DEATH BY CHI­RO­PRAC­TOR

Thou­sands swear by them – but how qual­i­fied are they? This 80-year-old’s spine was snapped by a ther­a­pist and he died a day later. Most shock­ing? To his wi­dow’s fury, she’s STILL prac­tis­ing

Scottish Daily Mail - - News - by Jenny John­ston

Re­TIreD bank man­ager John Lawler loved to walk. He par­tic­u­larly loved to walk with his wife Joan. It made their chil­dren and grand­chil­dren smile that they would still walk hand in hand, even af­ter al­most 60 years to­gether.

ev­ery day the pair, both in their 80s, would stride out around the race­course near their home in York, or into town. Twice ev­ery day (there and back), they would walk past a chi­ro­prac­tor’s prac­tice.

When, back in 2017, John, then 79, started to be ir­ri­tated by a pain in his leg — not a chronic pain but one keep­ing him awake at night — his GP sug­gested he might ben­e­fit from a course of physio. Find­ing wait­ing lists for both the NHS and pri­vate phys­ios, they made an ap­point­ment with a chi­ro­prac­tor. That chi­ro­prac­tor was Ar­leen Scholten. Dr Ar­leen Scholten, ac­cord­ing to her web­site.

‘I don’t think Mum ac­tu­ally knew there was a dif­fer­ence be­tween a physio and a chi­ro­prac­tor,’ says their youngest daugh­ter Clare, 49, an ex­ec­u­tive in a Lon­don pub­lish­ing house. ‘I wouldn’t have been that aware of the dif­fer­ences ei­ther. I was only vaguely aware that Dad was go­ing for a spot of physio.’

Joan cer­tainly as­sumed that ‘Dr Scholten’ was a med­i­cal doc­tor. ‘You do, don’t you? Par­tic­u­larly that gen­er­a­tion,’ says David, 55, the cou­ple’s el­dest child who works in fi­nance.

‘You see cer­tifi­cates on the wall and you think, “These are peo­ple who know what they are do­ing.” You put your­self into their hands.’

With, in this case, ut­terly tragic con­se­quences. For John Lawler’s treat­ment for an ‘achy leg’ ended in the most shock­ing way. His spine was bro­ken as Mrs Scholten — who was not a med­i­cal doc­tor and was not even re­quired to have a first aid qual­i­fi­ca­tion in or­der to prac­tise as a chi­ro­prac­tor — per­formed a ‘drop ta­ble’ ma­nip­u­la­tion which in­volved giv­ing the pen­sioner a sud­den push while si­mul­ta­ne­ously drop­ping the ta­ble 2cm. He died the fol­low­ing day.

An in­quest in York this week heard that John’s spine ‘snapped like a rigid stick’. It was not known at the time that he was suf­fer­ing from a cal­ci­fy­ing con­di­tion, com­mon in old age, which meant his spine was more rigid. His fam­ily were present to hear ex­pert tes­ti­mony con­firm­ing that treat­ments on such a back would have been like ‘bend­ing a spoon back­wards and for­wards’ un­til it broke in two.

‘Maybe this treat­ment would have worked won­ders for a 30-yearold rugby player,’ says David, who sat with his mum and his sis­ter through all six days of har­row­ing ev­i­dence. But it should never have been at­tempted on my dad. He thought he was in safe hands and he was not.’

Joan, now 83, wit­nessed the in­jury. She was at his side — ‘like she al­ways was, 24 hours a day,’ says David — even in the treat­ment room, sit­ting less than two

me­tres from the ta­ble when John yelled out in agony that Mrs Scholten was hurt­ing him and that he could not move his arms or his legs.

She wit­nessed Mrs Scholten try­ing to turn John over, and then, as she found him un­re­spon­sive, her fran­tic (pan­icked, the Cana­dian-born chi­ro­prac­tor ad­mit­ted dur­ing the in­quest) at­tempts to re­sus­ci­tate him — at­tempts that the fam­ily claim made the al­ready se­ri­ous sit­u­a­tion worse.

‘When she called an am­bu­lance, she said she thought Dad had had a stroke, but to Mum she in­di­cated that maybe he hadn’t, be­cause his face was sym­met­ri­cal.

‘We now know that Dad would had sur­vived, had she done the thing ev­ery­one knows you should do when some­one has had a spinal in­jury: keep them sta­ble. In­stead, she moved him.

‘Mum was there when she hauled him off the ta­ble like a rag doll and tried to re­sus­ci­tate him.’

Mrs Scholten told paramedics she had been ap­ply­ing ‘gen­tle ma­nip­u­la­tion’ but did not tell them about us­ing the drop treat­ment. She said she was in a ‘com­plete and ut­ter state of panic’ and could not ex­plain why she had not men­tioned that el­e­ment of treat­ment.

