Hamilton chiropractic lawsuit Woman seeking $2 million
Woman stopped prescribed physio sessions Therapy may have eased pain
January 20, 2000 - page A-8
Joanna Frketich - Health Reporter
A Hamilton woman suing a chiropractor she claims hurt her neck stopped going
to physiotherapy recommended by doctors to treat the injury.
Physiotherapist Linda Stavnitzky testified yesterday that Pierrette (Pat)
Collin abruptly ended therapy sessions after three months.
Collin, 59, is suing Burlington chiropractor Dr. Derek Jasek for $2 million,
claiming his neck adjustments left her in constant pain for the past six
years.
The case is significant because it will examine chiropractic services at a
time when more Canadians than ever before are using the alternative therapy.
Stavnitzky told Superior Court Justice Paul Philp that Collin gave up
physiotherapy before trying a number of treatments that might have eased
severe pain in her neck, shoulder and right arm.
"You expected her to continue," asked defence lawyer Tim Lowman.
"Yes," answered Stavnitzky.
"You would expect, if given the opportunity to give further treatment or
other modalities, her condition would improve," asked Lowman.
"I would hope so," said Stavnitzky.
Doctors referred Collin to Parkdale Physiotherapy and Rehab Services in
March 1994 to treat the neck pain as well as chronic pain in her lower back,
right hip and leg.
She went to the Hamilton clinic frequently in March and April, but her
visits started to taper off in May. She went to the clinic for the last time
June 6 because the therapy didn't seem to be working.
"It was just a temporary help," said Stavnitzky.
This was the second time Collin had withdrawn from physiotherapy at the
Parkdale clinic. The first time was in December 1993 when she was seeing
Stavnitzky for the chronic pain in her lower back, right hip and leg caused
in part by osteoporosis, osteoarthritis and scoliosis, which is an abnormal
curvature of the spine.
Collin left physiotherapy because it wasn't helping and took her family
doctor's advice to see the chiropractor Feb. 2, 1994. She said Jasek
adjusted her neck without getting her permission or telling her the risks.
She testified last week she heard a crack and felt instant pain in her neck
after the manipulation. She said she went back to Jasek four more times over
the next couple of weeks and he adjusted her neck each time despite her
protests.
When the new pain in her neck, shoulder and arm didn't go away, a specialist
sent Collin back to physiotherapy. Stavnitzky said Collin came into the
clinic hunched over and holding her neck. It was the first time she heard
Collin talk of neck problems.
"She was complaining of a lot of neck and arm pain that seemed to override
the (back) pain," said Stavnitzky. "The pain was constant and was a
combination of aching and sharp pain."
The trial continues today.
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Chiropractor broke rules: Neck adjustment should have halted when pain began
January 19, 2000 - page A-2
Joanna Frketich - Health Reporter
A chiropractic expert says a Burlington chiropractor being sued for $2
million broke the rules and injured his patient.
Dr. John MacRae testified yesterday the chiropractor should never have
manipulated Pierrette (Pat) Collin's neck in the first place and should have
stopped when she told him she was in pain.
"My feeling is it was entirely unnecessary," said MacRae.
He said the treatment given by Dr. Derek Jasek on Feb. 2, 1994 caused a neck
injury that Collin claims has been painful for the last six years.
The case is important because it puts the alternative therapy under scrutiny
at a time when Canadians are turning to chiropractors more than ever before.
"Based on my findings and what I learned about her history, there was no
record ... of (neck) pain before her visit of Feb. 2," MacRae said.
"Rather, unfortunately, everything has taken place since that visit with Dr.
Jasek."
MacRae has practised chiropractics for almost 40 years and was an examiner
for the College of Chiropractors of Ontario. He designed exams and tested
graduates applying for their chiropractic licence until he retired in 1999.
He said Jasek went against guidelines set out by the Canadian Chiropractic
Association when he manipulated Collin's neck. Chiropractors are supposed to
concentrate only on the parts of the body that are in pain during a first
visit.
Collin went to Jasek for chronic pain in her lower back, right hip and leg
caused in part by osteoporosis, osteoarthritis and scoliosis, which is a
curvature of the spine. She says she had no neck pain before visiting the
chiropractor.
"The chief complaint should provide the major focus for this exam," MacRae
said.
He pointed out that Jasek's notes from his first meeting with Collin do not
list neck pain as a problem.
"Would that guideline be contravened in your opinion?" asked Collin's lawyer
Leonard Walker.
"Yes," MacRae replied.
However, defence lawyers said the guidelines were distributed to
chiropractors one month after Collin saw Jasek. They are also voluntary
rules that have not been adopted by the Ontario Chiropractic Association or
the College of Chiropractors.
