Stroke Caused by Neck Manipulation
Triggers Ambitious Lawsuit
Stephen Barrett, M.D.
In 2008, a Canadian woman who was paralyzed by a neck manipulation filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem. The suit, which is seeking more than $525 million in damages, targeted Alberta chiropractors who provide inappropriate spinal manipulations and regulators who have failed to curb their use. The plaintiffs are Sandra Nette and her husband David.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The vertebral artery is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining . The lawsuit claim document states:
- In 2007, Sandra underwent treatment that Edmonton chiropractor Gregory Stiles had recommended to correct "subluxations" and improve her health and wellness.
- The treatment was unnecessary and dangerous.
- Stiles manipulated Sandra's upper neck, rupturing both her right and left vertebral arteries, disrupting the blood flow to her brain and causing a cascade of strokes.
- As a result, Sandra has "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm .
Slight use of her right arm enables Sandra to use a computer keyboard to communicate through a voice synthesizer. Her plight is readily apparent in videos posted to YouTube .
In addition to litigating on their own behalf, the Nettes asked court to permit them to represent all persons who paid for or received spinal manipulation (other than spinal manipulation to treat a diagnosis of acute or sub-acute uncomplicated back pain) from an Alberta chiropractor during the past decade. They also wanted to have Stiles represent a class of Alberta chiropractors who provide inappropriate manipulation.
The lawsuit named three defendants:
- Gregory Stiles, and The Spa at Life Stiles, where Stiles works. Stiles has been an officer of the College's council and chairman of its quality assurance and marketing and promotion committees.
- The Alberta College and Association of Chiropractors (ACAC), for allegedly failing to properly regulate the use of spinal manipulations, particularly to the upper neck.
- The Alberta Ministry of Health, which is ultimately responsible for the health services offered to the public.
In 2008, Stiles's Web site stated:
- Chiropractors find and release areas of the spine that are out of balance and putting tension on the nervous system. These areas are called subluxations. With an adjustment the nervous system will work with greater ease so you can perform and function better.
- A subluxations [sic] is a spinal misalignment that causes nerve interference between the brain and the body. When nerve function is interfered with-muscles, blood vessels and organs may malfunction. This can produce pain, restrictive motion, degenerative changes or ill health.
- Adjustments will release the subluxations in your spine.
- Chiropractic can be used as a treatment of a specific ailment or you can choose to use it as a way of maintaining and improving your overall health and wellness. The first choice limits your time and benefits. The second gives you the opportunity to experience greater health and well being over time .
The suit charges that Stiles misrepresented the benefits and failed to adequately disclose the risks of spinal manipulation. The plaintiffs' lead lawyers are Daryl Wilson, Q.C. and Philip Tinkler, Esq., of Fraser Milner Casgrain LLP, one of Canada's largest law firms. In 2006, Tinkler, who heads the firm's Edmonton class-action group, negotiated a $100 million settlement in a suit against the Government of Alberta .
Course of the Lawsuit
After further examination of the facts, the Spa and its owners were voluntarily dismissed as a defendant. In July 2009, the Alberta Court of Queen's Bench concluded that the Ministry of Health did not owe a private duty of care to individual citizens and dismissed it as a defendant . In January 2010, the court dismissed the ACAC after concluding that (a) it did not owe a private duty of care to individual citizens and could not be held responsible for the conduct of its members, and (b) disputes about false claims by the association would be a matter for review by the legislature rather than the courts. The court also refused to certify the suit as a class action . The malpractice suit against Stiles is still active and will proceed. As of this writing, the plaintiffs have not decided whether to appeal the January 2010 ruling.
- Barrett S. Chiropractic's dirty secret: Neck manipulation and strokes .Quackwatch, Jan 18, 2009.
- Statement of Claim. In the Court of Queen's Bench of Alberta, Judicial District of Edmonton. Action No. 0803-08204 between Sandra Gay Nette and David Nette and Gregory John Stiles, The Spa at Life Stiles, Alberta College and Association of Chiropractors, and Her Majesty the Queen in Right of Alberta (Minister of Health and Wellness). Filed June 12, 2008.
- The Nette's Story. YouTube, accessed June 18, 2008.
- Chiropractic. Life Stiles Web site, accessed June 17, 2008 but subsequently removed.
- Alberta settles $100M case over financial assistance payments. CBC News, Jan 16, 2006.
- Belzil RP. Reasons for Judgment. Nette v. Stiles, 2009 ABQB 422, July 9, 2009.
- Belzil RP. Reasons for judgment re an application for certification of a class proceeding. Nette v. Stiles, 2010 ABQB 14, Jan 11, 1010.
This article was revised on January 21, 2010.