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IN THE MATTER OF THE THOMAS R. BRAIDWOOD, Q.C.,
COMMISSIONS OF INQUIRY UNDER THE PUBLIC INQUIRY ACT,
SB.C. 2007, c. 9
Phone: (604) 299-3595; Fax: (604) 299-3545
IN THE MATTER OF THE THOMAS R. BRAIDWOOD, Q.C.,
COMMISSIONS OF INQUIRY UNDER THE PUBLIC INQUIRY ACT,
SB.C. 2007, c. 9
Counsel for B.C. Civil Liberties Association:
Counsel for Public Service Alliance ofCanada:
Counsel for TASER International, Inc.
don't think we'll be all day, but obviously one
Tomorrow we have Mr. Orv Nickel, who is a
gentleman who will be giving evidence about use of
He is in Quebec tomorrow, so we will have
to do his evidence by teleconference in some way.
And unfortunately for the timing, he's only
available tomorrow afternoon starting at one
tomorrow morning but we'll have to sit tomorrow
afternoon, just sit, with your leave of course, as
long as it takes to finish his evidence.
Just to give a window to next week, Monday we
have Mr. Fredericks, who will be available
starting at 10:00 a.m., and that evidence will be
led by Mr. Butcher in chief, and if Commission
counsel has any questions, we can deal with that
indicated to you that he may have some evidence in
answer to Mr. Fredericks, and we're awaiting
As to the closing argument, it seems that
almost everyone is agreeable to starting on June
19th to accommodate a scheduling issue on the 22nd
yet, but in all probability what we'd like to do
is start the first day of closing argument on the
19th, the Friday, then not sit on the 22nd and
then come the 23rd and 24th, just finish.
say, almost everyone is able to accommodate that
change but we'll confirm it in the next couple of
appreciate your flexibility in our desire to
2Paul JankeIn chief on qualifications by Mr. Vertlieb
Now, I notice Mr. Neave is not here and I
don't know -- he hasn't told us he was going to
the evidence this morning, Mr. Commissioner, and
the witness for the morning is Dr. Paul Janke, a
Would you state your full name, please.
psychiatrist and well recognized in our medical
going to ask that the report, May 6, 2009, with
attached curriculum vitae, be the next exhibit.
May 6, 2009, with attached Curriculum Vitae
distributed and there's a number of counsel here
and all of my colleagues are free to, of course,
the proceedings with the medical evidence is
Commission counsel will take you through the
report in a brief way and then recognizing that
others may have questions that will go into more
3Paul JankeIn chief on qualifications by Mr. Vertlieb
EXAMINATION IN CHIEF ON QUALIFICATIONS BY MR. VERTLIEB:
Briefly tell us your background in medicine, where
specialized in the field of psychiatry.
I actually got -- my first post-high school
degree was my medical degree and that was at UBC
internship at St. Paul's Hospital, after which I
was licensed to practise medicine in the Province
internal medicine, mostly at St. Paul's Hospital,
before entering the psychiatry program.
finished the psychiatry program in June 1987, at
which time I became a Fellow of the Royal College
of Physicians of Canada, specialty in psychiatry.
Once I was in psychiatry, I always knew I
wanted to do forensic psychiatry, so as part of my
psychiatry training I did a rotation in forensic
psychiatry that, as it turns out, was primarily
under the supervision of Dr. O'Shaughnessy at
Youth Forensic Psychiatric Services.
Upon getting my fellowship, I entered into
private practice, which initially was a mix of
general psychiatry and forensic psychiatry, and
part time -- or half of my time was spent at Youth
Youth Forensic Psychiatric Services until the
responsibility for our in-patient assessment unit,
our out-patient department, and mental health
services in the Youth Custody Centre in South
prepare reports for a variety of different bodies.
The civil courts, criminal courts, various
I have a small private practice in which I
treat patients on an on-going basis.
So you have an extensive and broadly based
practice in psychiatry here in our province?
4Paul JankeRuling on qualificationsIn chief by Mr. Vertlieb
long time ago and a long way from psychiatry.
Dr. Janke, let's then deal with the assistance you
can give to the Commissioner concerning the issue
around the word "delirium" and its different
Delirium in its simplest definition is a clouding
of consciousness that occurs in the context of
other physical factors or illnesses.
commonly seen in hospitalized patients who are
suffering from a variety of processes.
be related to the medications they're on, may be
related to infection, may be related to the
withdrawal from substances and the accompanying
effects of that on an individual's functioning.
