OBJECTIVE: To describe some cases of severe or fatal symptoms that might be attributed to spinal manipulative therapy and one case that illustrates the importance of witnesses when a patient dies under unusual circumstances.

CLINICAL FEATURES: Three of these cases were fatal (two strokes and one heart attack) and one was potentially lethal (a bleeding basilar aneurysm). Another patient developed paresis of one arm and leg (cervical disc prolapse). A case of lower limb paresis and incontinence is also described (cauda equina).

INTERVENTION: Because of chance, none of these patients actually received chiropractic treatment.

CONCLUSION: The incidence of iatrogenic events that occur after chiropractic treatment is unknown. Such events are generally thought to be under-reported. However, the possibility of over-reporting should also be kept in mind.

This abstract is reproduced with the permission of the publisher. Article only available in print.