VOCA Victims of Chiropractic Abuse
Chiropractors called to court
June 21, 2008 Kevin Libin, National Post
Victims of neck-adjustment mishaps sue

CALGARY -At more than 80 pages, it is already an unusual statement of claim; the longest Edmonton lawyer Daryl Wilson has ever seen. "It's quite something, isn't it," beams the lawyer behind a massive class-action lawsuit filed last week against Alberta's chiropractors and government.

Also, the pages virtually seethe, accusing the chiropractic business of "masquerading in the white smock of science [to] perpetuate [the] unregulated indiscriminate use" of "dangerous" neck manipulations. Rails the claim: "It has got to be stopped."

The outrage is fuelled by the case of lead plaintiff Sandra Nette. Until last September, she was a fit 41-year-old land administrator with a love for singing and classical piano. Today she is tetrapalegic.

She "cannot move or communicate due to complete paralysis of nearly all voluntary muscles in her body," the claim explains. Sandra, her husband David says, "lives in a prison."

What happened, according to David Nette, is that Ms. Nette visited a chiropractor for a routine neck adjustment. Afterward she felt dizzy and nauseous. Soon, she was pulling her car to the side of the highway, calling for help. Hours later, Mr. Nette said, doctors told him his wife's vertebral arteries were torn; she had suffered a massive stroke.

This has happened before: cervical spine manipulations producing brain trauma or death. Lawsuits have followed. Even public inquiries, as in the chiropractic-related deaths of Saskatchewan's Laurie Jean Mathiason and Ontario's Lana Dale Lewis. But the Nettes' suit is a first in that it targets not only practitioners, but regulators, and argues that spinal manipulation, a chiropractic staple, is illegitimate, and that in sanctioning it, the government and the Alberta College and Association of Chiropractors are not only advancing a useless treatment, but putting lives at risk.

The damages sought are also exceptional: a half-billion dollars -- $100-million for everyone injured by treatment, and a $400-million refund of adjustment fees collected by Alberta chiropractors for all treatments over the past decade, the maximum period for class actions.

The ACAC did not respond to several requests seeking comment on the claims, which have not been tested in court.

In the past, faced with criticisms over injuries such as Ms. Nette's, chiropractic associations have traditionally challenged the need for tougher restrictions, arguing that the dangers of neck manipulation are negligible (the odds of injury, they have stated, range from one in a million to one in four million treatments) and the benefits plentiful. They argue that physicians, threatened by alternative medicine, are "scare-mongering."

Chiropractors promote high-neck manipulation as a treatment for a medical textbook's worth of maladies -- gall stones, arthritis, head colds, constipation, appendicitis, diabetes, even SARS; as well as children's bed-wetting, colic, allergies, asthma and learning disabilities -- and routine adjustments are recommended. This all flows from the theories of Daniel David Palmer, an Ontario-born grocer and magnetic healer, who over a century ago claimed that all health stems from the straightness of the spine; all illness from misaligned "vertebral subluxations," rectifiable by rotating the neck to produce a popping sound.

This lawsuit calls such beliefs an "anachronistic holdover" from the Victorian era, when "insufficient scientific understanding existed to explain human physiological processes." Unlike in other cases of deaths or injuries, the strategy this time is not simply to establish a link between Ms. Nette's shattered health and her neck adjustment, but to demand the provincial health ministry, charged with a duty to the public, justify its endorsement of such an allegedly hazardous practice. " argues Mr. Wilson, who says he is planning similar lawsuits in other provinces.

Alberta offers a particularly vulnerable initial target. Prominent neurologists here have spoken out for years against the practice of vertebral manipulations, which are funded by provincial medicare; a group representing Alberta's pediatricians called on provincial officials a decade ago to end spinal adjustments on children and infants; and Saskatchewan's inquiry into Laurie Jean Mathiason's chiropractic-related death recommended to all "ministries of health in Canada" that chiropractors implement more careful procedures, including warning patients of risks, better patient screening and further testing of the links between neck manipulations and stroke.

Alberta's government evidently entrusted the provincial chiropractic association to look after those things. Sharon Mathiason, Laurie Jean's mother, wrote Alberta's health and wellness minister in 2005 concerned that those recommendations were being ignored.

"That's why you do an inquest," Ms. Mathiason says. "So that this doesn't hap pen again. That's the whole purpose of it."

In her reply, then-health minister Iris Evans wrote: "My department relies on the chiropractic profession's expertise to govern itself."

The industry, plaintiffs maintain, failed to do so adequately and "consistently disregarded the public interest," perhaps, they charge, because the ACAC is both a regulatory college and the profession's advocacy association.

Faith in D. D. Palmer's "vertebral subluxation" theories is mixed even within the chiropractic community, says Wayne MacPhail, the Hamilton co-author of Spin Doctors: The Chiropractic Industry Under Examination.

But purists dominate and will brook neither dissent nor criticism of their traditional beliefs. "There are some folks ... who really get the fact that this is buggering up the profession ... but if they even talk about leaving subluxation behind, they just get shit upon from a high height."

