|Chiropractic neck adjustment is not the probable cause of the death by stroke of Lana Davis Lewis, an expert witness has told an inquest.Dr. Scott Haldeman, chiropractor and medical doctor, was called by the coroner's office to review all the key records and the controversial autopsy finding of its own forensic pathologist, the now-retired Dr. John Deck.Haldeman, a professor of neurology at the University of California, said the stroke was almost certainly a natural consequence of advanced artherosclerotic disease including, in particular, a diseased left vertebral artery inside Lewis' skull."The suggestion that trauma from manipulation caused bleeding (inside the skull) is without scientific validity."Haldeman told the jury that stroke is one of three major causes of death in Canada, but Canada's 5,000 chiropractors together report only 2.3 strokes per year in patients due to neck adjustment causing injury to neck arteries. This is minuscule in comparison to the millions of office visits annually.Some of the traditional tension between doctors and chiropractors arises from the fact that only one in 47 chiropractors will see a stroke caused by manipulation at any time in their career, he said. Neurologists are fewer in number and clustered on stroke victims, so one in two neurologists is likely at some time in their career to see a patient with stroke from neck adjustment. All cerebral and vascular neurologists are likely to see such cases.It's a matter of the same facts, but a very different professional perception, Haldeman told the inquest.Research suggests some people are predisposed to stroke, Haldeman said. The inquest will hear that Lewis had extremely high blood pressure, neglected to take blood thinners, and smoked a pack of cigarettes a day for 25 years.Coroner Barry McLellan admitted Haldeman as an expert witness over objections from Lewis family counsel Amani Oakley, who called him an advocate for chiropractic. Haldeman said about 70 per cent of his work as an expert witness is in defence of chiropractors, but he has testified for others against chiropractors. Haldeman said he has spent 20 years urging chiropractors to adopt a scientific approach to their profession. His research on the results of non-surgical treatment of the spine has been published in respected medical journals, including the Canadian Medical Association Journal, Spine, and the Journal of Neurology.Haldeman said there have been a few cases in which neck adjustment caused injury to the vertebral artery and stroke, but on the evidence, Lewis' case is not one of them.