Katie May Op-Ed


New facts about Katie May

Reports about the accidental death of Katie May, a former Playboy model, illustrate how extremely important facts were mischaracterized or ignored yet went viral across the nation in the media to impugn the reputation of the entire chiropractic profession.

TMZ.com initially reported “Katie May Stroke Triggered by Brutal Photo Shoot Fall.”[i] However, her friends reported there was no fall.  Katie May complained after a photo shoot session that she “just held a pose and kinked her neck.”[ii] She sought a chiropractor two days later. The LA coroner’s office months later attributed her death to “neck manipulation.”

Not so fast—this conclusion may also lack scientific credibility.

    Apparently the medical examiner did not do his homework on the scientific literature concerning strokes and manipulation before he rendered his decision attributing the cause of death to neck manipulation.

Research now suggests any link between manipulation and stroke is actually a timing issue – a situation where the patient was already in the midst of a dissection or stroke and just so happened to have seen a chiropractor for neck pain or headaches during that time frame.[iii]

Researchers also agree vertebral arteries can experience tearing from seemingly innocuous movements — from sneezing, painting a ceiling or having hair washed in a salon — that involve turning or extending the neck and the arteries, either suddenly, in an awkward position or holding it for a long length of time in that strained position as was the situation in the Katie May case when she posed with her head extended backwards for a prolong period of time.[iv]

Neurologist Robert Harbaugh, MD, confirms “the chiropractor got caught in the middle” and was unlikely to have caused the original tear. “And if [the chiropractor] had dislodged [the pre-existing] clot, her neurological symptoms would have happened immediately,” he said, rather than progressing slowly over the day. [v]

Compare Neck Pain Treatments
     Totally lost in this emotional story of Katie May’s death is the relative safety of chiropractic manipulation compared to medical spine care.

A recent Gallup survey[vi] comparing serious side effects and deaths among spinal treatments—drugs, surgery, and manipulation—for neck pain proved extremely favorable to chiropractic care:

Simple arithmetic of these facts shows spine surgery for neck[vii] and back pain[viii] accounts for 2,300 serious side-effects/deaths per 1 million encounters. NSAIDs/Aspirin[ix] and prescription opioid pain[x] medications account for 207 serious side-effects/deaths per million. Combining these stats, overall 2,507 people per million are seriously injured or die from medical spine treatments.

On the other hand, the rate of serious side-effects/deaths from manipulation is estimated at 1 in 5.85 million adjustments.[xi] Considering American chiropractors treated 33 million patients in 2014, this equates to 5 or 6 serious or fatal events annually in the entire country.

In comparison, when medical spine care providers see an equivalent 33 million patients, this equates to 82,731 serious events or deaths annually.

      Indeed, who’s hurting who, begging the question: where are the media reports about the thousands of medical accidents?

The rate of adverse events associated with chiropractic care is less than having a stroke while having your hair washed in a salon or sitting in a dentist’s chair,[xii] or being hit by lightning (one in 600,000).[xiii]  It equates to one occurrence in 48 chiropractic careers.[xiv]

Yet, while reading the plethora of articles in the Katie May incident, the public would assume this happens on a daily basis in every chiropractor’s office.

Medical Deaths and Mistakes

Not only was this comparison ignored as to the relative safety of neck pain treatments, nor did medical reporters embarrass their own colleagues when the British Medical Journal revealed in 2016 medical care is the third-leading cause of death in the United States in the range of 251,000 per year (that the authors admit is a conservative estimate) that equates to 700 deaths per day due to medical mistakes.[xv]

 Nor did the media in 2013 sound the same alarm of patient safety when the BMJ published on its website, Clinical Evidence, an article suggesting over half of medical care is ineffective, unproven or too dangerous to use[xvi]

Yet when one chiropractic patient has a serious event or death, all hell breaks loose in the media to condemn an entire profession. Indeed, is this “fair and balanced” journalism? Considering most health reporters on television are MDs and most lay reporters suffer from chirophobia, we cannot expect this topic to get an objective investigation.

       People need to understand all the facts of Katie May’s death and be aware the greatest likelihood of harm stems from medical care treatments, not chiropractic care.

[i] http://www.tmz.com/2016/02/05/model-katie-may-stroke-fall-photo-shoot/

[ii] Sean D. Hamill, Medical examiner says neck manipulation killed Internet phenomPittsburgh Post-Gazette, Oct. 23, 2016

[iii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271108/

[iv] https://www.ncbi.nlm.nih.gov/pubmed/21739395

[v] Sean D. Hamill, Medical examiner says neck manipulation killed Internet phenomPittsburgh Post-Gazette, Oct. 23, 2016

[vi] http://www.palmer.edu/gallup-report/sources/

[vii] Marquez-Lara A, Nandyala SV, Hassanzadeh H, Noureldin M, Sankaranarayanan S, Singh K: Sentinel Events in Cervical Spine Surgery. Spine 2014 Jan 29 [Epub ahead of print],   http://www.ncbi.nlm.nih.gov/pubmed/24480955

[viii] Smith, JS et al. Rates and causes of mortality associated with spine surgery based on 108,419 procedures: a review of the Scoliosis Research Society Morbidity and Mortality Database. Spine 2012, Nov 1;37(23):1975-82

[ix] Lanas A et al. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal anti-inflammatory drug use. Am J Gastroenterology 2005, Aug;100(8):1685-93.

[x] Email to American Chiropractic Association from Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, April 29, 2014.

[xi] Haldeman S, Carey P, Townsend M, Papadopoulos C: Arterial dissections following cervical manipulation: the chiropractic experience. CMAJ 2001;165:905.

[xii] Management of Medical Emergencies in the Dental Office: Conditions in Each Country, the Extent of Treatment by the Dentist, Anesth Prog. 2006 Spring; 53(1): 20–24.

doi:  10.2344/0003-3006(2006)53[20:MOMEIT]2.0.CO;2

[xiii] Allan G.J. Terrett, Current Concepts in Vertebrobasilar Complications Following Spinal Manipulation (West Des Moines, IA:  NCMIC Group Inc., 2001).

[xiv] G Bronfort, M Haas, R Evans, G Kawchuk, and S Dagenais, “Evidence-informed Management of Chronic Low Back Pain with Spinal Manipulation and Mobilization,” Spine 8/1 (January-February 2008):213-25.

[xvi] http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html