MacRae told Superior Court Justice Paul Philp that Jasek should have acted
immediately after learning Collin was in pain, which is unusual after a neck
adjustment. He said Jasek should have put a neck collar on Collin, ordered
an X-ray, and possibly even sent her to a neurologist.
He agreed with defence lawyer Tim Lowman that Jasek would have no way of
knowing Collin was in pain if she didn't tell him. Collin has testified she
cried out in severe pain and Jasek's notes indicate there was neck stiffness
after the treatment.
MacRae said Jasek should have stopped manipulating Collin's neck right away.
Instead, Collin claims he immediately adjusted her neck again. He also
adjusted her neck during four more appointments in February 1994.
"I would be very surprised at anyone continuing to treat any area with
injury or trauma to this extent in the same manner as (he) had originally,"
MacRae said. "It has the potential of causing further injury."
MacRae said Jasek should have informed Collin of the risks of a neck
adjustment and got her consent before giving her the treatment.
Collin says Jasek never told her what he was going to do and didn't get her
permission or explain the possible risks before adjusting her neck.
The trial continues tomorrow.
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Family doctor recommended chiropractor Woman complained of neck pain after treatment for hip and leg
January 18, 2000 - page A-3
Joanna Frketich - Health Reporter
A Hamilton family doctor says his patient had no neck pain before she
visited the chiropractor she is suing for $2 million.
Dr. Richard Tytus testified yesterday his long-time patient started
complaining to him about constant pain in her neck, right shoulder and arm
in March 1994, a month after she received neck adjustments from Dr. Derek
Jasek.
"She never had any neck pain prior to that," Tytus said.
Pierrette (Pat) Collin, 59, has launched a lawsuit against Jasek claiming
his treatment left her with a permanent neck injury.
The case is significant because it will examine chiropractic services at a
time when the alternative therapy is at the height of its popularity in
Canada. It is one of a number of recent lawsuits against members of the
profession. A Hamilton man and his family are suing a chiropractic clinic
for $10 million because they say a neck adjustment led to a stroke.
Tytus told Superior Court Justice Paul Philp that he recommended Collin see
the chiropractor after other therapies failed to ease chronic pain in her
back, right hip and leg. The pain had been getting worse for about three
years and was caused in part by osteoporosis, osteoarthritis and scoliosis,
which is an abnormal curvature of the spine. Tytus tried a variety of
medications and physiotherapy to lessen the chronic pain, but none was
working.
"She was very uncomfortable," Tytus said. "She was unable to sit
comfortably, she was bent over and she seemed in constant distress."
The back, hip and leg pain was interfering with Collin's job as a baker in
the family's catering business -- Pierre's Fine Foods Inc. As a result,
Tytus said Collin asked him to help her get a disability pension. This
contradicts Collin who testified last week that Tytus suggested the pension
to her.
Before agreeing to help Collin get the pension, Tytus wanted to make sure
there was nothing else he could do to alleviate the chronic pain. In
February 1994, he referred her to a rheumatologist and the chiropractor. At
the time, Jasek was working in the same office building as Tytus, but the
chiropractor has since moved his practice to Burlington.
"He was known to you to be a good chiropractor," defence lawyer Tim Lowman
said. "You recognized the importance and value of chiropractic services."
"Absolutely," Tytus said. He said he was "quite happy" with the care Jasek
had been providing to his patients.
However, Tytus was surprised when a couple of weeks after the chiropractor's
appointment he received a report from the rheumatologist saying Collin was
having problems with her neck as well as her back, hip and leg.
When Collin visited Tytus in March 1994 she told him the chiropractor had
hurt her neck. Since then the east-end woman has complained about neck pain
during every visit to the family doctor and a variety of treatments have not
helped.
Tytus testified he finally agreed to help Collin get the disability pension
in April 1994, two months after she saw the chiropractor.
Last week, the defence suggested Collin applied for the pension and listed
neck pain as one of her problems at least one month before she was treated
by Jasek. But Tytus insisted he didn't fill out any pension forms before the
appointment with the chiropractor.
Collin's final appeal for the pension was turned down four years ago.
Tytus said he told Collin she would have to slow down her work in 1993
because the heavy lifting and bending was contributing to her chronic back,
hip and leg pain.
However, he said she didn't stop working until March 1994, which is after
she started having neck pain.
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Doctor says neck injury could have many causes Lawsuit claims chiropractor caused pain
January 15, 2000 page A-5
Joanna Frketich; Health Reporter
The director of MRI services for Hamilton's superhospital says a woman suing
a Burlington chiropractor for $2 million has a minor neck injury that could
have happened anywhere.
