LONDON, Feb 1: A 29-year-old woman in the UK tragically died after seeking chiropractic care for neck pain following an injury. According to a report from the Gateshead and South Tyneside Coroner, Joanna Kowalczyk passed away on October 19, 2021, due to the consequences of chiropractic treatment combined with a stroke and an undiagnosed arterial dissection.

Kowalczyk first sustained an arterial dissection during a personal training session in September 2021. An arterial dissection occurs when there is a tear along the inside lining of an artery, often in the head, neck, or spine. After hearing a crack in her neck, Kowalczyk sought medical attention at the hospital, where a CT scan was performed. Medics suggested she undergo a lumbar puncture to rule out a hemorrhage, but she chose to self-discharge from the hospital and instead sought chiropractic therapy.

She informed the chiropractor about her CT scan, but the chiropractor did not obtain her full medical records before beginning treatment. Kowalczyk began a four-week chiropractic regimen. On October 16, 2021, during a later session, she suddenly experienced dizziness, vomiting, double vision, tingling in her right hand and foot, and difficulty speaking. The chiropractor suspected a stroke and performed a FAST test, which came back negative, and her symptoms improved. However, a second chiropractor was consulted, and both advised Kowalczyk to go to the hospital. She declined and was instead escorted home by her partner.

Later that day, Kowalczyk was treated by paramedics, who diagnosed her with a migraine, as dizziness and migraine symptoms were considered typical after chiropractic treatments. Despite negative FAST tests, Kowalczyk had, in fact, suffered a stroke. According to the coroner's report, the paramedic missed signs of stroke, as they were unaware that stroke symptoms can subside quickly. Had the paramedic noted Kowalczyk's inability to mobilize unaided, she would have been assessed as FAST positive, and her condition could have been treated more urgently.

The next day, Kowalczyk’s condition worsened, and paramedics again attended to her. Because of her reduced consciousness, a FAST test could not be performed. She was transported to Queen Elizabeth Hospital, where she required intubation and ventilation. A CT scan revealed a maturing obstruction near the base of her skull, and a CT angiogram confirmed a left vertebral artery dissection. Unfortunately, no treatment options were available, and Kowalczyk passed away two days later.

Assistant Coroner Leila Benyounes recommended that the General Chiropractic Council (GCC) implement rules requiring chiropractors to obtain patients' medical histories before commencing treatment. The report was sent to both the GCC and the North East Ambulance Service (NEAS), with a deadline of April 25 for their responses.

Benyounes expressed concern over the failure to obtain Kowalczyk’s medical records, particularly in light of her recent medical treatment. "In my opinion, action should be taken to prevent future deaths, and I believe you have the power to take such action," she stated.

The GCC responded, acknowledging the coroner’s concerns, and expressed condolences to Kowalczyk's family. "We expect chiropractors to provide good quality care that is patient-centred, safe, and effective," the GCC added.

The NEAS also expressed condolences, calling Kowalczyk's death a "tragic case." The service affirmed that its paramedics are trained to recognize stroke symptoms and react accordingly. NEAS also conducted its own investigation, which supported the paramedic’s clinical decision-making and care plan.

This tragic incident has raised concerns about the practices surrounding chiropractic care and medical assessment protocols, with calls for more stringent regulations to prevent similar tragedies in the future.