A CORONER has raised concerns that chiropractors aren’t required to check patient medical records after a woman’s death.
Gymgoer Joanna Kowalczyk, 29, had visited a chiropractic clinic after developing a “severe headache” from a neck injury she’d obtained while training at the gym.
She initially attended hospital and was due to undergo a medical procedure but discharged herself after researching alternative treatments, opting for chiropractic therapy.
Her medical history showed she regularly suffered migraines and joint hypermobility issues.
She also had an undiagnosed connective tissue disorder which made her susceptible to arterial dissections, which are rare tears in the lining of an artery.
It can be life-threatening and cause neurological problems, including stroke.
It’s thought Ms Kowalczyk suffered an arterial dissection when she injured her neck in the gym after she felt a “crack to her neck“.
She suffered acute dissections to the same location when a chiropractor at the clinic “cracked her neck” as part of treatment.
Ms Kowalczyk, from Gateshead, Tyne and Wear, died several days later on October 19, 2021, at Gateshead’s Queen Elizabeth Hospital, an inquest heard.
Coronor Leila Benyounes has now called on the General Chiropractic Council to introduce new rules surrounding obtaining medical records following her tragic death.
The assistant coroner for Gateshead and South Tyneside, has urged chiropractors to obtain medical records when they assess patients.
Ms Kowalczyk’s practitioner did not obtain any records, it was heard.
[bc_video account_id=”5067014667001″ application_id=”” aspect_ratio=”16:9″ autoplay=”” caption=”Woman, 31, wins $1million payout after suffering stroke during ‘routine’ treatment at chiropractor” embed=”in-page” experience_id=”” height=”100%” language_detection=”” max_height=”360px” max_width=”640px” min_width=”0px” mute=”” padding_top=”56%” picture_in_picture=”” player_id=”default” playlist_id=”” playsinline=”” sizing=”responsive” video_id=”6319556801112″ video_ids=”” width=”640px”]As part of the inquest into Ms Kowalczyk’s death, it was detailed she injured her neck in September 2021 during a PT session.
A day later she visited the emergency department of a hospital and it was recommended that she undergo a medical procedure called a lumbar puncture, also known as a spinal tap.
But, it was heard Ms Kowalczyk “self-discharged” from the hospital prior to the procedure, which she was undergoing to rule out the possibility of a haemorrhage, and visited the chiropractor.
She was diagnosed with cervical facet joint syndrome and “adjustments and manipulation” were recommended, which Ms Kowalczyk consented to.
It was heard she informed the chiropractor that she had recently visited the hospital and had a CT scan and that further investigations were advised, but told them she had self-discharged herself.
Ms Kowalczyk said the doctor was aware she was coming to see a chiropractor, who did not obtain any medical records prior to carrying out treatment.
Over the following weeks, Ms Kowalczyk underwent four chiropractic treatments at an unnamed clinic.
Stroke triggered
During a session on October 16, after “the left adjustment to the neck”, Ms Kowalczyk started to experience “immediate symptoms of dizziness and room spinning”.
It was heard she developed double vision, tingling in her right hand and right foot, was struggling to speak, and even vomited.
She stayed in the clinic where she rested for some hours.
The patient was advised to seek medical attention at hospital by both chiropractors, but she did not wish to attend.
Later that day, paramedics treated Ms Kowalczyk after she started to experience speech difficulty which was associated with a stroke.
They diagnosed Ms Kowalczyk with a migraine after hearing that the “symptoms of dizziness and migraine were normal after the chiropractic treatment”.
[quote credit=”Coronor Leila Benyounes” credit-meta=”Assistant coroner for Gateshead and South Tyneside”]The evidence on behalf of the treating chiropractor was that he did not consider it necessary to request GP records or hospital records, before assessment or treatment[/quote]The inquest heard that the paramedic “was not aware that symptoms of stroke could stop after a short period of time”.
The coroner said that had they recognised that Ms Kowalczyk was “unable to mobilise unaided” then they would have taken her to hospital on that day.
But this did not happen and the following day, Ms Kowalczyk fell “gravely unwell with a reduced level of consciousness” and emergency services were called again.
It was heard she deteriorated in the ambulance on the way to hospital and required “intubation and ventilation”.
Ms Kowalczyk passed on October 19.
The coroner said: “Joanna Kowalczyk died due to a combination of the consequences of chiropractic treatment following a naturally occurring medical event, on a background of an undiagnosed medical condition.”
The coroner returned a formal verdict of hospital death but issued a Prevention of Future Deaths report to North East Ambulance Service and the General Chiropractic Council in light of her passing.
Ms Benyounes said: “The evidence on behalf of the treating chiropractor was that he did not consider it necessary to request GP records or hospital records, before assessment or treatment despite being informed about the Deceased’s recent hospital attendance, investigation which was recommended, and her discharge against medical advice.
“Even in the updated consent form I have been provided with, which was designed by the British Chiropractic Association, there is no prompt or question designed for the chiropractor to ask to consider obtaining medical records before assessment or treatment, and when this may be appropriate.
“The only reference to medical records is a consent to communicate as deemed necessary for the treatment, and for a report to be sent to the GP after treatment.
“I am concerned that consideration to obtaining medical records should always be given before assessment, particularly where recent medical treatment or investigations has been undertaken.”
The organisations have 56 days to respond to the coroner’s comments.
[boxout headline=”Uses of chiropractic treatment “]CHIROPRACTIC is a type of complementary and alternative medicine (CAM) that uses manual therapy to treat issues with the joints, muscles, and bones.
Chiropractors use their hands to manipulate the spine and other joints to help them move properly.
Chiropractic can mainly help with pain in muscles and joints, such as:
Chiropractic is not widely available on the NHS, but it may be offered in exceptional circumstances in some areas.
Most people who have chiropractic treatment pay for it privately.
You do not need to see a GP before making an appointment, but it’s best to speak to them for advice first.
Some people may experience side effects from treatment, such as:
- aches and pains
- stiffness
- tiredness
These side effects are usually mild and pass in a few days.
There’ s a risk of more serious problems, such as stroke, from spinal manipulation.
If you’re unsure whether chiropractic is safe for you, speak to a GP.
Source: NHS