to everyday living with a spinal injury.

Curbing crashes, reducing costs

Nationally and locally, the focus for curbing crash costs relies on reducing the number of wrecks and minimizing their severity. Much of that starts with public service campaigns to simply get drivers to improve their habits.

"It doesn't have to be complicated and it doesn't have to be technologically advanced," said Deborah Hersman, outgoing president and CEO of the National Safety Council.

In Texas, 43 percent of those killed in crashes in 2017 were not wearing seat belts. Simply increasing seat belt use from the current 91 percent to 96 percent of all vehicle passengers could save lives and millions of dollars.

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Transportation officials also factor safety into road plans. Along Interstate 45 north of Houston, the Texas Department of Transportation installed miles of cable median barrier over the last decade to keep cars and trucks from crossing the grassy divide and hitting oncoming traffic. A 2016 plan called for spending $590 million more to add 1,150 more miles of concrete or cable barriers.

Another $360 million over five years was proposed to install 20,000 miles of rumble strips statewide. Both initiatives are a small share of the $6.4 billion TxDOT spends annually.

"Some of these things are not that complicated," said James Bass, director of TxDOT. "Or that expensive."

Their benefits, however, can be difficult to make into an economic argument.

"When you make some improvement in a highway or cars that reduce the likelihood of an accident, that reduces the cost," said Robert Ohsfeldt, a health policy and management expert at Texas A&M University. "But any intervention that slows people down has a cost to it."

Figuring it out

The morning he crashed, Anzaldua woke up around 5 a.m. and headed for home from a friend's house after a night of dancing in College Station.

He figured he would drive home, grab some coffee and doughnuts, and power through the day. It was no big deal. He did it all the time.

These days, every bit of movement Anzaldua can coax out of his body, every reawakening of weakened muscle, is a milestone.

He had to learn how to swallow again, and to talk — and eventually, to lift his hands and arms.

It took months of painstaking physical and occupational therapy just to be able to sit up without feeling drained.

In truth, the therapy never ends.

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Anzaldua sat at the Jacksons' home on a recent Friday, as Lance fried deer sausage and dropped sliced potatoes into a bubbling pot of soup.

Two of Anzaldua's friends were on their way to visit. They stop by every Friday, sometimes on weekends. They talk about girls, dip tobacco and joke around.

"We hang out here, but it's not the same," Anzaldua said. "We talk, we BS, but it used to be we could do the same thing throwing a baseball or in a deer stand."

On a napkin on the table in front of him sat a small white candle.

As his friends joked and chatted, Anzaldua fumbled with the votive. Nearly two months after the crash, he regained some use of his left arm, and three weeks after that, some function returned to his right. He has yet to regain use of his fingers. He spends countless hours at home working to improve his arm strength and exercising his arms and hands.

He reached for the candle several times, unsuccessfully. He tugged the napkin, bringing the candle slightly closer. Several tries later, he brushed the votive into the open palm of his right hand.

"I might take a minute, but I figured it out," he said, breaking into a satisfied grin.

Through it all, Anzaldua has retained his athlete's focus on the physical demands of his recovery. He tries not to think of the financial costs, or of the statistics that say people with serious spinal cord injuries such as his have significantly shorter life expectancies.

He admits that during some of the worst moments after the crash, hooked to a ventilator and trapped inside his damaged body, he wanted to die. He feels differently now.

"If that was my time to go, I wouldn't be sitting here right now," he said.

He is grateful for friends and the caring they have shown. He is encouraged by the progress he has made, and determined to keep pushing.

Doctors say he may continue to improve, but only to a point. Most patients with spinal cord injuries only see marked improvement in function in the first two years after their injuries. Anzaldua knows that whatever function he regains in that time frame is likely to be all he will get.

"At my two year mark, what I got is what I got, and it's time to move on."

St. John Barned-Smith joined the Houston Chronicle in 2014 and covers public safety and major disasters. He has worked on two teams named Pulitzer finalists in recent years – for covering Hurricane Harvey and for helping show how Texas unlawfully denied education services to children with special needs. He previously reported in Philadelphia and Maryland and spent two years in the Peace Corps in Paraguay. Follow him on Twitter or email tips to st.john.smith@chron.com.

Dug Begley is the transportation writer for the Houston Chronicle. Contact him at dug.begley@chron.com. Follow him on Twitter @DugBegley.

Godofredo A. Vasquez is a staff photographer for the Houston Chronicle, primarily covering breaking news. Godofredo was born in El Salvador but grew up in the Bay Area, where he attended San Francisco State University and graduated with a B.A. in Photojournalism. Before joining the Chronicle in early 2017, Godofredo spent two years working for the Corvallis Gazette-Times and the Albany Democrat-Herald in Oregon. Follow him on Twitter and Instagram at @godovasquez, or reach him by email at godofredo.vasquez@chron.com.

Interactives and design by Jordan Rubio

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