The primary feature of delirium is a clouding of
consciousness, in other words, an impairment of
the ability to perceive and interact with the
A cardinal feature of delirium is that it is
of time when an individual may be fully aware of
their surroundings and interact appropriately with
their surroundings, and other times when the
individual is not at all in touch with their
surroundings and will be responding totally to
internal stimulus, ideas within their head.
So generally it's associated with some kind of
So you used the word "infection."
have an infection that can be severe enough that
the brain just stops working properly; is that a
individual has suffered severe injuries and has
multiple system failures, liver failure, kidney
failure, other kinds of failure that just impair
the ability of the brain to function.
We've heard that delirium is really centring
Is delirium something that you would have to be a
psychiatrist to diagnose or would this be
something that a family physician could come in
I would expect a family physician who has patients
who are in hospital or has elderly patients will
come into contact with delirium not infrequently.
It's a common occurrence towards the end of our
lives because of multiple system failures and
As a psychiatrist, you would deal with it more
often perhaps than a family doctor; is that a fair
As a general psychiatrist, probably not.
have any kind of a hospital practice or deal with
patients in any kind of a custodial type of
circumstance, you're going to come into contact
with individuals who are both medically ill,
severely psychiatrically ill, or have ingested a
hospital-based practice, consultation-liaison
psychiatrists, deal with delirium on a constant
So moving, then, to the issue at hand, namely the
-- certainly in the moments before his tasering by
the RCMP, let's deal with Mr. Dziekanski's state.
You've covered the documents and materials that
You've spoken with no one else about this case?
You haven't spoken with any of the witnesses, for
example, or any of the parties to the event?
Tell us what your conclusion is about Mr.
Dziekanski's state, his cognitive state, at the
time he was dealing with the police, and then I'm
going to ask you to tell us why you have that
Well, at the time Mr. Dziekanski was dealing with
the police and for the period of time immediately
before it, the part that's captured on what's
referred to as the Pritchard videos, Mr.
striking is that whenever there is an opportunity,
he interacts with the people around him.
responsive to his environment, responds to
directions, and is acting in a way that, in my
mind, rules out delirium but certainly indicates
that he was in a highly stressed and agitated
What is it about the interaction with people and
the way he was with others that brings you to rule
We see Mr. Dziekanski on several occasions in the
videos interacting with other people in the
an article lifted up above his arms and people are
yelling "No," he puts it down as opposed to
carrying on with whatever thought he had in his
More importantly, when the police arrive on
the scene, he clearly recognizes the police.
calls out "Polizia, polizia" at least once or
He appears to follow their directions.
In my mind, that all indicates an operating mind
that's interacting with the environment and
responding to the environment, in the context, in
You have seen Dr. Lu's report that comes to a
And you know Dr. Lu to be a well respected
works in the -- has worked in consultation-
medicine and I know that he has been doing
forensic work over the last four or five years
that I -- I want to make sure I'm not minimizing,
but I think it's been four or five years.
certainly been aware of his reports over the last
During these proceedings, a number of times there
have been references to the fact that Mr.
Dziekanski appears to have been sweating.
Tell us about your view of that comment and that
video it looks like he's sweating and it appears
there's been consistent descriptions of him
in which human beings may sweat, some of us to a
You read the document that was sent to you called
"Circumstances," which was a lengthy recitation of
events that have taken place here at this inquiry.
And in that is detailed the observations some have
made of Mr. Dziekanski from the time he landed in
Vancouver and was dealing with Border Services
people and his interactions with Customs,
opinion about his mental state during his time
immediately before the police interaction and
that you notice in the other hours that he was in
Vancouver that's inconsistent with the opinion
have represents an individual who's agitated,
opportunity to interact with somebody, he appears
surroundings and he responds to direction in a
manner that I think would be consistent with his
undoubtedly was overtired, hungry, stressed,
I just want to have a few terms defined while we
have the benefit of your evidence here.
report at page 4, you go through observations one
by one, and I'm looking right now, page 4,
Tell us what you mean by "moderate to severe
What I'm referring to is the fact that Mr.
