Injured patients want new rules for chiropractors
HARTFORD, Conn. --When Brittmarie Harwe woke up with a sore neck and shoulder in 1993, she sought help from a chiropractor recommended by a friend.
But at her second visit, something went terribly wrong.
"When he did the first (adjustment), I felt it, like a rushing noise in my head, dizzy," recalled Harwe. "He looked me in the eye and realized I was in distress ... I was having a stroke, right then and there."
Harwe, 26 at the time, was rushed to the hospital, where she learned that her left vertebral artery had been crushed. In the days and years that followed, Harwe suffered from paralysis, vision loss, weakness and coordination problems, a paralyzed vocal cord and an inability to swallow. Today, she still uses a feeding tube.
Harwe plans to tell state lawmakers Monday that she had no idea stroke was one of the risks of cervical manipulation by a chiropractor. The legislature's Public Health Committee is considering legislation that would require chiropractors to inform patients, both in writing and verbally, of the risks and possible side effects of their treatments.
State chiropractors say the legislation is unnecessary and unfairly punitive. They argue that a state law requiring a patient to give informed consent before a procedure is excessive given the statistically remote risk of injury and death. And they say that the malpractice insurance premiums paid by chiropractors -- markedly smaller than those paid by physicians and other medical personnel -- prove the risks are small.
"I think it's appropriate for the public health community to be concerned about issues of public safety, but I think at best this proposal is a misplaced attempt at patient advocacy and is perhaps prejudicial against the chiropractic profession," said Dr. Matthew N. Pagano, D.C., president of the Connecticut Chiropractic Association.
Sen. Mary Ann Handley, D-Manchester, co-chairman of the Public Health Committee, said she's going into Monday's hearing with an open mind.
"My intention is to sit there and listen to what people have to say," she said.
Lawmakers are being asked to take a close look at chiropractors this session. The insurance committee is debating another bill -- opposed by a state chiropractic association -- that would require Connecticut's insurance department to make public information regarding medical malpractice claims against chiropractors.
The state public health department currently collects data about closed claims regarding physicians, surgeons, hospitals, advanced practice registered nurses and physician assistants.
Both bills were proposed by Sen. Leonard Fasano, R-North Haven, who has a constituent who suffered a stroke after a chiropractic visit. While he agrees many people benefit from visits to chiropractors, Fasano said consumers should have as much information as possible.
"What is so bad about saying here are the potential risks?" Fasano said.
Harwe, now 40 and living in Wethersfield, said if she had such information in 1993, she likely would not have had the chiropractic procedure.
"In this day and age of technology, when it is so easy to get the information out to people, just give it to them and let the person make their own decision," she said.
Pagano said he believes both bills unfairly single out chiropractors. He said no other medical professionals in Connecticut must obtain informed consent from patients.
"If the state hasn't deemed it necessary to have informed consent mandated by all professions, why are they contemplating singling out one profession?" said Pagano, who has a chiropractic practice in Winsted and provides patients with a consent form outlining potential risks.
Pagano said the bills are especially troubling because the risks from adjustments are so low. The American Chiropractic Association says the risk of death or major neurological complications from cervical manipulation are one in 4 million -- the same as flying 425 miles on a commercial airline.
He pointed out that the annual malpractice insurance premium paid by a chiropractor in Connecticut is about $2,000 a year, compared with about $120,000 a year for obstetricians and anesthesiologists.
"I think malpractice rates are determined by a profession's claim history," Pagano said. "If a profession has a drastically lower number of claims, that's going to be reflected in the malpractice premiums."
According to the Connecticut Board of Chiropractic Examiners, which disciplines chiropractors, the state public health department received 57 complaints about chiropractors between Jan. 1, 2002, and Dec. 31, 2006. That's 1 percent of the 4,941 complaints the department received for all licensed medical professionals. Of the 57 complaints, the board issued 15 disciplinary orders.
Janet Levy of Woodbridge, Fasano's constituent, formed the group Victims of Chiropractic Abuse last June. Five years ago, she woke up with a stiff shoulder ache and went to a chiropractor recommended by a friend.
She immediately got a headache, but the chiropractor said it was only a reaction to the treatment. Days later, she went to the hospital and learned she had had a mini-stroke caused by a torn artery and needed emergency brain surgery.
At the time, she was 48 and ran five miles a day. After the surgery, she was told she wouldn't walk again. But Levy persevered and went through two years of physical and occupational therapy, seven hours a day. Today she can walk, but still has balance problems and other neurological defects.
Levy said she could saved herself from those two years of suffering if she had know about the risks she faced.
"You think it's safe. You think it's natural," she said. "Those two words just throw you off. What do you have to lose?"