Abstract
A man age of sixties has referred to a physician with a diagnosis of decompensated liver cirrhosis, hyperammonemia and esophageal varices and received medications. He lived alone and was a taxi driver. Although he had been advised to quit driving a vehicle by the physician, he drove a vehicle daily. One day, he drove a vehicle for the opposite direction to his intended destination. Then, he deviated to the oncoming lane and collided to an oncoming vehicle. He suffered from multiple lacerations of the lower extremities, comminuted fractures of the left tibia and fibula and transferred to a hospital, however, died next day due to the hemorrhagic shock. At the forensic autopsy performed two days after his death, progressed liver cirrhosis, splenomegaly, and ascites were found in addition to the injuries. As the hyperammonemia was observed by blood examination, he was considered as suffering from hepatic encephalopathy and this condition is suspected as the cause of the vehicle collision. Although the health condition of the driver becomes a cause of motor vehicle collisions, it is not widely recognized that the progressed liver cirrhosis can affect the ability to safely drive a vehicle. With this case, we emphasize the importance of confirming driving ability of the patients with progressed liver diseases and guiding about driving a vehicle adequately. Also, keeping good adherence of the patients and advising to quit driving with patients’ family if necessary are required for the prevention of health-related motor vehicle collisions.