A history of practitioners being jailed for practising medicine without a licence has infused much of the profession with something resembling a garrison mentality.

Allan Halowski, a former president of the Alberta Chiropractic Association, challenged reform-minded practitioners a few years ago in an industry journal, boasting that as a proud "Chiropractic dinosaur" he would, citing the words of D. D. Palmer's son, B. J. Palmer, practise chiropractics within the law, with out the law or against the law.

In the law's eyes, Mr. Wilson notes, traditions and orthodoxy count for much less.

"The wonderful thing about the legal process is that it does not rely upon beliefs...

"It carefully evaluates and weighs scientific, rational, logical, evidence," he says.

If the case proceeds to court, it will surely mark the most forceful challenge yet to the practice, "putting the heart of chiropractic on trial," says Mr. McPhail.

"It's similar to if neurology were put on trial on the basis of the fact that the neuron didn't exist."

He expects Canada's chiropractors to defend their case fiercely.

CHIROPRACTIC IN BRIEF - Chiropractic care is an alternative form of medicine based on the belief there is a strong relationship between the body's structure and its functions. Chiropractors practise hands-on manipulation, mainly of the spine, usually for treatment of problems with the muscles, joints, bones, and connective tissue such as cartilage, ligaments and tendons. - The word "chiropractic" combines the Greek words cheir (hand) and praxis (action) and means "done by hand." It is one of the oldest healing methods and was described by Hippocrates in ancient Greece. It was revived in 1895 in the United States by Daniel David Palmer, a self-taught healer who believed the body has a natural healing ability controlled by the nervous system. He concluded that "adjusting" the bones of the spinal column affected nerve flow to other body parts. - The most common complaints treated by chiropractors are back pain, neck pain, headaches, sports injuries and repetitive strains. Patients are also treated for pain from such conditions as arthritis. - Apart from manipulation, chiroptractors often use other methods, including ultrasound, electrical stimulation, magnetic therapy, homeopathy, laser treatment and acupuncture.


Sandra Nette's $500-million class-action lawsuit launched last week may be the biggest, most far-reaching case of its kind, going as high as the government health ministry. But chiropractors across Canada have faced numerous lawsuits and inquiries in the past investigating the link between the chiropractic staple of cervical spine manipulation and severe brain damage or death -- though there have been several other cases reported of Canadian fatalities or disabilities allegedly from chiropractic treatment that victims or their families have opted not to pursue in court. - Ontario convened a public inquest into the death of Lana Dale Lewis, a 45-year-old Toronto mother after she died from a series of strokes after a visit to her chiropractor for migraines in 1996. The jury ruled Ms. Lewis's death an "accident" caused by her chiropractic treatment and recommended deeper study into the potential dangers of neck manipulation. Ms. Lewis's family filed a suit against the Canadian Memorial Chiropractic College, the Ontario Chiropractic Association and her chiropractor for $12-million. - Saskatchewan held an inquiry in 1998 to investigate the death that same year of 22-year-old Laurie Jean Mathiason, who suffered a massive stroke on her chiropractor's table and later died. The chief of the Royal University Hospital's medical imaging department concluded that Ms. Mathiason's death was the result of her chiropractor applying a "forceful manipulation of the neck." The inquiry recommended all "ministries of health in Canada" conduct further studies into the risks of neck manipulation and that chiropractors disclose to patients the potential risk of strokes before treatment. - A coroner's report last year on the death of Quebec mother of two, Pierrette Parisien, who died at 36 the year previous after a neck manipulation concluded the treatment caused "damages to the blood vessels in her neck, leading to her death." The Quebec Order of Chiropractors agreed that the adjustments should not have been administered. It fined the practitioner $6,000, but permitted him to continue practising. - Calgarian Lisa Wolny sued her chiropractor for $150,000 after a 2001 neck manipulation resulted in a series of strokes in the then-33-year-old, resulting in permanent brain damage and lost motor skills. Her husband claimed that when he came to pick up his wife from the chiropractor, she was on the floor of the office, vomiting and convulsing, but staff told him her body was "eliminating toxins." The case was settled out of court. - Ontario's Diane Rodrigue began campaigning against vertebral manipulation after being rendered quadriplegic after a visit to her chiropractor in 1994. Then 30 years old, Ms. Rodrigue had sought treatment for neck pain. She won a $1-million settlement from the Canadian Chiropractic Association. She has demanded Ontario "put an immediate end to chiropractic neck manipulation."

Chiropractic associations have aggressively defended their methods and frequently dispute calls to increase risk awareness, something the Canadian Chiropractic Association (CCA) has called "scaremongering." The Alberta College and Association of Chiropractors has dismissed the effort for greater controls as part of the "political agenda" of physicians opposed to alternative treatments, and said the "the chances are one in a million" of patients being injured by neck manipulation.

The CCA estimates that Canadians pay roughly 40 million visits to the country's 6,000 chiropractors each year.

-- Kevin Libin, National Post

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