"I would say it is a small disc herniation," said Dr. Joseph Fairbrother of
the Hamilton Health Sciences Corporation."There is a broad range of causes
or circumstances in which a patient could experience a disc herniation."
Pierrette (Pat) Collin, 59, claims in her lawsuit against Dr. Derek Jasek
that his treatment caused a ruptured disc in her neck to press against her
spinal cord. The east-end woman said the injury has left her in constant
pain for the past six years.
The case is significant because it will put the alternative therapy under
the microscope at a time when chiropractic services are more popular than
ever in Canada.
Fairbrother testified yesterday that magnetic resonance imaging (MRI) shows
Collin has a moderate injury. But he can't tell from the tests when the
injury happened or how. He agreed with defence lawyer Tim Lowman that the
injury could have been caused by a number of different things including
Collin turning her head too quickly.
"The films don't tell you the age of the herniation," stated Lowman. "As to
the cause of the herniation, the films don't help to tell you that either."
Fairbrother described Collin's injury as a disc bulging out between two of
the vertebrae in her neck and pressing against her spinal cord. Discs in the
spine separate the vertebrae, acting as shock-absorbing cushions. The discs
have a tough outer belt that keeps the jelly-like interior intact. If the
belt tears, as it has in Collin's case, then the soft substance will bulge
and can cause pain as it touches the spinal cord. It is a common injury that
can happen on its own with old age.
But Fairbrother told Superior Court Justice Paul Philp that Collin's spine
in her neck is mostly normal and isn't showing much sign of this type of
aging. He said the type of injury she has was more likely caused by a sudden
event and would result in instant pain.
Collin claims she had no neck pain before visiting the chiropractor for the
first time February 2, 1994.
While Fairbrother testified the herniated disc is small now, he added it
could have been larger when the injury first took place. The MRI was taken
in August 1995, more than a year after the chiropractic treatment.
"It's clear over time and with conservative treatment the natural history of
most cervical disc herniations is to become smaller," said Fairbrother. "The
degree to which they became smaller is unpredictable."
The trial continues Monday.
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Doctor questions treatments Neurologist says chiropractor should have stopped manipulating woman's neck
January 14, 2000 page A-3
Joanna Frketich; Health Reporter
The head of neurology at Hamilton's superhospital said a woman suing a
chiropractor for $2 million has a neck injury that could have been caused by
the doctor's treatment.
Dr. Robert Duke also testified yesterday that the chiropractor should have
stopped manipulating the Hamilton woman's neck after finding out she was in
pain.
"A prudent practitioner would at that point back off," said Duke, of the
Hamilton Health Sciences Corporation. "To continue manipulating in the face
of pain would be negligent."
Pierrette (Pat) Collin, 59, claims in her lawsuit against Burlington
chiropractor Dr. Derek Jasek that she has been in constant pain since he
treated her six years ago.
The case is meaningful because it will give the public a closer look at an
alternative treatment that has grown immensely popular.
Superior Court Justice Paul Philp was told magnetic resonance imaging (MRI)
shows Collin has a ruptured disc in her neck pressing against her spinal
cord. Duke said the injury is one of the risks of a neck adjustment, which
forces the neck to rotate further than it normally does and puts stress on
the discs in the spine.
Collin claimed Jasek never explained those health risks or got her
permission before manipulating her neck in February 1994. The east-end woman
went to Jasek to treat chronic pain in her lower back, right hip and leg
caused partly by osteoporosis and osteoarthritis. She said she had no neck
pain before visiting the chiropractor.
"I would see manipulation as potentially helpful in patients with neck
symptoms ... If the patient has no symptoms I don't see how it could
benefit, and it could pose a risk," Duke said. "I think it is wrong to
manipulate the neck (if there are no symptoms)."
Duke said risks can be as severe as stroke, which is why he suggests
chiropractors never perform a neck adjustment without making sure it is
absolutely necessary first.
"I would feel the minimum would be an X-ray of the neck prior to
manipulation," he said.
Collin claimed Jasek saw her for only a few minutes before doing the neck
adjustment and never took an X-ray. She said he also adjusted her neck four
more times over the next two weeks despite her protests.
"If there was manipulation at all, it should have been directed to the
symptomatic area," said Duke. That would suggest Jasek should have only done
manipulations on Collin's lower back, hip and right leg.
