Death associated with inadvertent hydrocodone overdose in a child with a respiratory tract infection

A 3-year-old child died of the combined effects of a bacterial superinfection and a relative overdose of hydrocodone prescribed for a cough due to a presumed viral respiratory tract infection. This case illustrates the importance of evaluating the effects of prescribed medication in assessing the cause and mechanism of death in children dying suddenly of presumed natural disease.     

Toxicology and Circumstances of Completed Suicide by Means Other than Overdose*

Abstract: To determine the prevalence and circumstances of psychoactive substances amongst nonoverdose completed suicide, 1436 consecutive cases autopsied at the NSW Department of Forensic Medicine over the period 1/1/1997–12/31/2006 were analyzed. Substances were detected in 67.2% of cases, and illicit drugs in 20.1%. Alcohol was present in 40.6% of cases. Males were more likely to be positive for alcohol, cannabis, and psychostimulants, and females for pharmaceuticals. Illicits were associated with younger age. Alcohol was most prominent amongst toxicity cases, as were opioids, psychostimulants amongst gunshot cases, and pharmaceuticals amongst drownings. Cases in which drug and alcohol histories were noted were more likely to have a substance detected. Alcohol was more common where a suicide note was left and where relationship problems were involved. Pharmaceuticals were more common where a previous attempt was noted. Licit and illicit substances are strongly associated with suicide, even when the method does not involve drug overdose.     

Saint Gobain patron of pharmaceutical patentees?

In recent years there has been much complaint from originatingpharmaceutical companies that the test of obviousness appliedin the UK, as evidenced by decisions of the Patent Court onpharmaceutical related patents, is set unfairly low. This isof particular impact where ‘formulation’ type patentsare concerned. That is, typically, those patents that claiman existing active ingredient mixed, formulated, or combinedwith other known components or in a different way. Pharmaceuticalcompanies complain that the vulnerability of such patents againstinvalidity proceedings in the UK fails to protect the considerableinvestment made in the development of these formulations againstgeneric competition. This article looks at whether the reasons for this concern canbe traced to particular sub-tests that have been used by thecourts to try to answer the statutory test for obviousness.In particular, the sub-tests of ‘lying in the road’and ‘obvious to try’ are examined and the questionof whether there has been an imbalance between these two sub-testsis explored. Further, it is argued that the decisions in therecent cases of Saint-Gobain and Angiotech suggest that therehas been a shift in how the Court of Appeal assesses obviousness.This is away from the ‘obvious to try with a reasonableexpectation of success’ standard to one of ‘obviousto try if success is self-evident’. If the Court of Appeal follows the line taken in these two casesthen pharmaceutical patents of the formulations kind shoulda face better prospect of surviving invalidity challenges basedon obviousness in future.     

Understanding management: Henry Mintzberg on the activities of managers

The Nature of Managerial Work, 2^nd edition. By Henry Mintzberg . Engle‐wood Cliffs, N.J.: Prentice‐Hall.     

Recent developments in German corporate governance

This paper provides an overview of the German corporate governance system. We review the governance role of large shareholders, creditors, the product market and the supervisory board. We also discuss the importance of mergers and acquisitions, the market in block trades, and the lack of a hostile takeover market. Given that Germany is often referred to as a bank-based economy, we pay particular attention to the role of the universal banks (Hausbanken). We show that the German system is characterised by a market for partial corporate control, large shareholders and bank/creditor monitoring, a two-tier (management and supervisory) board with co-determination between shareholders and employees on the supervisory board, a disciplinary product–market, and corporate governance regulation largely based on EU directives but with deep roots in the German codes and legal doctrine. Another important feature of the German system is its corporate governance efficiency criterion which is focused on the maximisation of stakeholder value rather than shareholder value. However, the German corporate governance system has experienced many important changes over the last decade. First, the relationship between ownership or control concentration and profitability has changed over time. Second, the pay-for-performance relation is influenced by large shareholder control: in firms with controlling blockholders and when a universal bank is simultaneously an equity- and debtholder, the pay-for-performance relation is lower than in widely held firms or blockholder-controlled firms. Third, since 1995 several major regulatory initiatives (including voluntary codes) have increased transparency and accountability.