Garret Graves, who served in the House of Representatives until last year, was quoted in the July 27 article by Jack Brook, “Louisiana cancels $3 billion coastal restoration project funded by oil” that was distributed worldwide by the Associated Press.  The article, regarding the potential loss of coastal restoration funds from the Deepwater Horizon Oil Spill Settlement Fund, is an important topic which warrants a serious discussion. 

Statements attributed to you in the article  include “I don’t know what chiropractor or palm reader they got advice from on this but – baffling that someone thought this was a good idea.” (The quote has been used again by former Rep. Graves on social media.

In the letter sent by ICA’s CEO, Dr. Edwin Cordero, the following comments were provided:

“This quote from you has no place in such a serious discussion and implies that chiropractors lack credibility.  Whether provided as a cheap shot at the profession or out of a lack of understanding of the strong evidence-base supporting the safety and benefit of regular chiropractic care, your quote undermines the valuable work of more than 100,000 Doctors of Chiropractic in the United States including the more than 700 in the state of Louisiana. 

Chiropractors (Doctors of Chiropractic):

• Recognized as Essential Health Care Providers by the US Government.
• Physician level providers in Medicare, Medicaid, DOD and VA.
• Licensed in Every US State.
• Chiropractic Care is a covered service in Medicare, Medicaid, US military and Veterans Administration health care. 
• Extensive licensing and educational requirements: 
  • 3-4 Year Graduate Degree requiring minimum of  7 years undergraduate with science pre-requisites.  All US Chiropractic Programs are Accredited by the CCE, which is US Department of Education approved.
  • Licensure requires passage of 4 Boad Exams provided by the National Board of Chiropractic Examiners (NBCE) exams and fulfilling any state-specific licensing requirements.
• Safety of chiropractic validated through medical malpractice rates that are among the lowest in health care.
• Research including studies conducted by the US Defense Department show benefits of chiropractic care for improved performance, strength, and recovery.
• Studies show that for patients in pain, chiropractic is first line of care, the rate of opioid prescriptions being filled is reduced by at least 50%.
• Workman’s Compensation Research Institute Study found chiropractic care was less expensive for on-the-job injuries, and that employees returned to work more quickly.”

Dr. Cordero concludes the letter with a request for corrective action be taken. The full letter is available below:

“This is a tragic situation, but it’s also a gross misrepresentation of the chiropractic profession,” said Dr. Edwin Cordero, CEO of the ICA. “It’s yet another example of sensational journalism that draws conclusions without evidence, science, or clinical context.”

A Pattern of Blame Without Clinical Facts

Every time a vascular event occurs, and a chiropractor is even remotely involved in the patient’s history, it becomes headline news regardless of timing, medical context, or alternative risk factors. In this case, the patient herself stated that her symptoms developed weeks after the adjustment.

“If a traumatic arterial dissection truly occurred at the moment of care, we’d expect immediate neurological symptoms like severe headache, nausea, or difficulty walking,” Dr. Cordero noted. “Delayed symptom onset matters. That’s clinical evidence being ignored.”

Research Clearly Refutes a Causal Link

The best available research supports what principled chiropractors have long known: there is no causal relationship between cervical chiropractic adjustments and vertebral artery dissection.

A major population-based study by Cassidy et al. (2008), published in Spine, examined all vertebrobasilar strokes in Ontario over nine years and found no increased risk of stroke associated with chiropractic care compared to medical care. Patients experiencing early dissection symptoms like neck pain or headache—were just as likely to see a chiropractor as a medical doctor, showing that the stroke process had likely begun before any visit occurred.

This conclusion is supported by the American Heart Association and multiple systematic reviews, including a 2016 meta-analysis published in Cureus and a 2021 study in Chiropractic & Manual Therapies. Together, these findings make it clear: correlation does not equal causation when it comes to chiropractic care and VAD.

References:

1. Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S176-83. doi: 10.1097/BRS.0b013e3181644600. Erratum in: Spine (Phila Pa 1976). 2010 Mar 1;35(5):595. PMID: 18204390.
2. Biller J, Sacco RL, Albuquerque FC, et al. (2014). Cervical Arterial Dissections and Association with Cervical Manipulative Therapy: A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, 45(10):3155–3174. DOI: 10.1161/STR.0000000000000016
3. Church EW, Sieg EP, Zalatimo OA, et al. (2016). Systematic review and meta-analysis of chiropractic care and cervical artery dissection: no evidence for causation. Cureus, 8(2):e498. DOI: 10.7759/cureus.498
4. Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. (2021). Risk of cervical artery dissection after chiropractic spinal manipulation in Medicare B beneficiaries aged 65 to 99 years with neck pain. Chiropractic & Manual Therapies, 29:16. DOI: 10.1186/s12998-021-00367-5

Overlooked Clinical Red Flags

According to People Magazine, Klundt had previously undergone breast explant surgery and suffered from chronic muscular pain, key indicators that should have prompted a comprehensive clinical evaluation. Additionally, the provider performing the adjustment was a substitute chiropractor, not her usual doctor.

“Every chiropractor must take full responsibility for history-taking and red flag screening, regardless of whether the patient has been to the office before,” Dr. Cordero emphasized. “Shared offices don’t mean shared clinical insight.”

Post-COVID Vascular Risks Must Be Considered

While the article avoids broader physiological context, chiropractors must not. The literature now identifies a potential link between post-COVID exposure (including vaccination) and vascular inflammation, clotting disorders, and endothelial damage—all factors that complicate case presentations.

“We’re not saying COVID caused this injury,” Dr. Cordero stated. “We’re saying that failing to consider the full clinical picture including immune system history is negligent.”

Chiropractic Is Safe, Effective, and Trusted by Millions

Chiropractors deliver over 280 million patient visits annually in the U.S.—that’s more than 1 million visits per day with one of the lowest malpractice claim rates in healthcare. Serious adverse events remain exceedingly rare, with studies estimating a risk of 1–2 incidents per million cervical adjustments.

“Every day, chiropractors help millions live healthier lives without drugs or surgery,” said

Dr. Cordero. “And yet when something goes wrong even with multiple unknowns the media zeroes in on chiropractic. Meanwhile, the 250,000+ deaths from medical errors each year barely get a mention.”

What Chiropractors Must Do Now

To protect patients and themselves chiropractors must:

•      Treat every adjustment like it’s the first

•      Re-screen frequently for red flags and systemic symptoms

•      Ask about surgeries, medications, and immune status

•      Document thoroughly, including “normal” findings

•      Refer out when anything seems off

“If your notes don’t reflect your thinking,” said Dr. Cordero, “then legally, it’s as if you didn’t think at all.”

The ICA Will Keep Standing in the Gap

The ICA will continue to defend principled chiropractic care, push back on media misinformation, and ensure our drug-free identity is protected.  We also promote evidence-informed clinical decision making and best practices.

“This isn’t just about one article—it’s about the future of our profession,” said

Dr. Cordero. “And we’re not backing down.”

To learn more about ICA advocacy and how to get involved, visit www.chiropractic.org.

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