Whenever I report a case of arterial dissection after spinal manipulation, a defender of the indefensible comments that the case does not prove anything.
Let’s try again, shall we?
It has been reported that Nerissa E. Weeks has filed a negligence complaint against Dr. Jack J. Cacic and his business, Lake Worth Chiropractic & Wellness (LWCW). Weeks, a resident of Lake Worth, alleges that she suffered permanent neurological injuries due to the negligence of Dr. Cacic during chiropractic treatments at LWCW. Weeks initially sought treatment from Cacic on January 12, 2023, for low back pain related to a herniated disc in her lumbar spine. Following this initial visit, she returned to Cacic’s office several months later on June 26, 2023, complaining of neck pain and headaches.
During subsequent visits on June 26 and June 28, Cacic performed cervical manipulations and other treatments without obtaining appropriate informed consent from Weeks regarding the risks involved. On June 30, following another session of cervical manipulations by Cacic, Weeks experienced severe dizziness and vertigo shortly after the procedure. She was subsequently hospitalized and diagnosed with an acute right vertebral artery dissection and an ischemic stroke.
Weeks contends that Cacic failed to recognize symptoms indicative of a vertebral artery dissection and did not provide adequate care consistent with professional standards. The complaint states: “As a direct and proximate result of the negligence of the Defendants, WEEKS suffered permanent neurologic injuries due to an acute thromboembolic cerebrovascular accident.”
The plaintiff is seeking damages exceeding $50,000 for medical expenses, loss of earnings, pain and suffering, mental anguish, disability, impairment, and other related costs incurred due to the alleged negligence. Represented by attorney Hector Buigas from Morgan & Morgan P.A., Weeks demands compensatory damages along with interest, taxable costs, attorneys’ fees, prejudgment interest on medical bills as well as any other relief deemed proper by the court.
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How many more such cases do we need before chiropractors admit that cervical manipulations do more harm than good?
How long until all chiropractors explain to their patients that cervical manipulations do more harm than good?
How long until cervical manipulations become obsolete?
25 Responses to Patient sues a US chiropractor for negligence leading to vertebral artery dissection and stroke
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It is interesting they took the position that the VAD was pre-existing. I wonder if they think the VAD occurred when she was at the gym a few days prior to seeking care as that is when the initial symptoms started.
Do you have a point, DC?
I could make several points but they seem wasted here. But he should have considered exercise as a probable causative factor of VAD especially since “heavy lifting” was one of the most common history findings in this study on CAD.
Neurology 2013;80;1950-1957
Education
Mr Thompson, your sock puppet ‘DC’ is lying by omission, as usual:
A history of recently going to the gym was listed in the filing.
Try to keep up.
Pretzel logic. 🥨
This may (or may not) be an isolated instance but, in any event, it’s an example of a general lack of training & competence on the part of chiropractors to recognize medical issues / complications. In my many years of observing chiropractic, I’ve noted way too many such occurrences. DCs simply do not have sufficient medical training to be entrusted with general health issues. They have an inflated notion of their training & capabilities.
Adverse events can happen. Why they happen can be due to several reasons.
I am so glad we have someone as wise as this amongst our discussants!
It has been demonstrated that a preexisting VAD can and does cause non-specific symptoms from the head and neck area and cannot be ruled out by examination and history. Also, it has not been demostrated or subtantiated that cervical manipulation is superior to non-manipulative methods or even “wait-and-see”. It is also evident that a preexisting VAD should be considered an absolute contra-indication to any sort of manipulation due to the risk of further damage, clot-dislodgement and stroke.
This is the reason cervical manipulation should never be performed for non-specific symptoms from the area.
Furthermore there is no evidence it has benefit as a prophylactic measure in the abscence of sypmptoms.
The simple, non-refutable conclusion is that cervical manipulation should not be allowed in healthcare for any reason.
I cannot grasp why some contributers to this discourse have such a hard time understanding this.
Well, this isn’t completely true.
In this dose response study light massage was used as a control.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107442/?fbclid=IwZXh0bgNhZW0CMTEAAR2N48dQNayb86hCUwUKX_R_zwz4corB-F-jbZ3ipRWnBd4bd4DGRScOQvk_aem_ZmFrZWR1bW15MTZieXRlcw
There are often clinical indicators/risk factors present.