Dziekanski facially looks like he's agitated.
times he's yelling and gesticulating in what
not constantly but almost all the time he's in
to as psychomotor behaviour, and because of the
You made comments in paragraph 6 of your report
about the chairs and the automatic door.
others have watched that video and made comments
perspective, namely watching the video and
watching Mr. Dziekanski standing there while the
Tell the Commissioner your impression, watching
him with your trained eye, so to speak, and what
you observed and the significance of that.
I saw Mr. Dziekanski standing in the doorway.
appears to be aware that the door is opening and
closing behind him but he's focusing on other
people or other circumstances at the time.
he's simply -- he's aware of it but ignoring it,
which is not quite the same as being unaware of
actually interact with him, to know what his
degree we're all speculating when we look at the
video and say, this is what was going on in his
And when you say "We're all speculating," you mean
"we" from the standpoint of the medical people?
The medical people for sure, and anyone who
attempts to interpret what was going on in his
It may be self-evident, but just briefly tell us
why the diagnosis of delirium would be one where
you'd want to have an actual visit or assessment
Well, to diagnose delirium, you have to know that
the person is not oriented to their environment,
that they are not fully aware of where they are,
what the time is, what's going on, who the various
people are that they're dealing with.
simply not possible in this kind of a video where
there's nothing like that kind of interaction, not
It's also important in diagnosing delirium to
have the opportunity to either assess the person
repeatedly - in other words, you get to see them
consciousness may vary - or be able to review
materials that tell you that the person's
consciousness or awareness has varied over time.
So the result of your assessment is that you rule
out delirium in this case of Mr. Dziekanski?
I think that when I look at the video and when I
review the circumstances, which is what I based my
opinion on, we have an individual who on repeated
occasions interacts appropriately, appears to be
and contradict a diagnosis of delirium.
view the video in particular, I see multiple
instances where he is interacting with his
environment and responding to his environment.
That's not consistent with delirium.
Dr. Janke, my name is Helen Roberts.
counsel for the Government of Canada.
10Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
CROSS-EXAMINATION BY MS. ROBERTS ON BEHALF OF THE
First, what exactly were you asked to do for the
I was asked to review Dr. Lu's report and to offer
my opinion with respect to the diagnosis of
And were you given any additional information
apart from what you've listed on page 1, either in
Now, as I read your report, you disagree with
sufficiency of the evidence for a diagnosis of
And the second is the diagnosis of delirium
And he listed a great number of materials that
he'd reviewed on pages 2 to 6 of his report?
And you'll agree that you didn't have all of that
For instance, you had a very abbreviated form of
circumstances whereas he had full statements from
And in outlining your practice, am I correct in
thinking your clinical practice relates to seeing
private office forensic practice where I'm doing
is with Youth Forensic Psychiatric Services, where
I am seeing individuals who've been admitted to
the in-patient assessment unit for assessment for
court purposes or I'm following people who are in
the custody centre for psychiatric needs or I'm
seeing people in the out-patient who are being
seen for ongoing treatment and/or assessment.
And I think you made the distinction -- you talked
11Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
about psychiatrists who practise in a hospital
setting probably see more delirium than you do in
And would it be fair to assume that you might have
more time during an appointment than they might
have as they do rounds and have to see a whole
much time as you need to make an accurate
psychiatrists who practise in a hospital setting
are more used to making a quicker diagnosis just
because of the time constraints and the nature of
That would be true when we compare it to my
private office practice but not to my practice in
Youth Forensic Psychiatric Services, where I have
clinics where I'm seeing six to ten youth over the
course of a morning and would have at least the
same if not less time than most consultation-
liaison psychiatrists would have available.
I take it you don't have any issue with the fact
that Dr. Lu would be qualified to diagnose
Oh, I would expect a first-year psychiatric
resident to be able to diagnose delirium.
psychiatrist to decide whether he or she had
sufficient information to make a diagnosis?
That's as an individual making a diagnosis.
psychiatry where we're offering independent
medical opinion, the standard is expected to be
level of investigation and review of material.
access to more material than you did and he
evidently felt that the had sufficient information
psychiatrists are governed or practise according
to the DSM-IV
, which is the Diagnostic and
Statistical Manual of Mental Disorders
12Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
North American psychiatrists use that to make
And you'd be familiar with the diagnosis of
delirium as set out in the DSM-IV
And as I understand it, they set out delirium in
One is delirium related to a medical condition?
