Coroner's Finding: Ghanbarzadeh, Masoud

51y · Male·blunt trauma of the chest sustained in a motor vehicle crash; hypovolemic shock due to severe internal bleeding from cardiac and thoracic injuries

A 51-year-old man with schizophrenia, bipolar disorder, chronic pain, and substance use disorder died from blunt chest trauma following a motor vehicle crash. He had a history of two previous crashes associated with high levels of tramadol and diazepam. On the day of death, despite appearing normal at a morning GP appointment, he was observed driving erratically approximately 45 minutes later. Autopsy revealed therapeutic and toxic levels of diazepam, tramadol, oxazepam, olanzapine, and THC. The coroner found these drugs significantly impaired his driving ability. His GP had authorised additional medication two days prior after the patient falsely claimed to be travelling. While the GP's prescribing was deemed sound by medical review, the case highlights risks of drug-seeking behaviour, polypharmacy with CNS depressants, and the challenge of identifying impairment in patients with mental illness and chronic pain requiring opioids.