Since we first learned at ChiroFutures Malpractice Insurance Program that the "natural" version of COVID's Spike protein affected the vascular epithelium we have been urging chiropractors to be on guard and have a heightened sense of caution when assessing their patients. That concern grew when it was realized that the Spike protein in the vaccine did the same thing.

ChiroFutures was the only malpractice provider to warn our insureds about this.

Now, many months later our malpractice program has seen incident reports, complaints and lawsuits related to vascular issues coming in on an increased basis. While vascular related incidents and lawsuits have always been a concern of chiropractic malpractice programs and there has always been a "regular" number of these on a yearly basis - what we are seeing and hearing now is unprecedented.

We are urging you to pay very close attention and take the necessary steps to mitigate you being blamed for something occurring in your patients that is a result of either the "naturally" occurring Spike protein and/or the version in the vaccine.

Given that about 70% of the population in the United States has been injected and perhaps a greater number has contracted COVID this means that the vast majority of your patients may be at risk - which means that YOU are at risk in terms of being blamed for the incidents occurring as a result.

We have been getting an increasing number of calls from our insureds with questions about the relation of such issues to COVID, vaccines etc. Other than our anecdotal experience from our insureds we don't have any other data to draw any firm conclusions.

Having been in the malpractice insurance business for over 30 years now I can tell you from my personal experience that it's highly unusual and you should be on high alert - not just to protect your patients but to protect yourself and your practice.

The reports include an increase in pregnant women experiencing these episodes so the concern is heightened in that regard. Even more concerning are reports involving children. We are typically used to seeing stroke and vascular claims involving middle aged women but now we are seeing these in men. We have seen everything from fainting spells in the office, falls off tables, passing out in the hallway, unexplained nosebleeds, strokes, dissections etc. These are occurring both before, during and after care.

PLEASE understand that as with stroke and dissection claims previously - there is no evidence that chiropractors are CAUSING these. As has always been the case the relationship is temporal (timing) meaning that because the incident occurred during or after a visit to the chiropractor then the chiropractor gets blamed for causing it.

The reality of course is that the vascular issue was pre-existing and/or already in progress when the patient sought care and it may not have been caught prior to the adjustment.

Our recommendation is simply to do what you would normally do when confronted with patients presenting to you with potential vascular issues i.e. screening for stroke and dissection. The difference is that we encourage you to expand your risk pool in regards to potential patients that might be affected.

We also urge you to take a more focused history in this area on your patients including asking them about any history of COVID or vaccines. We understand that many chiropractors do not want to get into vaccine discussions and many are tired from dealing with and talking about COVID - we are tired of it as well. But ignoring it will not help you. In fact it will make things worse for you if you have a claim.

We are not telling you to get into discussions about whether or not they should or should not have gotten vaccinated or whether they should or not.

We are telling you to simply document whether or not they have had it in your records.

Then conduct a focused vascular and neurological examination.

It is crucial to understand that doing these things will NOT stop anyone from blaming you for an event and making a claim. What it will do is mitigate (lessen) the ability of plaintiff's lawyers and their experts to claim you were negligent and/or violated the standard of care.

Not doing these things will be considered an aggravating factor by the attorney and the expert and it will be used to paint you as incompetent and and uncaring doctor who does not follow the standard of care.

An important note: We understand that many of our insureds focus their practice objective on the location, analysis and correction of vertebral subluxation and may not be doing things like taking blood pressure, conducting vascular exams or ordering advanced imaging. We get it. However, if you are not going to do it then we very strongly recommend that you find a medical provider in your community that will work with you to address any concerns that come up in your history taking - before you adjust.

Once you adjust and the event unfolds there is no way to get that toothpaste back into the tube.

In this regard we have provided several educational pieces for you in the Member's Only section on these risks and mitigation.

They include three brand new video presentations and a podcast lecture related to the vascular events and incidents we are seeing being blamed on chiropractors.

The first on vascular endothelial damage by Amy Haas DC, Ph.D which will explain the pathophysiological mechanisms involved.

The second by Kate Rufolo DC and covers risk management and screening procedures.

The third is a recording of a lecture by Matthew McCoy DC, MPH on the clinical issues related to these risks.

They are all located in the Members Only section of our website and can be found under the Stroke & Dissection resources.

Please review these and adjust your clinical protocols as needed.

Matthew McCoy DC, MPH
CEO & Co-Founder
ChiroFutures Malpractice Program
https://chirofutures.org/