Or, sorry, substance addiction or withdrawal?
And the last one is referred to as not otherwise
conditions that can cause delirium according to
, that would include electrolyte
And electrolyte imbalances could be caused by
And the medical conditions that can cause delirium
And that could include dilated cardiomyopathy?
If there is compromised cardiac output, yes.
And then when we deal with the delirium that can
And do those substances also include nicotine?
I'm not sure that I've ever seen delirium
And then as I understand it, the category of
13Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
multiple etiology is if there's a number of
factors that can contribute to causing delirium in
And the category of not otherwise specified.
read -- I'll just read you something from the
under section 780.09, if anybody's
This category should be used to diagnose a
delirium that does not meet criteria for any
of the specific types of delirium described
So it's the left-over category, if you will?
It's the left-over ones where you don't know the
multiple etiologies or you're not sure of them.
But you know the person is delirious.
A clinical presentation of delirium that is
there is insufficient evidence to establish a
Delirium due to causes not listed in this
The example they give is sensory deprivation.
So the DSM
itself seems to envisage that you can
insufficient evidence to establish a specific
So the fact that we can't say with any certainty
what the cause of delirium might be in Mr.
Dziekanski, that doesn't prevent -- if the
clinical picture fits delirium, that doesn't
14Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
prevent a psychiatrist from diagnosing delirium?
Have you been provided with Dr. Lu's third report
I've only been provided with what's listed.
Dr. Lu has prepared a third report responding in
to say we should put it before you, then.
And he addresses your report on page 3 of this new
And he says that he's reviewed your May 6th --
pause a minute, Doctor, and maybe you should read
I don't believe Dr. Lu's third report has been
marked as an exhibit, if that's what you're
If you need some time to review it again, let me
In the first paragraph he points out that
you differ from him in the possibility of a
And then he says you dismiss the important finding
that Mr. Dziekanski was hyperventilating.
I believe that should say "breaths."
-- per minute is extremely difficult to self-
sustain and is almost always a sign of some
Is that a finding that's relevant to a diagnosis
15Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
And in the second paragraph, he talks about
withdrawal, dehydration and delirium can have
significant fluid imbalance that oral fluid
and a few glasses of water simply will not
I think he's differing from you as to whether
Mr. Dziekanski might have been suffering from
Well, he's said three different things.
agree with him -- saying someone's in potential
alcohol withdrawal gives us no information at all.
If we say a person in alcohol withdrawal will have
a fluid imbalance, he's entirely correct.
need to rehydrate those individuals and you need
to do it in a careful, controlled fashion.
With dehydration -- well, I may be dehydrated
if I'm on the stand for three hours and don't have
is significant or serious dehydration.
would agree with him that a few glasses of water
would not be sufficient to deal with someone who's
And finally, delirium is, as I think we've
already established, a multi-factorial state with
multiple different causes, all of which would
likely require the use of intravenous fluid to
circular logic in the sense that if he assumes
there's dehydration -- delirium, then yes, these
delirium and we need to address his state, then I
Doctor, you unfortunately have not had the benefit
of seeing the medical records from Poland or the
-- a bit of background that we've heard.
I've seen some medical records from Poland.
16Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
You've seen the Immigration Canada form.
hadn't slept for a couple of nights prior to his
That he had been smoking up till two days before
That he had a fear of flying to the extent where
he was clinging to a radiator and didn't want to
go to the airport and also vomited several times
You've seen Dr. Lee's report so you know that he
is of the view that Mr. Dziekanski suffered from
We've also had evidence, and it's in Dr. Lee's
report, that there were no stomach contents, and
according to Dr. Lee, that suggests he hadn't
taken any food for a significant period, and I
can't remember if it's 28 to 48 hours or something
I can't recall either but I do recall that.
We have some evidence that you may not have been
provided in terms of his lack of sleep, his
possible withdrawal from alcohol and nicotine,
hadn't eaten well for a couple of days.
he was found with the airline breakfast still in
evidence than perhaps you had to work with.
I'm not sure that I was unaware of much -- I
believe I was aware of much of that information.
What I was going to say was, could all those
factors be interpreted in the way that Dr. Lu has
interpreted them, to say that he was possibly
withdrawing from alcohol and was dehydrated?
Yes, they could be interpreted that way.
17Paul JankeCross-exam by Ms. Roberts (for Government of Canada)
I take it it's not uncommon for psychiatrists to
reach different conclusions about patients?
