Tag Archives: Hawaii

Hawaii’s New Strick E-Bike Law to Prevent Brain Injury

Dr. Josh Green in white coat with stethoscope in office and Hawaiian flag

Governor Josh Green signed Act 259 (HB 2021) on July 15, 2026, giving Hawaii its first comprehensive statewide e-bike framework. The law requires helmets for all riders under 18, bars anyone under 15 from operating an e-bike, and prohibits riders under 16 from using Class 2 or Class 3 models without adult supervision.

The measure grew out of an alarming rise in head trauma. Hawaii Department of Health data reported that e-bike injuries more than doubled between 2022 and 2025, from 106 to 244. Honolulu EMS also found that 81 percent of the e-bike patients that were treated wore no head protection. Honolulu-based Kapi’olani Medical Center’s trauma team reported that e-bike crashes recently became the leading cause of injury among the children it treated.

Man riding a bicycle on the sandy beach during sunset

Green, previously an emergency physician, has been blunt about the stakes. “If they have a head trauma, they’re probably going to have long-standing disability from the traumatic head injury,” he said in a September 2025 interview.

The law also reclassifies machines exceeding 28 mph as e-motorcycles, subject to licensing, registration, and insurance. California imposes comparable rules, while New Jersey now goes further, requiring helmets for e-bike riders of every age.

See also: E-Bikes and Brain Injury: The Risks, the Recovery, and the Law

NIH Hypoglycemia-Fall Studies Explain “Marvel” Actor’s Trauma

When Marvel actress Evangeline Lilly fainted and fell face-first onto a Hawaiian boulder in May 2025, she sustained a brain injury. During her beach outing, the actress fainted and fell face-first onto a boulder, resulting in brain damage affecting “almost every area” of cognitive function. Last week, as has been widely reported, the actress revealed on Instagram that recent brain scans confirm lasting damage from this fall.

As to her prior medical history, Lilly has revealed that she suffers from hypoglycemia, or low blood sugar. Since she was a child, she has explained that she would have fainting spells due to this condition. Hypoglycemia-induced falls can lead to traumatic brain injury. (While such falls can happen at any age, older adults with diabetes are particularly at risk.) NIH-published studies have documented this dangerous cascade. Research found in the NIH PubMed database confirms that hypoglycemia can trigger loss of consciousness and substantially increase fall risk. A 2025 study examined how hypoglycemia-induced falls cause distinctive brain damage patterns affecting the hippocampus, cerebral cortex, and basal ganglia. Researchers at Washington University School of Medicine, funded by NIH grants, found that hypoglycemic brain injuries differ from other trauma types, causing widespread neuronal death when glucose levels drop critically low.

The “Lost” star now faces what she calls an “uphill battle” for recovery that is an all too familiar journey experienced by many from this medically recognized connection.