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Appeals Court Overturns $285,019 Award to
Former Chiropractic Students

The Missouri Court of Appeals has overturned a large damage award to nineteen 1997 graduates of Cleveland Chiropractic College (CCC), in Kansas City, who had charged that their education had been inadequate. The suit, filed in Kansas City, Missouri, in 1999, charged that the school had failed to provide adequate teaching as promised by promotional literature and school representatives [1]. The suit sought a total of $22 million for breach of contract, unjust enrichment, and fraud. The allegations included:

• During the recruiting process, school representatives said that the clinical experience they would receive would be invaluable in learning to diagnose various ailments and that the school would provide an "ample" supply of patients to complete their clinical requirements. Similar representations were made in literature used to recruit them.
• Implicit in these representations was a promise that the students would not only earn a chiropractic degree but would acquire sufficient skills in the diagnosis and treatment of physical ailments to enable passage of their home state licensing examinations.
• When the students approached their final year and eligibility to work in the Clinic as student interns, the school's faculty told them that, to meet the minimum clinical experience required for graduation, they would have to recruit patients from among their friends, family members, neighbors, co-workers, and, in some cases, complete strangers.
• Although the Clinic director told one student that the school had never promised to provide patients, some student overheard admission representatives making the very same representations to prospective students touring the clinic.
• Although some students had patients "passed down" to them by graduating interns, many students who received no "pass-down" patients and were not from Kansas City were unable to recruit enough patients to graduate on time. School representatives encouraged these students to "market themselves" in the community and create their own "mini-practice" by using the school's spinal screening equipment to interest patients in the Clinic. One student who found that this was not enough was advised by a faculty member to "cold-call" prospective patients listed in the Kansas City telephone directory.
• While solicitation and marketing efforts enabled students to eventually meet the quantitative requirements for clinical service, they were not able to develop the diagnostic skills necessary for chiropractic practice because most of the recruited individuals were generally symptom-free and did not need any major chiropractic adjustment.
• Adding insult to injury, the school profited handsomely or had the fees paid by the patients or by the students themselves on the patients' behalf for any treatments (whether needed or not) that the patients received.
• As a result of inadequate instruction, the plaintiffs were not adequately prepared to pass their board examinations and were unable to enter into a chiropractic practice due to lack of basic experience in diagnosis. Virtually all of the plaintiffs found it necessary to take review and preparatory courses (at additional cost) before sitting for their respective board examinations. Some felt that their practical experience was so lacking that they were forced to educate themselves as unpaid interns under the tutelage of licensed chiropractors in their home states. This deficiency was a direct result of the school's failure to provide an "ample volume and variety of patients" to allow the students to relate their classroom education to real-world patients who had acute ailments and symptoms.

CCC president Carl Cleveland III stated that the school would defend the suit viogorously [2]. The plaintiffs wererepresented by James J. Jarrow, Esq., of Baker Sterchi Cowden & Rice, of Kansas City, Missouri.

In November 2000, when the case came to trial the students said that a school statement that the college's clinic had "ample volume and variety" of patients had been crucial in their decision to attend the school. The jury decided that the college had not committed fraud or breach of contract. However, the jury awarded each of the former students $1 for actual damages and $15,000 in punitive damages for negligently failing to disclose that the students would have to recruit most of their own patients [3]. When the college appealed, the appeals court upheld the jury's conclusions but threw out the punitive damage award. The court ruled that the students did not present convincing evidence to show that the college knew that misrepresenting patient availability would result in injury or loss to its students [4]. Even though the lawsuit was unsuccessful, the case is important because it exposed the fact that many students have trouble finding enough genuine patients to meet accreditation standards.

In 1996, in a similar suit, the jury awarded $93,000 in actual damages plus $45,000 in punitive damages to Julie Bernet, a former CCC student who stated that to meet quotas, students were required to entice friends and family into the clinic and then charge them for chiropractic treatment they did not need [5]. During the trial, a former instructor testified that between 1991 and 1995, she knew of no student who met the clinical requirements solely by relying on patients provided by the clinic [6]. The case was later settled for an undisclosed sum [1].

References

1. Trokyna et al v. Cleveland Chiropractic College. Civil action No. 99-0746-CV-W-2. Filed Aug 3, 1999, in the United States District Court for the Western District of Missouri.
2. Morris M. Chiropractic college students file suit. Class says recruiting patients was a part of the requirements. Kansas City Star, Aug 5, 1999, p B2.
3. Jury finds for former chiropractic students on one point, school on two. Associated Press, Nov 29, 2000.
4. Morris M. Punitive damages awarded to ex-students of KC chiropractic college thrown out. Kansas City Star, Feb 22, 2002.
5. Burnet J. Affidavit, April 12, 1996.
6. Menninger B. Student policies questioned in school verdict. Kansas City Business Journal, July 12-18, 1996, pp. 1,42.