Particularly in medical-legal settings.
On page 6 of your report, sir, at the top.
In the first full sentence, "It would be."
It would be my considered psychiatric opinion
that Mr. Pritchard's video of Mr. Dziekanski
does not demonstrate significant signs or
You use the words "significant signs or symptoms
Given that delirium is a state of agitation,
usually with a state of -- it can vary from either
being somnolent or highly agitated, he certainly
showed signs or symptoms that could have been
Whether or not he met the official diagnosis of
delirium, I take it your evidence is he was highly
And would you agree that's abnormal behaviour?
-- and that he was nervous and upset.
airport people have testified that they've not
abnormal for a tired, stressed passenger, if you
I -- if they haven't observed it, then I can't
And in that situation it was appropriate for
people to call the police to deal with Mr.
The problem with that question is that we're
talking about a long period of time in which
18Paul JankeCross-exam by Ms. Roberts (for Government of Canada)Cross-exam by Mr. Hira (for Cst. Kwesi Millington)
me was it appropriate to call at the time of the
Pritchard video, or was it appropriate to -- would
it have been appropriate to call two hours, four
hours, six hours, eight hours, ten hours, twelve
behaviour in the later stages before the police
arrive, in other words when he's banging on the
glass, when he's yelling, swearing, destroying
Yes, I think that was appropriate to get people
who would be trained in dealing with that
situation in an appropriate fashion.
And once the police were called, it would be their
I would expect it to be their duty, and it's been
my experience that they make it their duty to deal
Doctor, my name is Ravi Hira and I represent
CROSS-EXAMINATION BY MR. HIRA ON BEHALF OF CONSTABLE
The first issue that I'd like to deal with is,
I'll have to look at the date because I -- I think
May 4, May 5, I'm not going to quibble over that.
Mr. Commissioner, I wonder whether I could
take five minutes just to look at the file.
19Paul JankeCross-exam by Mr. Hira (for Cst. Kwesi Millington)
CROSS-EXAMINATION BY MR. HIRA ON BEHALF OF CONSTABLE
Thank you for letting me look at your file,
from the Commission enclosing the materials that
You reviewed the materials and provided, frankly,
an incredible turnaround, the eight-page report of
Now, was there any specific question posed to you
And so the purpose of your report -- I've gone
through your report and I don't note in there any
purpose or question, unless I'm missing something.
I haven't read it recently, but I'm going to
supposed to do, was there someone or something,
some question that was posed to you, such as,
would you review Dr. Lu's initial report and
office by Mr. Vertlieb, and that's the question
could I provide an opinion reviewing Dr. Lu's
20Paul JankeCross-exam by Mr. Hira (for Cst. Kwesi Millington)
you've given earlier and not unlike the one I've
tried to paraphrase was posed on that date?
gave in examination by Mr. Vertlieb, you noted
that the process that you're undertaking to some
degree had -- well, has a considerable degree of
And when you say that he responded or appeared to
respond to police direction, that is speculation
I'm not sure I'd call it speculation.
what I'm referring to is that police give
directions; he appears to move in the direction
Now, I noted that you analyzed -- that you
made some notes regarding the video.
And with respect to those notes, the last page of
your notes - if I may approach you - you have a
You have a time period starting at 3:05.
read the three lines that appear after that.
"Interaction with police and appears to respond to
police, you would agree with me that picking up a
stapler, opening it and holding it in a clenched
fist, chest high, with the other fist clenched,
that doesn't appear to be a proper response to the
I wouldn't call it a proper response to police,
consistent with the circumstances he found
21Paul JankeCross-exam by Mr. Hira (for Cst. Kwesi Millington)Cross-exam by Mr. Butcher (for Cst. Bill Bentley)
next one, is it, "The translation."?
I think it may have been reformatted so I wasn't
Can I show him my paragraph (indiscernible -
Okay, the third full paragraph, "The translation
.were consistent with the circumstances he
And you're basing that on Exhibit 33, the
As I speak no Polish, I would have to, yes.
will trash this office," "I will smash the glass,
see" -- you view those as consistent with the
anxious, clearly is unsure as to what is going on
or why he's where he is, and he's responding with
Butcher and I act for Constable Bill Bentley.