Example
Risk factors for VAD were reported in seven patients, including smoking [30,35], trauma [30,32], fibromuscular dysplasia [31], history of migraine [29], family history of aortic aneurysm [29], and intravenous drug use [34].
https://www.cureus.com/articles/212663-symptoms-of-patients-with-vertebral-artery-dissection-presenting-to-chiropractors-a-systematic-review-and-meta-analysis?fbclid=IwZXh0bgNhZW0CMTEAAR3Lvw4FqF4bDSclu5T9iiaL4vUkGxyOWk_u2LKK5BqAo7MjUIRsEKFPlPk_aem_ZmFrZWR1bW15MTZieXRlcw#!/
And one could ask:
what is the probability that someone with a VAD walks into a chiropractic clinic?
What is the probability that after a proper history and exam the VAD isn’t high in the diff dx?
What is the probability that if a properly applied cSMT is performed on a pre-existing VAD it causes an emboli/stroke?
It’s nice to call for a ban on cSMT but it’s not feasible with the current state of evidence…and a legal filing isn’t going to add much weight.
I understand that a group of Medical Doctors many years ago, had actually taken the Chiropractic ” profession” to Court.
Unfortunately the legal outcome did not fair well for the medical profession. Their case was muddied and twisted to the point where what was really needed for change, got pushed out of view.
So why exactly was this legal attempt stalemated? Sharper minds and a much higher pay grade than mine are needed to explore the “why” and take a different approach moving forward.
Perhaps however it is now time, given all the new evidence of chiropractic harm, for a new generation of MEDICAL Doctors to team up and introduce new evidence of malpractice. To re-visit the legal shortfalls of the past.
It is my opinion that as long as chiropractors continue to identify as real Doctors, the confusion, and serious needless injuries/death will continue.
All the posts and facts condemning this barbaric neck twisting fiasco is out there and all have made their cases. I understand that Chiropractors do not want their names or profession tarnished and may wish to remain silent. But for those who do stand up and choose not to engage in this aspect of their training which endorses rapid upper neck manipulation…, I applaud you!
“I understand that a group of Medical Doctors many years ago, had actually taken the Chiropractic ” profession” to Court.
“Unfortunately the legal outcome did not fair well for the medical profession. Their case was muddied and twisted to the point where what was really needed for change, got pushed out of view.
“So why exactly was this legal attempt stalemated? Sharper minds and a much higher pay grade than mine are needed to explore the “why” and take a different approach moving forward.”
Many years ago, long enough for me to only dimly recall everything that was said, I attended a meeting at which a lawyer who had been involved in the case told me that the it was poorly handled by the AMA attorneys.
I believe that the judge ruled that the AMA didn’t make a good case, but she specifically stated that chiropractic is unscientific.
A wikipedia article gives a good account of the case:
Better report than Wikipedia
https://law.justia.com/cases/federal/district-courts/FSupp/671/1465/2595129/
It’s interesting to read the following summary of what the judge had to say about chiropractic in that Wilk v AMA case.
“In 1987, federal court judge Susan Getzendanner concluded that during the 1960s “there was a lot of material available to the AMA [American Medical Association] Committee on Quackery that supported its belief that all chiropractic was unscientific and deleterious.” The judge also noted that chiropractors still took too many x-rays. However, she ruled that the AMA had engaged in an illegal boycott. She concluded that the dominant reason for the AMA’s anti-chiropractic campaign was the belief that chiropractic was not in the best interest of patients. But she ruled that this did not justify attempting to contain and eliminate an entire licensed profession without first demonstrating that a less restrictive campaign could not succeed in protecting the public. Although chiropractors trumpet the antitrust ruling as an endorsement of their effectiveness, the case was decided on narrow legal grounds (restraint of trade) and was not an evaluation of chiropractic methods.”
Ref: http://www.chirobase.org/08Legal/AT/at00.html
Have a look at a mirror first… You might be unpleasantly surprised
Could not agree more David.
Thank you for your words of wisdom.
There have been many stories done by the CBC on this issue please check them out before you let someone twist your neck.
It can be life changing and not in a good way.
Chiropractic manipulation can cause several different types of stroke. They can vary in degrees including death.