Duke explained Collin's injury was similar to a squashed jelly doughnut. The
discs in the spine separate each vertebrae and act as a shock absorbing
cushion. The discs have a tough outer belt that keeps the jelly-like
interior intact. If the belt tears, then the soft substance will bulge out
and can press against the spinal cord, causing pain. It is a common injury
that can happen on its own with old age. But Duke said the type of bulge
Collin has is usually caused by some sort of trauma such as a neck
adjustment.
While the size of Collin's herniated disc would normally result in no pain,
Duke said the MRI was taken more than a year after the chiropractic
treatment, so the size of the injury had likely gone down. He also testified
only 25 per cent of people with a rupture in the area of Collin's injury
would feel the pain radiating from their right neck to their right thumb as
she does. The other 75 per cent would feel it from their neck to their
middle finger.
Duke's examinations of Collin found she is able to move her neck without
problems and has normal use of her right and left hand.
The trial continues tomorrow.
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Woman suing chiropractor still on payroll Her son says he gave her a raise
even though she could not work at her old job
News Thursday, January 13, 2000 A-6
Joanna Frketich; Health Reporter
A Hamilton woman who says she had to stop working as a baker because a
chiropractor's treatment left her permanently disabled is still on the
company's payroll.
Pierrette (Pat) Collin, 59, gets $750 a month from her family's catering
business despite severe neck pain she says interfered with her work. She
even got a raise in 1997 -- three years after the injury.
"I've continued paying my mother what I did because she's my mother,"
explained Collin's son Marc, who runs Pierre's Fine Foods Inc. in Hamilton's
east end.
He was testifying in the Superior Court yesterday as part of a $2 million
lawsuit against Burlington chiropractor Dr. Derek Jasek. The lawsuit stems
from a neck adjustment Jasek gave Collin, which she claims has left her in
constant pain for the past six years.
The case is important because it will examine chiropractic services at a
time when the alternative therapy is at the height of its popularity in
Canada. It is one of a number of recent lawsuits against members of the
profession. A Hamilton man and his family are suing a chiropractic clinic
for $10 million because they say a neck adjustment led to a stroke.
Marc Collin, 33, testified his mother hasn't been able to work as a baker
since five visits to the chiropractor in February 1994. She does only
clerical work now for the family business, such as answering the phone,
ordering supplies or making menus. Her son says she works only a fraction of
the 12- to 14-hour days she used to put into the company started by her and
her husband, Pierre.
However, Marc Collin has continued to give his mother a paycheque for the
last six years, saying he didn't want to deny her an income. Her final
appeal for a disability pension was turned down in May 1996 -- the same year
his father retired from the business.
He also gave her a raise from $600 a month to $750 a month about three years
ago. He claims it had nothing to do with her work performance. It was merely
a goodwill gesture because the company was doing well.
"I felt I could give her a little more." he said.
Marc Collin and his wife Susan Lusted testified Collin had no neck problems
before she visited the chiropractor. But since the neck adjustment on Feb.
2, 1994, she hasn't stopped complaining about pain in her neck, right
shoulder, arm and hand.
"I find it has probably worsened as it has gone on," said Marc Collin. "It's
always there for her."
Both said she was suffering from lower back, right hip and leg pain partly
caused by osteoporosis when she went to Jasek after conventional therapies
had failed. They said the leg and hip pain had changed her from a vibrant,
strong woman to a "shell of her former self."
Her friend Violet Lusted (Susan Lusted's mother) testified she had hoped the
chiropractor would help ease Collin's pain and was surprised when she picked
her up from the first appointment to find her very upset.
"She said the 'blank blank' hurt my neck," Violet Lusted said.
All three testified they didn't take Collin to a hospital or a doctor after
the neck adjustment.
"I told her (the chiropractor) knows what he's doing," Marc Collin said.
"It's probably got to hurt before it gets better."
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Woman in pain before her adjustment Lawyer links trouble to osteoporosis
January 12, 2000 page A-3
Joanna Frketich; Health Reporter
Defence lawyers for a Burlington chiropractor being sued for $2 million say
the patient was in pain and unable to work long before she visited the
doctor.
Lawyer Tim Lowman yesterday questioned the Hamilton woman's claims that she
had to stop working as a baker in the family business, babysitting her
grandchildren and cleaning her house after a visit to Dr. Derek Jasek left
her with a permanent neck injury.
Pierrette (Pat) Collin, 59, has launched a $2-million lawsuit against Jasek,
saying she can no longer perform even simple tasks, such as doing her hair,
because of constant pain in her neck, right shoulder, arm and hand.
The case is significant because it will put the alternative therapy under
the microscope at a time when chiropractic services are more popular than
ever in Canada.
However, Lowman suggested Collin had to quit working at Pierre's Fine Foods
Inc., give up most of the household chores, and was having difficulty
sleeping months before she saw Jasek for treatment in February 1994.
