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`Something was not right'
Chiropractor says she didn't use unusual force in neck adjustment
By Dan Zakreski
of The StarPhoenix

Thursday, September 10, 1998

Saskatoon chiropractor Stacey Kramer says she "had a gut instinct something was not right" moments after manipulating Laurie Jean Mathiason's neck on Feb. 4, she testified Wednesday.

Under questioning, however, she insisted the procedure she administered was not unusually forceful.

Mathiason, 20, slipped into a coma after the procedure and died in hospital shortly after. Whether Kramer could have foreseen what happened and the role the procedure played in bringing on the crisis emerged as key issues in the second day of a coroner's inquest.

Photos by Greg Pender Chiropractor Stacey Kramer told reporters the inquest should be about how her patient died, not whether her profession is safe

As Kramer testified inside Court of Queen's Bench, the president of the Canadian Chiropractic Protective Association expressed concerns on the courthouse steps that the inquest was turning into a general attack on chiropractors.

Paul Carey disputed earlier comments from a radiologist at Royal University Hospital. Brent Burbridge had testified how he'd seen at least a dozen patients show neurological symptoms after chiropractic treatment.

Carey said that was "an interesting comment. . . . If that's so, then how come none of them are published?

It's a personal opinion, not supported by the literature or data."

Kramer later added "this is supposed to be an inquest into what happened, not whether this is a safe profession."

Kramer appeared to contradict Burbridge's testimony when questioned by Silas Halyk, the Mathiason family lawyer. Burbridge had said that, after examining Mathiason's X-rays, it appeared an arterial rupture had been caused by a forceful manipulation of her neck.

Kramer, however, said "it was not a forceful adjustment. . . . If anything, it was gentler than usual."

A chiropractic adjustment is a repositioning or correction of the vertebrae.

Halyk spent most of the morning questioning Kramer, who struggled at times to maintain her composure during the tense exchanges. At one point, Halyk asked whether Kramer should be addressed as "Ms. or Mrs. Kramer."

"I'm Dr. Kramer," she responded.

Halyk then asked whether she had a medical degree and whether she was trained to deal with medical emergencies. She replied that she had no medical degree, but that she had extensive training to deal with chiropractic emergencies.

She conceded, however, that there this no medical emergency equipment in a chiropractor's office. There are no cervical collars, they do not have oxygen, nor are they allowed to administer intravenous drips.

The extent of the emergency treatment given was to check Mathiason's airway, to take her pulse and keep her still.

Kramer treated Mathiason 17 times between July 1997 and February 1998. Halyk questioned her extensively about Mathiason's treatment history, and the type of questions asked before a treatment program begins.

Kramer said that Mathiason was first seen by Stanley Lewchuk, another chiropractor in the office. Lewchuk did the pre-treatment interviews, which include a confidential case history that lists previous physical traumas such as injuries from a car crash, a family medical history and a consent form.

Halyk noted there were a number of blanks on Mathiason's history and consent forms.

"Did you go over this list, this questionnaire, item by item, with the patient?" he asked.

Kramer responded: "It would be my practice to ask, but I do not recall specifically asking. I don't know what happened during his examination.

"I would trust that Dr. Lewchuk did the proper screenings."

On the day of her last treatment, Mathiason complained of a sore neck and said she had not slept well. She had been worked on by Kramer the day before.

Calgary physiotherapist Jim Meadows sat through the day's testimony and read the autopsy report. Based on this evidence, he testified how he thought that "the manipulation on Feb. 3 did the damage and the manipulation on Feb. 4 finished it off."

Meadows performs similar manipulations. He said there is no sure clinical test to determine whether there is an injured artery. He said the safest route is to "listen to the patient and ask specific questions."

The inquest continues today.

Saskatoon Star Phoenix

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