Mystery surrounds woman's death

No answer for mourning Guelph man two years after his wife's fatal stroke

PAUL BENEDETTI AND WAYNE MACPHAIL

FAMILY PHOTO Guelph woman Dora Labonte died after a sudden stroke in 2002, just days before her 41st birthday.

GUELPH (Jul 10, 2004)

On the evening of June 17, 2002, Joe Labonte says he got a frantic call from his wife Dora.

He was in North Carolina on business. His wife was at home in Guelph. She sounded frightened.

"The chiropractor did something that really scared me," Joe Labonte claims she told him.

His wife had been seeing the same chiropractor for nearly 10 years and had never had a complaint until then.

When he arrived home the next day, his wife's condition had worsened. She was holding the back of her neck and complained of a terrible, stabbing headache. Her vision was blurred and she had intermittent hearing loss.

"She was scared, definitely scared. She was uncomfortable, agitated. Not herself," said Labonte.

Five days later, Dora was rushed to Guelph General Hospital. Within minutes of arriving, a sudden stroke left her in a coma. She had suffered traumatic injury to two small arteries that ran up the back of her neck to her brain. That injury -- internal tearing of the vertebral arteries -- resulted in blood clots that entered the brain's blood supply, causing a fatal stroke.

On July 11, despite numerous surgeries, Dora Labonte died. She was two days shy of her 41st birthday.

Two years later, Joe Labonte, 43, still doesn't know for sure what killed the mother of his three sons. He and his wife were high school sweethearts who were both 21 years old when they married. Originally from St. Catharines, they had lived for 15 years in Guelph, where Dora ran a growing bookkeeping business, while Joe worked for Orion Bus Industries as a safety officer.

"We had a great marriage and things were really coming together," he said. "It was fun. We had started travelling. We started to be able to do things that we had put off for many years."

After a protracted 11-month investigation, marked by delays and errors, the Office of the Chief Coroner for Ontario ruled that the cause of death could not be determined.

Labonte finds that unbelievable.

He says the coroner's finding was politically motivated and defies common sense. While the coroner's office was investigating Dora Labonte's case, it was also mired in the two-year inquest into the stroke death of a 45-year-old Toronto woman caused by a chiropractic neck manipulation.

Chiropractic neck manipulation, frequently used to treat neck pain, headache and other ailments, is controversial. Critics charge that rapidly twisting the upper neck can damage the delicate vertebral arteries, leading to stroke and, sometimes, death. Chiropractors say the procedure, which they perform 250 million times a year in North America, is safe.

In April this year, a collective of physicians, victims and their families called for a Canadian moratorium on all upper neck manipulation.

Labonte feels the Lana Dale Lewis inquest -- one of the longest, most costly and combative inquiries the coroner's office had ever conducted -- was responsible for the delays in the investigation, and ultimately, for the decision about his wife's death.

"I was getting frustrated with the politics. It really felt as though we were getting into more of a political problem than a scientific one," said Labonte. "Delays, hidden agendas. I don't know what those agendas were behind the scenes. But nothing was up front. They were not asking logical questions in a timely fashion."

Labonte charges that the coroner's office misled him about hospital records and X-rays and was guilty of taking weeks, and often months, to respond to inquiries from his lawyer.

For example, Labonte says that Dr. James Cairns, the deputy chief coroner, told him on Dec. 4, 2002 -- six months after Dora's death -- that the office had all the relevant hospital X-rays. But when the family checked with the radiologist at Toronto Western Hospital, they discovered that Cairns had in fact not even requested the X-rays until Dec. 24, almost three weeks later.

Cairns agrees.

"I don't in any way take away from his statement at all. I did not have the X-rays. Quite right," said Cairns.

"I had asked my secretary to get the X-rays. I was under the impression that it had been done. He is quite right, it had not been done."

Labonte also says it took months for the coroner's office to provide him with any information on what those X-rays showed. He says this is only one example of many setbacks his family had to endure, while the very public Lana Dale Lewis inquest continued to be plagued by its own interruptions, blunders by the coroner's office, turf wars and personnel changes.

