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Chiropractic immediately suspected in death:
Sequence of events caused pathologist to form early opinion
Vanessa Lu
Health Policy Reporter
The pathologist who conducted the autopsy on Lana Lewis admitted yesterday that he had formed the opinion that her death was linked to chiropractic neck manipulation before reviewing all of the pathological evidence.

Dr. John Deck made the statement during intense questioning by coroner's counsel Tom Schneider, which at times seemed like a hostile cross-examination.

"I had a provisional opinion," Deck said. "It was based on the temporal relationship of the events."

Lewis, a 45-year-old mother of three, died in September, 1996, just 17 days after she underwent a neck manipulation. The inquest, which began this week, is examining the link between stroke and chiropractic manipulation, as well as whether risk factors such as atherosclerosis the build-up of plaque in blood vessels predisposed Lewis to suffering a stroke.

Deck testified that he has done more than 10,000 autopsies, and that he was working with a preliminary opinion as he does with any death.

"I had a definitive date for chiropractic neck manipulation. I had a definitive date for a stroke. I had a definitive date for a death. It was highly probable that it would turn out this way."

But it was only in December, 2001 that Deck revised his report after finding a tear he missed in his initial examination in Lewis' vertebral artery, which runs up the spine into the skull.

In his questioning, Schneider repeatedly suggested to Deck that since the tear was inside Lewis' skull, not outside as is usually the case with neck manipulation, the tear could be more accurately attributed to plaque breaking off.

Deck said he saw no evidence of a clear pathway for plaque to rupture; therefore it was an unlikely scenario.

"It is more likely to be the result of trauma," he said.

Although the tear likely occurred two to three days before Lewis' death, Deck said injuries sometimes bleed long after an immediate trauma.

He added the coincidence of plaque rupturing just days after undergoing a chiropractic adjustment was hard to believe.

During testimony yesterday, it was also revealed that Deck took part in a highly unusual meeting requested by officials of the chiropractic community, months before he had completed his initial autopsy report.

The Dec. 5, 1996 meeting took place with then-regional coroner Dr. Robert Huxter, Dr. Murray Naiberg, the investigating coroner, Jean Moss, president of the Canadian Memorial Chiropractic College, Paul Carey, president of the Canadian Chiropractic Protective Association, and Jaroslaw Grod, then-deputy registrar of the College of Chiropractors of Ontario, a regulatory body.

Deck testified that it was discussed whether there were any early results in the Lewis case and his preliminary view that the death was linked to chiropractic neck manipulation.

He said the six-day interval between the adjustment and when Lewis suffered a stroke was pointed out, adding the chiropractors emphasized symptoms should have emerged sooner if there was a causal link.

Despite the meeting, Deck insisted he didn't feel pressure to alter his opinions. "I would say I wasn't pressured, but the meeting itself was a kind of pressure," he said.

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