Dr. Larry Foreman treats injured ATV riders at the Arroyo Grande Community Hospital. (Joe Johnston/The Tribune, San Luis Obispo, Calif.)

Larry Foreman is “a libertarian at heart,” but not when it comes to kids. A veteran emergency room physician — he works at the closest ER to the Oceano Dunes State Vehicular Recreation Area in San Luis Obispo County, Calif. — he’s seen an endless queue of injured riders of all-terrain vehicles, including children as young as 4. Eventually, Foreman had enough and began speaking out about kids and ATVs.

More than 10,000 people have been killed in ATV crashes since federal authorities began keeping track in the 1980s. More sobering still is that more than 2,500 deaths and hundreds of thousands of injuries have involved kids under 16. The big numbers belie the disarming appearance of the squat, four-wheelers, which look like overgrown toys. Yet the powerful vehicles, also known as “quads,” can reach highway speeds, and unlike cars and trucks offer no protection in rollovers.

ATV manufacturers profess a strong interest in safety, especially for kids. They’ve developed a model state law with tough safety requirements, including mandatory helmet use, training for young riders, and a ban on use of high-speed, adult-model ATVs by kids under 16. Keeping kids off adult machines “is not a safety issue, it’s the safety issue,” said Tom Yager, vice president of the Specialty Vehicle Institute of America, the Irvine-based trade group of leading ATV producers.

Foreman was thinking along the same lines. After he took his concerns to the California chapter of the American College of Emergency Physicians, the group drafted legislation that borrowed heavily from the industry’s model law. At first glance, it appeared the doctors and manufacturers could be potent allies — but it didn’t turn out that way.

Indeed, the ATV companies appeared indifferent, at best, when the California bill died in 2008. They stood passively the year before when similar legislation failed in Oregon. Critics, citing such episodes, accuse the industry of playing a double game — talking up safety measures to score PR points, then watching while off-roaders and dealers rise up to kill or water them down.

The companies firmly deny it. “Of course, I reject that we just pay lip service” to safety regulation, said Kathy Van Kleeck, senior vice president for government relations at the Specialty Vehicle Institute.

However, the institute did not field a lobbyist to push the California bill. The opponents — a coalition of off-road recreation and business interests — showed no such reluctance and, with help from lobbyists, managed to scuttle the measure.

But ATV makers didn’t just watch from the sidelines, records and interviews show. Several members of the Specialty Vehicle Institute — Yamaha, Kawasaki, Polaris and KTM — were also members of an advocacy group that lobbied against the bill.

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In the far southeast corner of California, the Imperial Sand Dunes stretch more than 40 miles, in some places rising 300 feet above the desert floor. The windblown remains of an ancient lake, the tawny sands draw only the hardiest visitors during long months of insane heat. But from late fall through winter, the dunes resound with the snarl of pulsating engines and unadulterated joy of hordes of off-road enthusiasts.

Long holiday weekends attract what may be the largest crowds of ATV, dirt bike and dune buggy riders anywhere in the world. The 165,000 this past Thanksgiving were far from a record. Old friends and extended families circle trailers and RVs to camp wagon-train style. It’s an off-road version of Burning Man, minus the carbon guilt.

Tom Coulombe, 48, of San Diego County, loves coming for “the dunes, the camaraderie, the people, the scene.” His 5- and 12-year-olds ride their own youth-model ATVs, an activity he describes as “very confidence-building.”

Trips to the dunes do end badly for some. On average, about six off-roaders die each year. Along with maps and guides at a ranger station, a brochure from Pioneers Memorial Hospital in Brawley helpfully announces: “Emergency Care … Closest ER.”

Riders appear to take the risks in stride, even humorously. “What is the craziest injury you have gotten at the dunes?!?” asked a recent post on a Facebook fan page for duners.

Though many accidents involve riders being thrown or crushed beneath ATVs, which typically weigh more than 600 pounds, manufacturers have successfully resisted a stability standard that could reduce the number of rollovers. Even so, riders almost uniformly blame tragedies on reckless conduct or dumb mistakes. Many seem fiercely protective of the manufacturers and contemptuous of liability claims — arguing, as the companies do, that only riders, not vehicles, are unsafe.