Cairns agrees there were unreasonable gaps in the complex Labonte investigation, but denies they were politically motivated.

"Do I agree that there was a delay? Yes. Do I agree that there was an undue delay? Yes, I accept that entirely.

"What we differ on is the motivation or the perception of motivation," said Cairns in a recent interview.

"I think (Labonte) feels that the delay was motivated by some issues with the Lewis inquest. All I can say is, it wasn't. That's it."

Labonte and the coroner's office also disagree on the cause of Dora's death.

Both agree that Dora was a healthy 40-year-old woman and that her autopsy revealed no medical conditions that would raise red flags. They also agree that Dora visited a chiropractor early in mid-June 2002, for headache treatment and experienced something that frightened her. Labonte is convinced it was a chiropractic neck adjustment, although his wife never explicitly described what happened to her.

Dr. Trevor Gillmore, of the coroner's office, interviewed the chiropractor, who said she did not do any dynamic adjustment of Dora Labonte's neck. Gillmore did not ask the chiropractor what her normal treatment for headache was, nor did he ask what her normal treatment for Dora Labonte was. The chiropractor's treatment record does not indicate neck manipulation was performed.

Although there was evidence of traumatic damage to both left and right vertebral arteries, there is some medical evidence that such damage, in extremely rare cases, can be caused by normal daily activities.

"The issue is: was her death due to chiropractic manipulation or was it due to natural causes? And we were not able to determine that from our investigation," said Cairns.

But Labonte finds that ludicrous. He says that you would have to believe his wife suffered extremely rare damage by natural causes to both arteries on the very same day she visited a chiropractor, a profession that often treats headache with neck manipulation. Labonte feels that the only way to figure out what really happened to his wife is to hold an inquest.

Cairns agrees.

"There is a temporal relationship. (The chiropractor) tells us she didn't do a neck manipulation," said Cairns. "To have taken this further, we would have had to go to inquest." But, he admits his office didn't proceed because of the Lana Dale Lewis inquest, which was already examining in great detail all the issues that would be raised by the Labonte case.

"If the Lana Dale Lewis inquest wasn't in existence, then we would have seriously considered: 'Do we need an inquest?' " said Cairns.

He said that, in recent years, the coroner's office has taken the view that it is better to do a few, deep inquests into systemic issues rather tackling every case on an individual basis.

Deputy chief coroner (inquests) Dr. Bonita Porter explained to the Labonte family last November that it would not make sense to hold another inquest until the response to the Lewis inquest jury's recommendations could be assessed. Those recommendations pointed to shortcomings in the coroner's office and called for increased study, reporting and documentation of chiropractic neck manipulation and stroke.

But, so far, the chiropractic community's response to the inquest -- it called the jury's decision "perverse" and the inquest process a "travesty" -- doesn't suggest that change is coming. The Canadian Chiropractic Association also threatened to challenge the jury's findings at Division Court. Cairns says that, so far, the chiropractors have taken no legal steps to do so.

Cairns says, that despite the chiropractors' public dismissal of the Lewis findings, his office must wait for the official response from the chiropractic community, which they have a year to file. He says that if his office finds the response inadequate, an inquest into Dora Labonte's death could still be called.

In the meantime, Joe Labonte has filed a multimillion-dollar civil suit against chiropractor Tracy Drynan of St. Catharines.

Drynan, in a statement of defence filed in February 2004, says she treated Dora Labonte for headache and neck stiffness with neck manipulation from 1993 to 1998. She discontinued the use of neck manipulation in 1998 and subsequently treated Dora with massage and soft tissue therapy.

On June 17, 2002, Drynan "administered soft tissue therapy treatment to the low and mid-back and the musculature of the right and left jaw," according to the statement of defence. She adds that the patient left the office "without exhibiting or complaining of any neurological complaints, pain and/or discomfort."

Labonte still hopes for a public inquiry into his wife's death.

"Without an inquest, she won't be counted as one of the women in Canada killed by neck manipulation," he explained. "She's a lost person."