Concerns over chiropractors 'not seeking GP notes'

A coroner has raised concerns that chiropractors do not have to request medical records before assessing a patient, following a woman's death.

Joanna Kowalczyk died on 19 October 2021 at Gateshead's Queen Elizabeth Hospital, weeks after she had gone to A&E complaining about a crack to her neck, which she had felt while at the gym.

But before a diagnosis could be made, Ms Kowalczyk discharged herself and sought treatment from a chiropractor.

The General Chiropractic Council (GCC) said its thoughts were with the woman's loved ones and it would consider the coroner's concerns.

Gateshead and South Tyneside assistant coroner Leila Benyounes said Ms Kowalczyk had a history of migraines.

In a recently published document, known as a prevention of future deaths report, she said Ms Kowalczyk went to A&E in September 2021 with neck pain.

The following day, she went a chiropractor and told them she had recently been to hospital.

Despite this, the chiropractor did not request any GP or hospital records, the coroner said.

Ms Kowalczyk underwent four chiropractor treatments between September and October.

During the fourth treatment, Ms Kowalczyk experienced double vision and struggled to speak.

The chiropractor tested her negative for stroke and her symptoms improved while she recovered at the practice, the report said.

Ms Kowalczyk was advised to go to hospital but she declined.

After being considered well enough to leave the practice, Ms Kowalczyk was told to go to A&E if she experienced any stroke symptoms.

Later that day, the North East Ambulance Service (NEAS) was called to her home where again she tested negative for stroke and was diagnosed with a migraine and left to rest.

The coroner said the paramedic was unaware that stroke symptoms could stop after a short period of time.

However, NEAS said the paramedic misunderstood the question in court.

Ms Benyounes said the paramedic did not observe that Ms Kowalczyk was unable to walk unaided, which would have meant transferring her to hospital immediately.

Paramedics returned the next day after she was reported to have a "reduced level of consciousness".

Hospital scans revealed brain tissue death and a tear in the wall in one of the neck's blood vessels.

Ms Kowalczyk died two days later.

The coroner said it was unclear if Ms Kowalczyk could have been saved if the tear had been identified earlier.

NEAS said it was a "tragic case" and it sent its condolences to her family.

It said paramedics were trained to "recognise stroke symptoms and react accordingly".

It added its own investigation supported the "clinical decision-making and care plan of the paramedic".

The coroner said she was concerned that chiropractors did not have to obtain a patient's medical records before assessing them.

These would have shown Ms Kowalczyk had discharged herself against medical advice, she said, adding that records should "always be considered" before treating someone.

GCC said: "We expect chiropractors to provide good quality care that is patient-centred, safe and effective".

The coroner said it was their opinion "action should be taken" by the GCC and NEAS "to prevent future deaths", and has given them until the end of April to respond.

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