Chiropractic lawsuits: two routes to a claim

The videos are popular on Instagram and YouTube: chiropractors manipulate patients’ necks to get that satisfying crack, apparently leading to relief. But things don’t always go so smoothly, and in cases where they don’t, there are legal remedies.

“It might not be something people think of right away, but if you’re injured as a result of a chiropractic procedure, it’s worthwhile to speak to a lawyer,” says Ryan Marinacci, associate at Bogoroch & Associates LLP. “Chiropractic negligence is fewer and farther between than other medical malpractice matters, but it’s an area of law that’s been well-established for many years.”

Two routes to a claim: negligence and informed consent

Similar to cases against physicians, common claims are negligence and failing to obtain informed consent.

One example of negligence that Bogoroch & Associates sees is when the chiropractor applies excessive force during spinal manipulation. Another is performing a manipulation when it’s contraindicated. People may go to the chiropractor with symptoms requiring a referral to a doctor, to the hospital, or for imaging. If chiropractors don’t make those referrals, it’s another type of negligence case. Similarly, there are certain red flag symptoms that chiropractors should recognize and act upon appropriately, resulting in a claim if they fail to do so.

A successful claim requires demonstrating that the chiropractor acted in a way that fell below the standard of care, or in a way that no other reasonably prudent chiropractor would have acted, which requires expert evidence from another chiropractor.

The plaintiff must prove causation as well. 

“Depending on what the alleged breach was — say that a certain manipulation resulted in a patient having a stroke — that type of causation evidence would come from a neurosurgeon or a neurologist as an expert witness,” Marinacci explains. In certain cases, a specialist referral may be required based on the patient’s presentation.

“If a patient is diagnosed with cancer that may have been caught earlier if the chiropractor had made the correct referral, an oncologist could discuss the progression of the cancer during the time the referral wasn’t made.”

Under informed consent, a patient receiving treatment of any kind is entitled to all relevant material information before they decide to go ahead. In the chiropractic context, that would include known risks, expected benefits, alternatives to undergoing the procedure, and the potential consequences of not receiving the treatment at all.

For example, there’s a known association between strokes and cervical spine manipulations. If a patient isn’t made aware of that before undergoing the treatment, that could be a failure to obtain informed consent. What constitutes material information is usually established through another chiropractor working as an expert witness.

Causation works a little differently in informed consent, hinging on the modified objective test. The patient must prove that they wouldn’t have agreed to the treatment if they’d been provided the correct information and that a reasonable patient in their circumstances also would not have undergone the treatment.

That said, even if a consent form was signed, it doesn’t mean the patient can’t sue if they suffer an adverse outcome, Marinacci notes. But it does become especially critical to retain counsel that has experience with the nuances of chiropractic negligence cases.

‘A very fraught area’

Chiropractic negligence has nuances that are unique to these types of claims, Marinacci says. Like other areas of medical malpractice, these cases really do turn on expert evidence and are very dependent on the literature — but in chiropractic negligence cases, “there’s a divide on the issue of causation.”

“Chiropractic is a very fraught area,” he says, adding that his hope is more people realize they do have recourse. If they’re injured by a treatment, reaching out to a lawyer is worthwhile.

“Any time a patient experiences a bad outcome or injury after seeing a chiropractor, it’s a good idea to speak to a lawyer with experience in this area, because it may have been avoidable,” he says. “Patients can be told this just happens, and if they take that at face value, they may never call a lawyer and end up with lifelong impairments without seeking legal recourse.”

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This article was produced in partnership with Bogoroch & Associates