“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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ICA CEO, Dr Edwin Cordero stated: “I want to be clear—what’s happening in Montana is exactly why Dr. B.J. Palmer founded the ICA and charged us with guarding the Sacred Trust. This fight was a warning shot—and we all know it won’t be the last. But let me assure you, the ICA will always rise to the occasion and stand firm for principled chiropractic, just as we’ve done throughout this entire legislative battle in Montana.”

Background: Chiropractic legislator Greg Oblander first introduced HB 500 and then HB 929 when the Montana Legislative session opened in January for its 90-day session. The process of introducing and seeing it signed into the law by the Governor has many steps; and as we learned in Montana a bill that has been voted down in committee can be resurrected and a bill that is tabled in committee can be ‘blasted’ to the floor.

The ICA was ‘boots on the ground’ in Montana with Board Member, Dr. Hugo Michael Gibson and Assembly Representative Dr. Donald Gibson both attending and testifying at the State Board meeting the House hearing, and the Senate. Additional ICA doctors in Montana also testified.  They were backed up with the ICA home office, most specifically our CEO and Executive Director.  ICA’s CEO, Dr. Edwin Cordero provided testimony via zoom and the ICA submitted extensive written testimony to both the House and Senate. We did significant outreach first in the House and then in the Senate.  While the legislature does not meet again until 2027, ICA will continue our engagement in Montana. 

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