Cru­cially, be­lieves David, the paramedics ar­rived think­ing they were deal­ing with a stroke, rather than a spinal in­jury. ‘If they had known, they would have treated him like they would some­one with a sports in­jury,’ he says. ‘Dad would have had a chance.’

In­deed the in­quest heard that had John been im­mo­bilised im­me­di­ately af­ter the frac­ture he would have sur­vived. He was taken to hos­pi­tal but never re­gained any feel­ing from the neck down. His spinal cord had been crushed to the point where vi­tal sig­nals were not get­ting from his brain to his or­gans.

Clare says: ‘A ju­nior doc­tor took us aside and said, “This is very bad. He will not re­cover from this.” It was so up­set­ting to see him ly­ing there, with blocks on ei­ther side of his head. Dad couldn’t really speak but he did know me. The sad­dest thing was that we would hold his hand but he would not feel it. It was up­set­ting for my Mum. He couldn’t feel her.’

John died at 6pm the fol­low­ing day. Clare had to make the call to her el­der sis­ter Sarah, 53, who lives in Aus­tralia. ‘That was a ter­ri­ble thing to have to do. It was dev­as­tat­ing enough for us. Sarah didn’t even get to say good­bye.’

For two years the fam­ily have been des­per­ate to have vi­tal ques­tions about John’s last hours an­swered, con­vinced that this was not just a freak ac­ci­dent but an avoid­able tragedy — one that ev­ery pa­tient should be aware of.

They had hoped that the coro­ner would record a ver­dict of un­law­ful killing. Coro­ner Jonathan Heath in­stead recorded a nar­ra­tive con­clu­sion that Mr Lawler suf­fered spinal in­juries while un­der­go­ing chi­ro­prac­tor ad­just­ment and died from res­pi­ra­tory de­pres­sion.

HoW­ever, he did say he would ask the chi­ro­prac­tic reg­u­la­tory au­thor­i­ties to con­sider first aid train­ing for chi­ro­prac­tors. He is also call­ing on the Gen­eral Chi­ro­prac­tic Coun­cil (GCC) to bring in pre-treat­ment imag­ing, such as X-rays or scans, to pro­tect the vul­ner­a­ble.

‘We’ve since dis­cov­ered that some chi­ro­prac­tors won’t treat pa­tients of Dad’s age, or cer­tainly not without do­ing scans first. He had a his­tory of de­gen­er­a­tive dis­ease, too. He’d had some rods in­serted in his lower back in 2009. He should not have been treated, quite sim­ply.’

David was hor­ri­fied to hear how the treat­ment was con­ducted. ‘It wasn’t like an hour-long ses­sion, a one-to-one. There were other pa­tients, with a low wall sep­a­rat­ing them, and the chi­ro­prac­tor would come round them all, do­ing the ma­nip­u­la­tions.

‘For one, she used a stick, an “ac­ti­va­tor”, which is a small hand­held de­vice that de­liv­ers a force to the spine. We heard the sound it would make dur­ing the in­quest. It was like a thud. There was a sense that a lot of it was for show.’

Yet it was the ta­ble-drop treat­ment which did the dam­age. This wasn’t the first time John had had it. At an ap­point­ment the pre­vi­ous day (he’d had five ses­sions, al­though only three were ‘hands on’) Mrs Scholten had car­ried out this pro­ce­dure, too. David adds: ‘Dad was shocked by that. Mum was shocked by it. They didn’t like it at all but they went off af­ter with no ill ef­fect, so Dad as­sumed it must be do­ing some good.’

The tragedy that has be­fallen this dig­ni­fied fam­ily can­not be over­stated. John had five grand­chil­dren, aged from ten to 22, and ‘in­fi­nite pa­tience with them’.

The fam­ily tragedy will be a wake-up call for the chi­ro­prac­tic pro­fes­sion, medicine’s more con­tentious cousin.

The in­dus­try, which has been be­set by claims of other in­juries, has long been vul­ner­a­ble to ac­cu­sa­tions of quack­ery.

‘I’m sure there are plenty of chi­ro­prac­tors who do amaz­ing work,’ says David. ‘But some of it is bonkers. Too much of it is wrapped up in quack­ery. Some chi­ro­prac­tors claim they can cure ev­ery­thing from the com­mon cold to di­ges­tion prob­lems, and that ev­ery ill has come about be­cause the spine needs to be ma­nip­u­lated. You can be­lieve that or not. You could re­gard it as just an al­ter­na­tive ther­apy like home­opa­thy. But it’s not like home­opa­thy. If this goes wrong, peo­ple can die. Those in the in­dus­try say it’s im­pos­si­ble but it hap­pened to Dad.

