World Neurosurgery
Available online 23 February 2021
Original article
Davis A.Hartnett BS
Structured Abstract
Objective
The objective of this investigation is to evaluate the relationship between chiropractic spinal manipulation and medical malpractice utilizing a legal database.
Methods
The legal database VerdictSearch was queried using the terms “chiropractor” OR “spinal manipulation” under the classification of “Medical Malpractice” between 1988 and 2018. Cases with chiropractors as defendants were identified. Relevant medicolegal characteristics were obtained including legal outcome (plaintiff/defense verdict, settlement), payment amount, nature of plaintiff claim, and type and location of alleged injury.
Results
A total of 48 cases involving chiropractic management in the US were reported. Of these, 93.8% (45) featured allegations involving spinal manipulation. The defense (practitioner) was victorious in 70.8% (34) of cases, with a plaintiff (patient) victory in 20.8% (10, mean payment $658,487 ± $697,045), and settlement in 8.3% (4, mean payment $596,667 ± $402,534). Overaggressive manipulation was the most frequent allegation (33.3%, 16 cases). A majority of cases alleged neurological injury of the spine as the reason for litigation (66.7%, 32 cases) with 87.5% (28/32) requiring surgery. C5-C6 disc herniation was the most frequently alleged injury (32.4%, 11/34, 83.3% requiring surgery) followed by C6-C7 herniation (26.5%, 9/34, 88.9% requiring surgery). Claims also alleged 7 cases of stroke (14.6%) and 2 rib fractures (4.2%) from manipulation therapy.
Conclusions
Litigation claims following chiropractic care predominately alleged neurological injury with consequent surgical management. Plaintiffs primarily alleged overaggressive treatment, though a majority of trials ended in defensive verdicts. Ongoing analysis of malpractice provides a unique lens through which to view this complicated topic.
© 2021 Published by Elsevier Inc.