Please do your homework before letting anyone touch your neck …
Laura Brownson
Victim of chiropractic stroke, vertebral
Dissection, carotid dissection, nervous system damage, nerve root damage, tearing of my muscle.
This is just some of what I suffer from.
Please be aware it can happen to you
What has this law suit that is yet to be proven (and it might end up justified) has to do with your comment “chiropractic cx manipulation does more harm than good”?
Please support your claim with refrence and Please DON’T quate yourself…
A hard-nosed chiropractor once told me that there’s a greater risk of stroke from bending the neck backwards for a shampoo at a hair salon than from chiropractic neck manipulation. But, at least there’s some potential benefit from getting one’s hair washed: clean hair. No one has tendered convincing argument for putative benefit from neck twisting.
Get your info from proper studies and have a look at most guidlines supporting cx spine manipulation for neck pain.
More harm than good? I was an on-call chiropractor in an ER for 6 years. We saw about 5% of patients presenting to the ER. There were no complaints and 97% satisfaction on patient surveys. Every new ER doc would comment, there should be a chiropractor in every ER. They could hand off non-neurological and non-orthopedic emergencies to us and have more time for life and limb threatening emergencies. In patient hospitalizations for back pain went way down. Use of narcotics went way down. The only reason the program ended was because the hospital was purchased. The new owner instituted a program to increase hospitalizations for back pain with an increase in advanced imaging and pain management procedures. An attorney even told me that a hospital representative asked him if he wanted to receive clients from the hospital’s pool of patients. The hospital’s bills were so high that the state had to institute new fee caps for hospitals. Maybe it is not that spinal manipulation is bad, maybe it is some of the situations in which it is employed. Another example is the long wait time for active military to get an appointment with a chiropractor in the military hospital system. One former battle injured soldier told me, the surgeons saved my life, but the chiropractor helped return me to life.
Was this one of your demonstrations of abject BS? [my bolding]
Very useful pseudomedical knowledge to possess in ER — if one’s objective is to do more harm than good.
Whereas:
You give a perfect example of taking something out of context. I don’t have exact recollection of what you searched out, but I believe I was telling the lay person not to try to figure out what diagnostic imaging test they needed, but rather to rely on their physician. I believe I was giving an example of what a physician might be considering when ordering a test–trying to show that their physician would be reasoning out why one test would be more important at a given time. I hope your 8th grade science teacher doesn’t find out that you are quoting Wikipedia. And I stand by certain tests are sensitive, i.e., they will give an indication that something is wrong but not identify it. Other tests are more specific, i.e., they will help identify what is wrong. A bone scan is sensitive, it will light up when there is increased metabolic activity, but it will not differentiate cancer from infection or fracture. In contrast a CT scan will be more specific and help differentiate between a fracture, cancer, and infection. Regardless, if I have a question about which diagnostic imaging study to order, I ask a radiologist. Additionally, what does this have to do with the documented good the on-call chiropractic program did? As an example, I was working with the Red Cross at Ground Zero providing chiropractic to the recovery workers. At about 3 AM, I got a call from an ER doctor. I told him where I was. He insisted that I stop at the ER on my way home and see a patient so he would not have to admit the patient for IV pain medication. That is the same ER doctor who returned to being an anesthesiologist at a prestigious NY City hospital. Because of his experience with me in the ER, he had me meet with the hospital’s chief of neurosurgery to investigate the possibility of the neurosurgeon using me to treat some of his patients. Is it possible that if I provided the same type of treatment, but my professional degree was physical therapist or doctor of osteopathy you wouldn’t be so critical? What type of doctor are you?
Your comment is too stupid to be worthy of a reply.
“I was an on-call chiropractor in an ER for 6 years. We saw about 5% of patients presenting to the ER. There were no complaints and 97% satisfaction on patient surveys. Every new ER doc would comment, there should be a chiropractor in every ER.”
Every NEW emergency doctor. Those are ones who haven’t been around long enough to discover the potential harm if you performed neck adjustments.
Speaking of neck adjustments, my guess is that experienced MDs wouldn’t let one of you guys anywhere near a neck!
How common is it for hospitals to have chiropractors on staff? And are they the same ones that would hire homeopaths & other wannabe doctors?