‘Now I don’t par­tic­u­larly want the chi­ro­prac­tor who treated him to go to prison but I do think that she and other chi­ro­prac­tors should be prop­erly reg­u­lated and in­ves­ti­gated when things go wrong.’

As­ton­ish­ingly for the fam­ily, Ar­leen Scholten is still work­ing as a chi­ro­prac­tor. It must be stressed that there have been no find­ings of any wrong­do­ing against Scholten.

She was ar­rested im­me­di­ately af­ter John’s death, and one of her bail con­di­tions was that she could not prac­tise un­til the po­lice inquiry was com­plete. No charges were brought, how­ever, and she was free to prac­tise again.

An inquiry by the GCC was also launched but has yet to be com­pleted. An ear­lier in­terim sus­pen­sion hear­ing, which David had ex­pected to at­tend, hav­ing com­plained to them about his fa­ther’s treat­ment, was con­ducted in pri­vate so as to avoid the risk of prej­u­dic­ing on­go­ing in­quiries. Mrs Scholten was not struck off the reg­is­ter.

He says: ‘Sus­pen­sion hear­ings are nor­mally open to the pub­lic but, on the day, they said I couldn’t be there. I find that un­ac­cept­able. This is a dif­fer­ent world. It seems to be a lit­tle self-reg­u­la­tory chi­ro­prac­tic bub­ble, where chi­ro­prac­tors reg­u­late chi­ro­prac­tors.’

The GCC is­sued this state­ment: ‘These are sad cir­cum­stances. It has been dif­fi­cult hear­ing the tes­ti­mony of those af­fected and our sym­pa­thy goes to the whole fam­ily. Since the tragic events the GCC has sought to keep the fam­ily in­formed about our ac­tions.

‘The In­ves­ti­gat­ing Com­mit­tee of the GCC met in Septem­ber 2017 to con­sider im­pos­ing an In­terim Sus­pen­sion or­der against the chi­ro­prac­tor’s reg­is­tra­tion. The com­mit­tee de­cided to hold its pro­ceed­ings in pri­vate — it con­sid­ered that not prej­u­dic­ing or jeop­ar­dis­ing im­por­tant ex­ter­nal in­quiries re­lat­ing to the mat­ter out­weighed the pub­lic in­ter­est in hold­ing the hear­ing in pub­lic.

‘Fol­low­ing the com­ple­tion of the in­quest we are now in a po­si­tion to re­sume the in­ves­ti­ga­tion opened in 2017 fol­low­ing the death of Mr Lawler.

‘The case is be­ing pre­pared for con­sid­er­a­tion by the GCC In­ves­ti­gat­ing Com­mit­tee for it to de­cide whether a hear­ing into the chi­ro­prac­tor’s fit­ness to prac­tise be held. We will progress this mat­ter as swiftly as pos­si­ble.’

The in­quest heard Mrs Scholten had since com­pleted a first aid course, and had made clear on her web­site that she was not a med­i­cal doc­tor (she has a BSc and a Doc­tor of Chi­ro­prac­tic de­gree from North­west­ern Col­lege of Chi­ro­prac­tic, dat­ing from 2001).

Af­ter the in­quest, she ex­pressed deep re­gret about what had hap­pened. A rep­re­sen­ta­tive said: ‘Ar­leen Scholten wishes to ex­press her deep­est sym­pa­thies to the fam­ily of Mr Lawler for their loss.

THIS was an ex­tremely rare and un­usual in­ci­dent, which has been thor­oughly in­ves­ti­gated by the coro­ner dur­ing the court of the in­quest. She will take on board the coro­ner’s find­ings and has al­ready made changes to her prac­tice since the in­ci­dent.’

on the web­site of her com­pany, Chi­ro­prac­tic1st, Mrs Scholten says she loves noth­ing more than hear­ing the ‘hun­dreds of tes­ti­monies of pa­tients young and old en­joy­ing life more be­cause of chi­ro­prac­tic care’.

Two-and-a-half years on, Joan no longer lives in York, hav­ing moved south to a re­tire­ment com­plex to be closer to her chil­dren and fur­ther from un­bear­able re­minders. Clare says: ‘You can have post­trau­matic stress af­ter wit­ness­ing what mum did, and I think she had some­thing like it. She didn’t want to be in the house without him.

‘She wants the nar­ra­tive to be known, and she wants to make sure this can­not hap­pen again.’

The last pho­to­graphs they have of John were taken a few days be­fore he died, on his 80th birth­day. The fam­ily went out for a meal and walked home to­gether. ‘Mum and Dad were in front of me, and I re­mem­ber they were hold­ing hands,’ says Clare. ‘even at the time, I thought that was lovely.’

Tragic: John with wife Joan

In­ves­ti­ga­tion: Chi­ro­prac­tor Ar­leen Scholten

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