CROSS-EXAMINATION BY MR. BUTCHER ON BEHALF OF CONSTABLE
The first area deals with the question of how long
have you had this divided practice between your
private forensic practice and your Youth Services
22Paul JankeCross-exam by Mr. Butcher (for Cst. Bill Bentley)
During that time, how often have you seen people
been in delirious states, usually secondary to
medication and severe psychiatric illness.
would not have seen many patients directly.
will have reviewed hundreds of files of people who
had suffered major injuries and been hospitalized
and then assessed and treated for delirium in that
But you're looking at that after the fact --
In a clinical setting, are we talking about once a
And I think you've conceded that Dr. Lu's practice
would involve dealing with people in active states
And that means working in a hospital with medical
Well, there's different aspects of psychiatric
practice, but consultation-liaison, that's a large
The second area has to do with a comment you made
I presume it's a fairly common feature of
Yes, it's a common feature of the people that see
In the youth population I'm dealing with,
probably 25 percent present with what we would
likely call dependence on various drugs and 75 to
90 percent are active heavy users of drugs.
it's part and parcel of that aspect of my
23Paul JankeCross-exam by Mr. Butcher (for Cst. Bill Bentley)
practice, addiction, either before the event
leading to the civil litigation or addiction
subsequent related to medical treatment, is
And I take it from the comment that you made that
I referred to that a person in withdrawal from
alcohol has to be treated quite carefully and --
Yes, because they have a tendency to go into
delirium, which can be a fatal condition.
And in a medical setting, what is done to assist
You would treat them with intravenous fluids.
would treat them with vitamins because of
particular problems that arise with rehydrating
people who haven't been eating properly.
typically treat their agitation and delirium with
medications such as benzodiazepines in low doses
would be used to manage the person's agitation.
Withdrawal without that medical treatment can be
number of the translation of the voice recording?
questions about things that were said, and we have
to the translation, at time mark 3:00, that's when
As I recall from viewing the video, this is when
he's having some interaction with the police, and
I believe it's when they are around him.
me it's, I think -- the impression I get is that
Mr. Dziekanski was happy to see the police
that seems to be his response, and then he becomes
what appears to be puzzled or upset by their
actions, and that's when he made that particular
that when I asked the translator whether it could
also be interpreted as "Have you lost your minds?"
he agreed with me that that was another version of
that translation, "Have you become stupid?"
"nuts" the other day but I was wrong.
perhaps Dr. Janke could then be excused.
witness stand, Ms. Roberts has asked that the
report of Dr. Lu, May 12th, 2009, be marked as an
exhibit, and that's totally reasonable.
this of course is in response to the order that
you made that the different medical practitioners
be sent material, and the plan would be that if
any of these experts write back, that that
material would be provided to the Commission as
I believe Mr. Neave has some questions and
issues regarding this report and the materials
I stand up to alert the Commission of that
rather than to try to elucidate his concerns.
of the things that may be an issue is whether or
not the transcripts of the doctors - Chambers,
Kerr, Janke and Tseng; that is the cross-
examination transcripts - were sent as well.
assist your last comment - that these have been
in, they've been sent out, and as far as we know
Just on that last point, I think the concern
was - and again, I'm not speaking for Mr. Neave -
whether or not Dr. Lu had them prior to his report
Well, the face of the report would suggest
transcripts as of May 12 would suggest not.
again -- now I'm going where I really don't want
to go, which is leave that to Mr. Neave.
(PROCEEDINGS ADJOURNED TO MAY 22, 2009, AT
Revisão da Literatura Evidências de eficácia da terapia cognitiva Evidences from the efficacy of the cognitive behavior therapy on schizophreniaElizA MARtHA dE PAivA bARREto1 , Hélio Elkis2 1 Psiquiatra, mestre em Psiquiatria pela Universidade de São Paulo (USP). Fellow em terapia cognitiva e comportamental pelo Departamento de Psiquiatria do Massachusetts General Hospital (EUA).
DMF – COS List Acetyl Salicylic Acid (Aspirin) Clarythromycin Acyclovir Clindamycin Hcl Albendazole Clotrimazole Allopurinol Dexamethasone Base and salts Ambroxol Hcl Dexthromethorphan Amidopyrine Diclofenac Sodium Amikacin Sulfate Diclofenac diethyl ammonium Aminophylline Anhydrous Dihydrostreptomycine Sulphate Amitripty