A gym-goer who suffered a severe headache after injuring her neck during a workout died following a visit to a chiropractor, an inquest has heard.
Joanna Kowalczyk, 29, declined a procedure at hospital for her injury and chose instead to try chiropractic therapy after researching alternative treatments.
Her medical history showed she regularly suffered migraines and joint hypermobility issues.
She also had an undiagnosed connective tissue disorder which made her susceptible to arterial dissections, which are rare tears in the lining of an artery and can be life-threatening, the inquest heard.
Ms Kowalczyk from Gateshead, Tyne and Wear, visited a clinic and told the chiropractor that she had discharged herself from hospital.
The chiropractor was unaware of her medical history and cracked her neck to try and help with the pain.
It is thought Ms Kowalczyk suffered an arterial dissection when she injured her neck in the gym and that she suffered acute dissections to the same location when a chiropractor cracked her neck.
Now her coroner has raised concerns that chiropractors aren’t required to check patient medical records after Ms Kowalczyk’s death.
Joanna Kowalczyk opted for chiropractic treatment instead of a hospital procedure. (file picture)
Coroner Leila Benyounes called on the General Chiropractic Council to introduce new rules surrounding obtaining medical records.
Ms Kowalczyk died on October 19, 2021, at Gateshead’s Queen Elizabeth Hospital several days after her chiropractic treatment.
The inquest heard she inured her neck in September 2021 during a PT session.
The next day she visited the emergency department of a hospital where it was recommended that she undergo a medical procedure called a lumbar puncture, also known as a spinal tap.
The aim of the procedure was to rule out the possibility of a haemorrhage, but Ms Kowalczyk self-discharged from the hospital, it was heard.
Chiropractors diagnosed her with cervical facet joint syndrome and she was recommended to undergo ‘adjustments and manipulation’, which Ms Kowalczyk consented to.
Ms Kowalczyk said her doctor was aware she was going to see a chiropractor, who did not obtain any medical records before her treatment.
In the following weeks, she underwent four chiropractic treatments at an unnamed clinic, it was heard.
Ms Kowalczyk died at Gateshead’s Queen Elizabeth Hospital just days after her chiropractic treatment
During a session on October 16, after ‘the left adjustment to the neck’, Ms Kowalczyk started to experience ‘immediate symptoms of dizziness and room spinning’.
She claimed to have developed double vision, tingling in her right hand and right foot, she was struggling to speak, and even vomited.
She stayed in the clinic where she rested for some hours.
The patient was advised to seek medical attention at hospital by both chiropractors, but she did not wish to attend.
Later that day, paramedics treated Ms Kowalczyk after she started to experience speech difficulty which was associated with a stroke.
They diagnosed Ms Kowalczyk with a migraine after hearing that the ‘symptoms of dizziness and migraine were normal after the chiropractic treatment’.
The inquest heard that the medical professional ‘was not aware that symptoms of stroke could stop after a short period of time’.
The coroner said that had they recognised that Ms Kowalczyk was ‘unable to move unaided’ then they would have taken her to hospital on that day.
However the following day, Ms Kowalczyk fell ‘gravely unwell with a reduced level of consciousness’ and paramedics were called again.
It was heard she deteriorated in the ambulance on the way to hospital and required ‘intubation and ventilation’.
Ms Kowalczyk died on October 19.
The coroner said: ‘Joanna Kowalczyk died due to a combination of the consequences of chiropractic treatment following a naturally occurring medical event, on a background of an undiagnosed medical condition.’
The coroner returned a formal verdict of hospital death but issued a Prevention of Future Deaths report to North East Ambulance Service and the General Chiropractic Council in light of her passing.
Ms Benyounes said: ‘The evidence on behalf of the treating chiropractor was that he did not consider it necessary to request GP records or hospital records, before assessment or treatment despite being informed about the Deceased’s recent hospital attendance, investigation which was recommended, and her discharge against medical advice.
‘Even in the updated consent form I have been provided with, which was designed by the British Chiropractic Association, there is no prompt or question designed for the chiropractor to ask to consider obtaining medical records before assessment or treatment, and when this may be appropriate.
‘The only reference to medical records is a consent to communicate as deemed necessary for the treatment, and for a report to be sent to the GP after treatment.
‘I am concerned that consideration to obtaining medical records should always be given before assessment, particularly where recent medical treatment or investigations has been undertaken.’
Ms Benyounes also raised concerns over how the attending paramedic was ‘not aware’ that symptoms of a stroke can ‘stop after a short time’.
The organisations have 56 days to respond to the coroner’s comments.
