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If you live in an urban area, you've probably noticed a rapid rise in electric micromobility devices. I certainly have here in LA. We're talking about things like e-bikes, e-scooters, Onewheels and electric unicycles. Riders zip across parking lots and roll down sidewalks and often end up in emergency rooms. And that is causing debate as to how they should be regulated. NPR's Katia Riddle reports.
KATIA RIDDLE, BYLINE: Electric unicycles are exactly what they sound like, self-balancing devices with a single wheel and a foot platform on either side. Riders can stand or sit as they travel. Mark Bentz is part of a group of e-rider enthusiasts in Portland, Oregon. He rides his, quote, "wheel," as he calls it, on his daily commute to work and just for fun. On this evening, he's standing outside at a restaurant where he plans to eat dinner before going for a ride. He points to his wheel.
MARK BENTZ: I can kind of wedge my foot between the spiked pedal and the pad system to even, like, ride with only one foot.
RIDDLE: Bentz and his friend Jennifer Crusher meet up most weeks with other e-riders to take their wheels out around town. Crusher has been doing this for a number of years.
JENNIFER CRUSHER: When you step into this vehicle, it's like you become Iron Man. You have so much power and so much control. It's like you're flying a dragon, and it's intoxicating.
RIDDLE: Bentz and Crusher are careful about safety. Crusher says she's got a reputation in the community as the safety mom who nags people to wear their helmets. Neither of them have ever had a bad accident, but they say they do happen.
BENTZ: I know of riders that have broken their backs, legs, arms, wrists. It can be a dangerous sport.
RIDDLE: Of course, people can break bones on pedal bicycles, as well, but experts say there's a key difference between these kinds of devices and those that are just human-powered.
JOHN MAA: When you put someone on an e-bike, there's just such a force.
RIDDLE: John Maa is a trauma surgeon in Marin County, California. He's become an outspoken advocate for restrictions and regulations on these micromobility devices. And he says it's basic physics that makes them more dangerous.
MAA: Kinetic energy, one-half mass times velocity squared - these devices are much heavier, and they're going twice as fast. And so the severe injuries, what we witness with e-bikes, are injuries that look like motorcycle crashes, not like bicycle crashes.
RIDDLE: A rider traveling 20 miles per hour, for example, carries nearly three times the kinetic energy of the same rider traveling 12 miles per hour. For an e-bike rider in a crash, that's a lot more potential impact on the brain. Several studies have shown that e-bike riders are significantly more likely than cyclists to incur traumatic brain injuries in a crash.
MAA: My first e-bike crash patient came in 2020 in August. It was an older gentleman who crashed into a guardrail, breaking, as I recall, 23 ribs. There are 24 in the human body.
RIDDLE: Since then, Maa has seen an increasing number of these injuries and even deaths.
MAA: One of the most tragic cases was of a recently retired nurse practitioner from UCSF going too fast downhill, losing control, suffering a lethal, traumatic brain injury and becoming an organ donor.
RIDDLE: There is no complete national count of these kinds of crashes. Federal databases often do not reliably distinguish devices like unicycles, e-bikes, and e-scooters from conventional bicycles and other vehicles. One place it is showing up in the numbers - hospitals. One health data company found a 7.5-fold increase in recent years in the rate of children showing up in emergency rooms with e-bike and e-scooter injuries. Doctors like Maa are speaking up lately about the risks, especially for children.
MAA: If you look at Orange County, San Diego, we are now seeing e-bike crashes as the No. 1 presenting condition for children in the emergency rooms at the pediatric trauma centers. This is astounding.
RIDDLE: At Rady Children's Hospital San Diego in 2023, e-bikes accounted for nearly 40% of pediatric-related incidents that required a trauma team response. At Rady Children's Health Orange County, e-bike injuries surpassed falls and motor vehicle collisions in 2025 to become the leading cause of pediatric emergency trauma visits. Maa helped lead a successful effort in Marin County to prohibit children under 16 from riding certain kinds of e-bikes. He says more laws like this are urgently needed.
MAA: This is a condition which, you know, largely did not exist before the pandemic.
RIDDLE: But some advocates for these devices don't agree that a rise in accidents can be blamed specifically on these electric micromobility devices. Matt Moore is with the nonprofit group PeopleForBikes. They do advocacy for bike-friendly policy. Moore says their group does appreciate the medical community speaking out about these deaths and accidents.
MATT MOORE: So they are rightfully, I think, raising the alarm.
RIDDLE: In many states, the legal limit on micromobility devices is 28 miles per hour. Many doctors argue that even this speed is too fast. But Moore says that many of the vehicles causing concern aren't legal e-bikes at all. It's another kind of device that goes even faster.
MOORE: They are what we're referring to as e-motos (ph). They're faster. They're more powerful. They're heavier, and they're being sold directly to consumers, rather than through a powersports dealer or a local bicycle shop.
RIDDLE: E-motos are a relatively new category. In many states, they have different restrictions than micromobility devices. They can't be ridden in bike lanes, for example. But Moore says it's hard to tell them apart from other kinds of e-bikes. He cites an example of one e-moto that can be purchased online but probably not at a bike shop concerned with following the law.
MOORE: So you can select a mode on the handlebars, and that device will only go a maximum of 20 miles per hour. The manufacturer tells people that that makes it street legal. But you can also use that switch to select unlimited mode and go 80 miles per hour.
RIDDLE: He says these devices should be regulated exactly like motorcycles. Some states and municipalities have taken regulation into their own hands, mostly aimed at slower e-bikes. New Jersey now requires e-bikes to be registered and riders to have a license. New York City has a 15-mile-per-hour speed limit for e-bikes and e-scooters. Advocates may not agree on why injury rates are rising, but many do agree on one thing.
MAA: It's really a failure of federal regulation.
RIDDLE: John Maa, the trauma surgeon, lays blame for this increase in accidents and deaths at the feet of the federal government. There's no consensus around what exactly the most productive federal regulation would look like. It could mean a focus on curbing super-fast e-motos or passing new speed limits for all devices or new laws and stricter enforcement of laws around kids riding them. Maa says the issue has received so little attention from national lawmakers, he's not optimistic.
MAA: I have no hope sitting here right now today that Congress is going to correct this mistake, but that's ultimately what needs to be done.
RIDDLE: If not Congress, it's unclear which federal agency would take responsibility. Critics say high-powered products marketed as e-bikes can fall into a regulatory and enforcement gap between federal agencies. As a national advocate in this space, Maa says he now regularly receives texts and calls about these accidents from all over the country.
MAA: It's that same tragedy - the parents, the siblings, the elected officials, the doctors clutching the photo of the young child who's died, you know, after yet another e-bike crash. It's like, why do we need to repeat this?
RIDDLE: Maa is afraid it's going to take a lot more repeating to get people's attention. Katia Riddle, NPR News.
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