[Medical assessment in suspected inability to drive a motor vehicle]. / Die ärztliche Untersuchung bei Verdacht auf Fahrunfähigkeit.

In questions of impaired driving, the expert statements of opinion are based primarily on the medical findings of the doctor involved. A proper medicolegal evaluation--and, as a consequence, the consistent legal evaluation of the event--depend entirely on the quality of this "statement by witness" on the actual psychophysiological condition of the accused motor vehicle driver. The Zurich Institute for Legal Medicine therefore developed a standardised method for the professionalisation of the medical examination of unfit drivers, such as those under the influence of drugs/medication, low levels of alcohol or fatigue. Based on literature searches, empirical knowledge and practical tests, a new medical examination procedure including a form was designed, which essentially includes an examination of the skin and the mucous membranes, a careful examination of the eyes, several tests of "divided attention" and the documentation of anomalies in the area of behaviour, mood and speech. The new procedure stands for a proper, performance-oriented strategy in the detection of impaired drivers.

Clozapine tissue concentrations following an apparent suicidal overdose of Clozaril.

Clozapine is a tricyclic dibenzodiazepine derivative that is classified as an "atypical" antipsychotic drug. A 25-year-old male was brought to a hospital emergency room following the ingestion of an estimated 20 100-mg tablets of clozapine. After several hours in the hospital, the patient died. The cause of death was listed as acute clozapine intoxication. It was also noted upon autopsy that the patient had an unusual eosinophilic myocarditis. The toxicological and pathological findings are presented in this report.

Cranial arteriovenous malformation: suicide by exsanguination.

Arteriovenous malformations of the scalp are potential sources of serious bleeding because of their location, inherent weakness, and high flow rates. A 40-year-old man used his vascular lesion as a means of suicide. Selected aspects of the historical background, diagnosis, and treatment of these vascular disorders are described.