If a medical examiner finds signs of early hepatic failure in a driver, what should they do?

In the scenario where a medical examiner identifies signs of early hepatic failure in a driver, the most appropriate action is to refer the driver to their Primary Care Provider (PCP). Early hepatic failure can indicate significant liver dysfunction, which may have serious health implications for the driver and potentially affect their ability to operate a vehicle safely.

Referring the driver to their PCP allows for a comprehensive evaluation and management of the underlying condition. The PCP is equipped to conduct further assessments, including history-taking, physical examinations, and the ordering of necessary tests. The PCP can also provide a treatment plan based on the results, ensuring the driver receives appropriate care.

While imaging tests such as an abdominal ultrasound or CT scan, and blood tests assessing liver function, are essential components of diagnosing and managing liver issues, they should follow the initial referral to the PCP. It is important for the medical examiner to ensure that the driver is clinically assessed and managed by a healthcare provider who can explore further diagnostic pathways and treatment options, rather than independently ordering tests that should ideally be ordered and interpreted by a physician familiar with the patient's complete medical history.