Family blames chiropractic procedure for stroke

By Leslie Papp
Toronto Star Medical Reporter
November 2, 1999

Paralyzing strokes due to chiropractic neck adjustments appear far more common than previously thought, according to data to be released at a news conference today.

Such strokes likely happen to scores of Canadian chiropractic patients each year despite the profession's long-standing claims that a stroke is a one-in-a-million risk, warns Dr. John Norris, professor of neurology at the University of Toronto and head of an expert group which complied the new data.

``This is dangerous,'' he said.

An inquest is being demanded today into the death of Lana Dale Lewis, a 45-year-old Toronto woman who died of a stroke. Her family has launched a $12 million lawsuit against her chiropractor, Dr. Philip Emanuele, and several leaders of the profession.

The statement of claim alleges that the stroke was likely due to a chiropractic manipulation. Details are to be released today.

``This left three children with no mother,'' says Mike Ford, Lewis' brother-in-law. ``It left 12 people without a sister, and left a mother and a stepfather without their daughter.''

Emanuele did not return telephone calls yesterday.

In the statement of claim, which must still be proven in court, the family alleges that Emanuele manipulated Lewis' neck on Aug. 26, 1996, without using an examination table. Instead, he reached over his office desk, it says.

She was being treated for migraine headaches.

Lewis ``suffered a grievous injury . . . which ultimately caused her death'' from a stroke 17 days later, states the family's court claim.

Following an autopsy, a coroner concluded her death couldn't be blamed on chiropractic treatment with absolute certainty but that ``the uncertainty was small . . . less than 10 per cent,'' states the claim.

Also named in the lawsuit is Jean Moss, head of the Canadian Memorial Chiropractic College. The family claims the college failed to teach Emanuele about risks involved in twisting the neck.

A spokesperson for the college said officials were consulting with their lawyer and unable to comment yesterday. ``We're going to see what happens at that news conference,'' said spokesperson Kelly Mills.

Blood vessels in the neck can be damaged by the forceful manipulations involved in chiropractic treatment, said Norris, of the Stroke Consortium, a network of about 100 stroke researchers in 45 centres.

``If you damage those arteries, if you pull the neck as chiropractors do, you can tear the inside lining of the artery. It produces an obstruction.''

The damaged lining traps blood and begins to balloon. This balloon can become so big it blocks blood flow to the brain, said Norris. Or a clot can form ``and that clot goes upstairs to the brain.'' In either case, a stroke results.

The consortium launched a study in March, asking its members to report any strokes caused by a neck artery ``dissection.'' In just eight months, 19 centres have reported more than 60 cases.

About 30 per cent were deemed ``spontaneous,'' meaning they occurred from trivial actions such as drying the neck with a towel or even coughing.

But 70 per cent of cases were due to neck trauma, and the largest cause was chiropractic manipulation, accounting for about 20 ``stroked out'' people.

``If our small number of centres is showing two chiropractic strokes a month, that means the whole consortium would produce four a month,'' Norris said.

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