Oregon investigators have reopened a case looking into the death of an 11-year-old girl who was killed by a diabetic driver with a previous history of losing consciousness at the wheel, police said.
"We reopened the case last week when it came to our attention that this was not the first time the driver got into a car crash because of a diabetic episode," Sgt. Bob Ray of the Washington County Sheriff's Department told ABC News. "We also learned the driver had run out of his diabetes supplies some time before the accident."
Kylie Hornych was killed in April when David Herman, a school teacher in Washington County, Ore., had a diabetic episode while driving, lost consciousness, and drove his car into the front of Hornych's home, where she was standing, authorities said.
"Kylie was just coming back from her neighbor's house when this driver in a Prius came down the wrong side of the road, hit a Jeep, and then crashed into the house," Hornych's grandmother, Carolyn Duffy, 64, of Portland, Ore., told ABC News.
"She was taken to the hospital, but by the time I got there she had died of a neck injury," Duffy said.
"Our family is having a really hard time, especially Kylie's mom and younger sister," Duffy added. "They were all so close. We just tell each other we love each other every day."
Police questioned Herman and decided not to press charges because there was no evidence of criminal activity.
"Officers asked Mr. Herman if he was ever in a car accident involving his diabetes, and Mr. Herman said this had been the first time," Ray said.
But an investigation conducted by ABC affiliate KATU on July 12 discovered that Herman had been involved in an accident in 2007 in which he crashed into a tree after having a diabetic episode while driving.
"We are very thankful to KATU for discovering that incident. Because of Mr. Herman's inconsistent statements, we are questioning his credibility and truthfulness," Ray said.
Herman did not return repeated requests for comment. ABC News could not reach his lawyer.
Hornych's family is relieved that the police have reopened the case.
"At first, we were very upset when we found out they were not pressing charges, but we dealt with it. We are elated that the police are giving this another look," Duffy said.
The Washington County Sheriff's Department is now investigating if Herman was reckless in managing his diabetes and could press charges at the end of the investigation.
"Four detectives have been assigned specifically to this case," Ray said. "We are interviewing people at the school where Mr. Herman works and other people who can help us determine if Mr. Herman has had a pattern of not taking care of his diabetes.
"In order to prosecute, it needs to be shown that Mr. Herman did not take reasonable steps to take care of himself medically," Ray added.
People who take insulin or other medication to treat their diabetes can lose consciousness when their blood glucose levels drop too low, triggering a condition called hypoglycemia.
"Lab tests have shown that hypoglycemia impairs proper brain function," Dr. Alexander Stork, a scientist at the Netherlands-based Academic Medical Center, who studies diabetes and driving in North America and Europe, told ABC News.
"As the individual's blood pressure gets lower, it becomes increasingly difficult to think and speak properly," Stork said. "The individual then reaches a point where he can no longer drive."
It can be difficult to establish whether a car accident resulted from diabetes, according to Stork.
"You would have to measure the driver's blood glucose level at the time of the accident," he said. "If you wait until after the accident, when the driver regains consciousness, their blood glucose level would have already returned to normal."
But Stork still insisted that diabetics take proper precautions.
"People with diabetes should always check their blood glucose levels before driving," Stork said. "And they should continue to check their levels every four hours while driving.
"And they should never drive in between taking their insulin injections and meals," Stork added.
"It is so important to be responsible if you are living with diabetes," said Duffy, who has a daughter with diabetes. "What makes Kylie's death so tragic is that it could have been avoided. It was senseless. My daughter always checks her blood sugar and carries glucose tablets with her."
According to Stork, while diabetics are at a higher risk than non-diabetics of getting into a car accident, the risk is still limited.
"The research is inconclusive, but we do know that there is a slightly higher risk with diabetics than non-diabetics," Stork said. "But to put this in context, the risks of new drivers or elderly drivers getting into a car accident is much, much higher."
Nevertheless, states do have laws regulating diabetic drivers who have had episodes of losing consciousness while driving.
Oregon requires people with diabetes to disclose "whether he or she has had a loss of consciousness or physical control, or had his or her ability to drive impaired, within the last two years," on their driver's license application, according to the American Diabetes Association.
Oregon also requires health care providers to "report individuals with functional or cognitive impairments that are so severe and uncontrollable that they are unable to safely operate a motor vehicle."
Duffy believes drivers with diabetes should be subject to the same rules as drivers with impaired vision.
"My driver's license says that I have to wear corrective lenses, so I always wear my glasses. In terms of responsibility, I do not see a difference between that and diabetes," she said.
"It's about spreading awareness," Duffy added. "Diabetics need to know they are responsible for checking their blood sugar before they get into a car."