"Even back in '93 when you were going to see the physiotherapist,you told
the physiotherapist you had pain in the night," Lowman said.
He suggested chronic pain in her lower back, right hip and leg -- caused
partly by osteoporosis -- has left Collin unable to do many of the things
she did before.
This pain brought her to Jasek in the first place. Her family doctor
suggested she give the chiropractor a try after conventional therapies
failed.
Collin told Superior Court Justice Paul Philp that Jasek never explained to
her what he was going to do or the possible risks, and didn't get her
consent before he manipulated her neck. She testified she heard a loud crack
and felt "unbelievable pain."
Collin said she went back four more times over the next two weeks expecting
Jasek to fix the problem and each time he manipulated her neck again despite
her protests.
She said the pain never went away and denied Lowman's suggestion that she
told at least one doctor her neck pain wasn't constant.
"I don't think there was one day when I didn't have to take pain killers or
Aspirin," she said.
Lowman questioned why Collin or her husband Pierre never complained about
Jasek's treatment to their family doctor, who recommended the chiropractor.
At that time, Jasek was practising in the same office as the family doctor
so the couple could have expressed their concern to him after any one of the
five appointments.
Lowman also suggested Collin has not always followed the advice of her
family doctor or specialists for treating her neck.
For example, Collin turned down intense physiotherapy recommended by at
least two doctors because she would have to go for the treatment five days a
week.
The trial continues today.
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Woman sues for millions over pain Chiropractor's care sparks suit
News Tuesday, January 11, 2000 page A-1
Joanna Frketich; Health Reporter
A Hamilton woman suing a chiropractor for millions of dollars says she has
been in constant pain for six years because of his treatment.
Pierrette (Pat) Collin, 59, testified during the first day of trial
yesterday that she screamed out in "unbelievable" pain when former Hamilton
chiropractor Dr. Derek Jasek adjusted her neck without her permission.
"It was the sharpest thing I ever had," she said. "It was like lightning. I
got scared. I thought my neck was broken."
The $2-million lawsuit against Jasek, who now practises in Burlington, will
put the controversial alternative therapy under the microscope for the next
three weeks. While chiropractic services are more popular than ever in
Canada, the profession has been hit with a number of recent lawsuits. In
addition to Collin, a Hamilton man and his family are suing a chiropractic
clinic for $10 million over a neck adjustment they say led to a stroke. And
a Toronto chiropractor is facing a $12-million lawsuit over the death of a
45-year-old patient from stroke.
Collin told Superior Court Justice Paul Philp she can no longer work as a
baker at her family's catering business, babysit her grandchildren or clean
her house because of constant pain on the right side of her neck. She has
had to give up favourite pastimes such as gardening and fishing and has
trouble sleeping at night.
"I can't even do my hair," she said. "Anything I do while lifting my (right)
arm hurts."
Collin said her right arm and hand have been numb and almost useless since
her first visit with the chiropractor on Feb. 2, 1994.
Her family doctor recommended Jasek -- whose office was in the same building
as his at the time -- after other treatments such as physiotherapy failed to
ease chronic pain in her lower back, right hip and leg. Collin said Jasek
never told her what he was going to do, and didn't explain the risks or get
her consent.
"I (lay) on my back and he started to massage my shoulders," said Collin. "I
said (to him), 'I have no problems there, it's my hip.'"
Jasek told her to relax and then suddenly pushed her neck to the left.
Collin said she heard a loud crack and felt instant pain.
"The pain was unbelievable and I yelled," said Jasek. "I asked him why he
did that and (told him) it hurt. He said it wasn't supposed to hurt."
Collin said she left the office in tears, afraid her neck had been seriously
injured. "I know I was crying," she said. "The tears were frozen on my
face."
Collin, who kept touching her neck and shoulder throughout her testimony,
said she went back to Jasek four times at the urging of her husband Pierre
and son Marc. She said each time she asked him not to adjust her neck, but
he ignored her request.
"I thought it was going to get better. I thought he was going to fix it."
The appointments stopped after she went to see a rheumatologist a couple of
weeks later and he advised her not to go back to the chiropractor. She said
she never had any neck or arm pain before visiting Jasek.
However, defence lawyer Tim Lowman pointed out Collin listed neck pain as
one of her illnesses when applying for a disability pension at least a month
before she went to see Jasek.
He also asked Collin why she didn't list neck pain as a problem in a letter
appealing the government's decision to deny her claim seven months after her
chiropractor appointment.
Collin's testimony continues today.
Outcome of the case
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