Pathologist's findings scrutinized at hearing
Doctor insists chiropractic to blame for death
John Deverell
Staff Reporter
Dr. John Deck, the seasoned coroner's pathologist who has blamed a chiropractic neck adjustment for the 1996 death of Lana Dale Lewis, has taken days of pounding at a coroner's inquest.

He hasn't backed down, but under tough cross-examination, which ended yesterday, Deck has made a series of admissions to the jury.

Lawyers Tim Danson, Brian Foster and Chris Paliare, acting for various chiropractic interests, have tried hard to paint the retired University of Toronto professor, who has participated in about 10,000 autopsies, as unscientific in his methods and biased against chiropractic.

Among the revelations:

  • The professor's protégé, Dr. Michael Pollanen, worked on the Lewis autopsy with Deck but disagrees on the major finding. Pollanen attributes the Lewis stroke to natural causes. He will testify today.

  • Deck formed his initial opinion about the cause of death before looking at the pathological evidence through a microscope. He wrote his first report on the strength of Pollanen's cuttings, slides and observations.

  • Deck's contribution to the coroner's first report on the fatal Lewis stroke involved no examination of the left vertebral artery immediately outside and inside the skull. These are the areas most likely to display injury from chiropractic manipulation if any such injury actually occurred. Deck did not realize that Pollanen had missed this section of the artery when cutting for slides.

  • During the subsequent controversies leading to the inquest, Deck developed a relationship with Dr. Murray Katz, a Montreal doctor who Deck describes as an anti-chiropractic zealot. Deck said Katz provided him with information about the relationship between chiropractic adjustment and stroke he otherwise would not have had. He said the information had no effect on his judgement.

  • Lewis' heart was donated and unavailable for examination at autopsy.

  • The initial slides of the vertebral arteries cut by Pollanen disappeared and eventually he had to cut another set.

  • A substantial box of files on the Lewis case has disappeared from the forensic pathology section of the coroner's office.

  • Deck has never seen a stroke originate in the vertebral artery, and can cite no reported cases of such an event resulting from chiropractic manipulation, unless there is a clear trauma-induced separation in the layers of the artery outside the skull. Deck could find no such injury when he finally examined the critical section of Lewis' left vertebral artery. He then hypothesized that there was some kind of injury that healed enough to be unobservable during the autopsy.

  • The pathologist has written three reports on the Lewis stroke, shifting ground a little each time.

  • Deck told the jury he was 60 per cent sure of his original finding of cause of death and that later, after going over the evidence and slides carefully, he became 90 per cent certain that chiropractic adjustment caused Lewis' death.

    One of the coroner's expert witnesses, Dr. Scott Haldeman, told the jury that Deck's theory — that Lewis' fatal stroke occurred after a chiropractic neck adjustment — is nowhere to be found in any medical textbook.

    It is far more likely, Haldeman said, that Lewis died naturally from the consequences of atherosclerosis, the hardening and splitting of the left vertebral artery wall inside the skull.

    But Deck maintained to the end of his examination yesterday that only his theory could explain all the pathological and clinical evidence. He said he continues to hold this opinion with a high degree of certainty.

    It would not be useful to write "cause of death undetermined" at the end of every autopsy report just because absolute proof is hard to come by, Deck said.

    Amani Oakley, counsel for the Lewis family in its $12-million civil suit against her chiropractor, invested considerable time at the inquest attacking Haldeman. She reminded the coroner's jury that some textbooks, including one on which Haldeman relied heavily, contain elements of support for Deck's hypothesis.

    New findings, she reminded the jury, do not spring full-blown from peer-reviewed medical journals. They have to start somewhere, possibly in a coroner's pathology lab.

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