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September 26, 2026
Picture a twelve-year-old on a Saturday morning, borrowing an electric bicycle that belongs to an older sibling. Within minutes, he is traveling at speeds no child on a conventional bike could match — and within an hour, he is in an emergency room with a brain injury. Multiply that scene across six major children’s hospitals, across thirteen thousand encounters, across three years — and you begin to understand what a landmark new study published in JAMA is trying to tell us.
The findings are not a prediction. They are a reckoning — and they demand our attention right now.
The research letter, led by Dr. Alan Schroeder of Stanford University School of Medicine, draws on a dataset of 13,307 injury encounters across six leading U.S. pediatric hospitals, covering the period from January 1, 2023, through March 31, 2026. The study is powered by PEDSnet, a national pediatric learning health system that aggregates comprehensive electronic health record data from major children’s health systems across the country.
The headline finding is stark: e-bicycle injuries are growing at 33% per quarter — and e-scooter injuries at 15% per quarter. By comparison, injuries from conventional, nonmotorized bicycles grew at just 2% per quarter over the same period. These are not gradual drifts. They are exponential curves.
Raw frequency only tells half the story. What makes this data truly alarming is what happens to children once they crash. E-bicycle injuries were not merely more common — they were more devastating.
Among all devices studied, e-bicycles recorded the highest hospitalization rate at 17% of all injury encounters, and the highest brain injury rate at 10% — a figure that is twice the rate seen with conventional bicycles. High-severity injuries (those requiring ICU-level care or major operative intervention) occurred in 8% of e-bike cases, compared to just 4% for nonmotorized bicycles.
Perhaps the most quietly shocking revelation in the data concerns age. Despite being legally associated with adult or near-adult use, a remarkable 24% of e-bicycle injuries occurred in children under 12. For e-scooters, the figure is even more striking: 44% of all e-scooter injuries treated across these six hospitals involved children younger than twelve years old.
“A substantial proportion of e-bicycle injuries and e-scooter injuries occurred in children younger than 12 years — well below the legal driving age.”
— Schroeder et al., JAMA, November 2, 2026
These are not teenagers pushing limits at the edge of adolescence. These are elementary-school-aged children — many of them riding devices designed to reach speeds far beyond what their developing bodies and reflexes can manage.
The study’s architecture is worth understanding, because it is precisely what gives these findings their weight. Schroeder and his colleagues used PEDSnet — a research infrastructure funded by the Patient-Centered Outcomes Research Institute through award RI-CHOP-01-PS10 — to access electronic health records from six institutions: Ann and Robert H. Lurie Children’s Hospital of Chicago, Children’s Hospital Colorado, Children’s Hospital of Philadelphia, Seattle Children’s Hospital, Stanford Children’s Health, and Texas Children’s Hospital.
Injuries were identified using ICD-10-CM external cause codes for e-bicycle injuries, a coding category introduced in October 2022 that for the first time allowed hospitals to systematically distinguish electric device injuries from conventional ones. The study followed the STROBE reporting guideline for observational research — the international gold standard for transparency in epidemiological studies.
Participating Hospitals: Ann and Robert H. Lurie Children’s Hospital of Chicago · Children’s Hospital Colorado · Children’s Hospital of Philadelphia · Seattle Children’s Hospital · Stanford Children’s Health · Texas Children’s Hospital
The authors are admirably candid about the limits of what they can conclude. Because injury rates were calculated against the total pool of emergency and inpatient patients — not against actual miles ridden — the study cannot definitively rank which device is riskiest per trip or per rider. It is also possible that part of the observed increase in e-bike injury reports reflects growing familiarity among hospital coders with the newly introduced ICD-10-CM codes, rather than an equivalent rise in actual incidents. The authors flag both of these caveats directly.
And yet — on the question of severity, neither caveat applies. The finding that e-bicycle injuries produce higher rates of hospitalization, brain injury, and life-threatening outcomes than conventional bicycle injuries is not a coding artifact. It is a clinical reality playing out in pediatric ICUs across the country.
A Final Word
Electric bicycles and scooters are not going away. They are, in many respects, a genuine transportation breakthrough — cleaner, faster, and more accessible than almost anything that came before them. But the data published in JAMA on November 2, 2026 makes one thing undeniable: without urgent attention to how these devices reach the hands of children, and without meaningful legislative and safety frameworks to govern that access, America’s pediatric emergency rooms will keep filling up — quarter after quarter, at 33% growth and counting.
The children in these statistics are not abstractions. They are someone’s Saturday morning.