Injuries usually involve “idiots … riding over their heads,” said Coulombe, expressing a common view.  “They just bought these big machines. They’re not respecting them. … Common sense has got to kick in.”

Not all tragedies involve inexperience or daredevil stunts, however.

Last May at Oceano Dunes, for example, Christopher Meadows, 24, was crushed to death when his ATV flipped and landed on top of him.

Meadows, an emergency medical technician and volunteer with the search and rescue unit of the San Luis Obispo Sheriff’s Department, was riding to help an injured rider when he tumbled down the steep face of a dune.

“He was well-trained,” said Sgt. Mark Maki, Meadows’ supervisor, “and it still happened to him.”

A month before Meadows’ death, Bill Orton, a former three-term congressman from Utah, was killed in west central Utah when his ATV flipped and landed on him.

While battles between off-roaders and conservation groups draw the headlines, safety debates often turn vitriolic, too, raising the issue of how to regulate a product that is both risky and wildly popular — particularly when many users are below the age of informed consent. Many off-roaders bristle at attempts to restrict young riders, accusing safety advocates of usurping parental rights and their freedom to ride as a family.

“I have a drawer of hate mail over this issue,” says Rachel Weintraub, a senior attorney with the Consumer Federation of America who has campaigned for tougher regulations. “I’ve been accused of destroying the American family, and many other things.”

Robin Ingle, a health statistician with the U.S. Consumer Product Safety Commission from 1998 to 2006, recalled some riders accusing the agency of “being the Taliban for trying to suggest some ways of dealing with the problem. … It’s very eerie to be in the group of people who they view as the enemy.”

In recent months, the safety commission has focused on halting cheap imported ATVs that lack basic safety features, such as front brakes. The commission is also under a congressional directive to study whether youth-model ATVs are too powerful.

Otherwise, for the last 20 years, the commission has done little but count casualties.

The agency took its boldest stand in 1987, when it filed a lawsuit against top distributors, declaring ATVs to be an “imminently hazardous consumer product.” In settling the case, the companies agreed to stop marketing three-wheel ATVs — considered more unstable than four-wheelers — but were spared the expense of recalling existing three-wheelers. The companies also agreed to expand consumer education, through prominent warning labels and free training with the purchase of a new ATV. However, the industry persuaded the commission not to require certain design changes, such as widening the stance of ATVs to reduce rollovers.

Casualty figures dropped or held steady for several years — but then rose sharply as ATVs grew in power and popularity. Injuries requiring emergency room treatment nearly tripled from 52,800 in 1997 to 150,900 in 2007, according to commission estimates.

Ingle left the agency in 2006 deeply frustrated by its failure to stem the rising arc of injuries and deaths. As the statistician in charge of tracking ATV deaths, Ingle posted a map in her office and taped dots at the sites of fatal crashes. “West Virginia was obliterated,” she recalled. “It was covered by dots.”

The blizzard of warnings, which put the onus on riders to avoid mistakes and reckless conduct, became an important defense in lawsuits. Since most crashes could be blamed on one or more warned-against behaviors, the companies had a “buffet of defenses” against almost any claim, said Ralph E. Chapman, a Mississippi plaintiffs’ lawyer.

“Never operate at speeds too fast for your skills or conditions,” one warning message states. Such advice is too vague to be useful, some critics contend, and is undermined by macho advertising claims, such as “Xtreme performance,” and “Now even more aggressive.”

Given the risk of rollover on steep or rocky ground, Ingle said the name itself, “all-terrain vehicle,” is misleading. It should be called a “most terrain vehicle” or “some terrain vehicle,” she said.

Carol Pollack-Nelson, a psychologist formerly with the CPSC, said the situation illustrates the need to improve design of risky products, rather than rely mainly on warnings. “You have a product that’s inherently got some pretty serious dangers,” she said, but no one gets one “to drive their granny to the store. … It goes fast, it goes over bumps, it goes over open terrain. Why else would they have bought the thing?”

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The industry has opposed expanding federal regulations, arguing that the states are best able to police rider safety.

State regulations vary widely. For example, 21 states have no helmet regulations while some others, including California, require helmets on public land only. Only four states bar use of adult models by kids under 16. Several have no safety regulations at all.

