Inquest into the death of Road Death 13 of 2024

77y · Male·Blunt force head and chest injuries from motor vehicle collision

A 77-year-old male with a history of seizures (2017, 2023) died from blunt force head and chest injuries sustained in a motor vehicle collision on 10 March 2024. The vehicle travelled at 157 km/h approaching a red traffic light, with braking applied 2-3 seconds before impact at 108 km/h. Toxicological analysis revealed therapeutic levels of lamotrigine and citalopram, with non-toxic mirtazapine. Critical finding: citalopram can reduce seizure threshold and reduce lamotrigine efficacy; mirtazapine causes drowsiness impairing coordination. An acute medical episode such as seizure cannot be excluded as the cause of the collision. The patient's driving license had been suspended for seizures in 2023 and reinstated in June 2023. Medical management involved potential drug-drug interactions that may have increased seizure risk in a patient with documented epilepsy and recent seizure activity.