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Back-Breaking Report

Comments by Murray Katz on John Wiens' broadside on the Saskatoon inquest

Chiropractor John Wiens view of the inquest in Saskatoon is quite a remarkable spin. The Jury accepted just about everyone of my recommendations. They agreed the benefit was not known, they agreed the risk were not known, they said there should be a warning in every chiropractic office about the dangers. Hardly an endorsement of cervical manipualtion.

The chiropractic lawyer did try to question me but the Judge cut him off saying his questions were a personal attack and were not pertinent. I was the Coroner's expert witness summing up what was said. I had prepared a background paper for the jury which the Judge felt was not necessary when the chiropractic lawyer objected to it.

Are they trying to infer that Saskatchewan professor David Cassidy is to get the Nobel prize?

COMMENTS ON THE RECOMMENDATIONS OF THE CORONER'S INQUEST INTO THE DEATH OF LAURA MATHIASON

A) To determine the incidence of strokes associated with cervical spinal manipulations.

Differing testimony was presented as to the incidence of strokes and neurological side effects. The chiropractors claimed it to be one in several million cervical manipulations. Dr. Brent Burbridge, the neuro-radiologist said he knew of a dozen recent cases of neurological complication in his own hospital in recent experience (The jaws of the chiropractors dropped open when they heard this.) He also said he would never allow a chiropractor to manipulate his neck. Dr. Murray Katz quoted numerous studies to show that the incidence was many times higher.

The Jury concluded that the incidence was not known and had to be determined by an independent source.

B) To determine the benefits and harmful effects that are associated with single and multiple cervical spinal manipulations.

The chiropractors claimed there were many benefits to cervical manipulation. This was disputed by other testimony. The Jury recommended that the benefits, if any, have to be determined.

C) To pursue development of effective screening tests that will identify patients who are at high risk of adverse complications when receiving cervical spinal manipulations.

No evidence was presented by the chiropractors to determine what a valid screening test may be. In fact, they suggested that there might not be any such tests. The Jury recommended that some type of test be developed.

RECOMMENDATIONS OF THE INQUEST OF INQUIRY INTO THE DEATH OF LAURIE JEAN MATHIASON

2. We recommend that the Ministries of Health in Canada

A) Develop a prototype patient and family medical history form, which elicits pertinent health data prior to chiropractic treatment. The administrative assistant at the clinic will ensure that requested information be fully provided on the form at the patient's initial visit. The chiropractor will verify and discuss all pertinent information on the form and explain to all patients his/her particular expertise before proceeding with treatment.

B) Collaborate with Chiropractic Associations to ensure that the contents of the consent for treatment form be discussed by the Chiropractor and the patient at the initial visit,

The testimony showed that there is a lack in patient understanding of the treatment they are being exposed to. The Jury felt the patient should be fully advised in advance of any cervical manipulation being undertaken.

C) In collaboration with Chiropractic Associations, ensure that literature indicating the risk of strokes and other inherent risks associated with chiropractic treatment be visible and available in the reception area of every Chiropractic facility.

This was perhaps the most dramatic recommendation. To emphasize the importance of the risks, the Jury felt that there should in effect be some warning that "the risk of stroke and other inherent risks associated with chiropractic treatment be visible and available in the reception area of every chiropractic facility".

D) After the development of the screening test(s) referred to in recommendation 1. C. Ensure that such test(s) be made mandatory before administering cervical spinal manipulation.

E) Increase communication and collaboration among all specialties in health care to maximize benefits and minimize risks inherent in cervical spinal manipulation treatments.

Typed from the handwritten document presented to Dr. John Nyssen by the Jury after hearing evidence into the death of Laurie Jean Mathiason.

R.W. Pick
2000 hrs. September 11, 1998