California is somewhere in the middle. It lacks a minimum age rule, so kids of any age may ride ATVs. It does require that riders under 14 have adult supervision and that the adult or child have safety training.

That wasn’t enough for Larry Foreman.

At the Arroyo Grande Community Hospital, he tired of seeing kids come in with cuts, fractures and worse. After a busy Sunday in 2004, he decided to do some research. He was stunned to find that in a recent 22-month period, the small rural hospital had treated 210 children with ATV-related injuries.

Foreman began meeting with officials and went on radio to talk up tougher regulations — quickly drawing fire from some off-roaders, including at least two who appealed to hospital officials to fire him. “I was just kind of on this Don Quixote quest, and the windmills were beating the heck out of me,” Foreman recalled.

Through his efforts, however, the American College of Emergency Physicians decided to make the issue a legislative priority. Its bill incorporated key elements of the industry’s model law — including expanded training and the ban on kids riding adult machines. State Sen. Abel Maldonado, Foreman’s representative and current nominee for lieutenant governor, agreed to carry the bill.

A coalition of off-road groups quickly mustered to fight it. In April 2008, on its annual “Lobby Day” in Sacramento, the California League of Off-Road Voters turned its members loose to visit legislators and talk against the bill.

Jim Suty, president of Friends of Oceano Dunes, an opposition group, said youngsters’ skills are best known to their parents, “so to put an arbitrary limit on age is ludicrous.” Suty, 42, said he began off-roading at a tender age, introduced his own young children to the sport, and saw no reason to single out ATVs from other risky pastimes — from soccer and football, to bike riding and climbing trees. Yet when it comes to ATVs, “the government is trying to parent my children and other children,” he complained.

“The sentiment among the ATV riders is that they ought to be able to determine independently what is safe for them and what is safe for their children,” said Elena Lopez-Gusman, executive director of the state chapter of the emergency physicians. “Our organization believes that there are some health and safety guidelines to prevent injuries, and it is the role of government to set some criteria for those, particularly when we’re talking about children — because our folks are the ones that see the direct consequences to peoples’ health and life and limb.”

The Specialty Vehicle Institute was a non-factor.

Saying it had been supportive, an institute official provided a copy of a letter from the group to Maldonado. “We commend you in introducing the legislation,” said the Feb. 27, 2008, letter. Keeping kids off adult machines is something “we … adamantly support.”

However, when FairWarning showed the letter to Dinora Ramirez, the Maldonado aide who managed the bill, she said she’d never seen it and couldn’t find it in her files. Ramirez said she didn’t know if it was lost in the mail or otherwise misplaced. Van Kleeck of the Specialty Vehicle Institute said she didn’t know, either, but was certain the letter was sent.

In any case, while opposition lobbyists were frequently in touch with Maldonado’s office, Ramirez said representatives of the Specialty Vehicle Institute never visited or called.

Van Kleeck said the institute does not always field lobbyists to push safety bills and tends to focus “on states that have no ATV safety legislation whatsoever.” Compared to many states, she said, “California does have a good safety law.”

Ultimately, opposition from the off-road coalition wasn’t the only roadblock. The state Off-Highway Motor Vehicle Recreation Division, a state parks branch closely aligned with rider groups, put a price tag of $375,000 a year on extra rider training. Because of the state’s budget crisis, that alone could have been enough to kill it.

It turned out that several top ATV manufacturers — all members of the Specialty Vehicle Institute — were on the opposing side as well, as members of the Off-Road Business Assn.

A national trade group based in Bakersfield, the association includes ATV dealers and four leading manufacturers: Yamaha Motor Corp. USA; Polaris Industries, Inc.; Kawasaki Motors Corp., USA; and KTM North America, Inc.

“It makes me wonder how committed those companies are that they allowed their name to be on both sides of the issue,” said Lopez-Gusman of the emergency physicians.

Van Kleeck said the manufacturers supported the off-road association for defending access to off-road areas — not for “opposing safety legislation, because they unequivocally support that.”

“I guess you have to ask yourself, do they really believe in safety, especially children’s safety?” Foreman mused. “They could have helped … out a lot more.”

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