Neck adjustment under microscope
Monday, April 22, 2002 – Print Edition, Page A12

It was a killer migraine that drove Lana Dale Lewis to a chiropractor for relief.

Seventeen days later, she suffered a fatal stroke.

Today, nearly six years after her death, a coroner's inquest will begin to examine whether there is a possible link between the chiropractic neck adjustment Ms. Lewis received and her stroke.

It will be the first inquest in Ontario -- and only the second in Canada -- to put chiropractic neck adjustments under the microscope.

The inquest is being held in Toronto and is expected to last about three weeks.

The 45-year-old mother of three died on Sept. 12, 1996, in a Toronto hospital. She had undergone a cervical manipulation of the first and second vertebrae in the neck. Her family has launched a multimillion-dollar lawsuit against the chiropractor who treated her at his Toronto clinic.

Neck manipulation has been a controversial procedure for decades. Its critics in the medical community argue that twisting the neck also twists the vertebral artery that goes up the back of the neck. This procedure can cause a tear in the artery's inner lining. A blood clot can form over the tear and travel into the brain to produce a stroke.

An adjustment can also dislodge a clot from a previous tear, doctors say.

The chiropractic community argues that the risk of stroke is minimal.

Ms. Lewis's health problems are expected to be a key focus at the inquest, with lawyers for the chiropractic community expected to argue that the stroke was caused by other factors, such as hypertension.

The 1998 inquest in Saskatoon into the death of Laurie Jean Mathiason did not find a definitive connection between the neck adjustment for lower back pain and the massive stroke the 20-year-old old suffered on her chiropractor's table. She died three days later on Feb. 4, 1998.

That jury recommended that more research be done on the relationship between strokes and neck manipulation. It also urged chiropractors to display literature indicating the risk of strokes associated with chiropractic treatment prominently in their offices

About 4.5 million people visit Canada's 5,300 chiropractors annually. Ontario has about 2,200 practising chiropractors.

The process that led up to the Lewis inquest was long and convoluted.

Despite repeated demands for an inquest from the Lewis family, Chief Coroner James Young announced in January of 2000 that there would not be one. He reversed his decision four months later.

The inquest was to have begun in the fall of 2000, but was postponed to January 22, 2001, and later to last April.

But when it was about to begin, a series of pre-inquest motions, including a successful attempt by lawyer Tim Danson to remove the agent chosen by the Lewis family to represent them, derailed the inquest. Mr. Danson represented the Canadian Memorial Chiropractic College in Toronto and the Canadian Chiropractic Association.

After a hearing, Coroner Barry McLellan ruled that Murray Katz, a Montreal pediatric practitioner, could not represent the Lewis family because a letter he had written to another coroner constituted inappropriate behaviour. The hearing was again postponed to give the family time to find another agent.

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