Insights from ChiroFutures on Navigating Patient Evaluations, Documentation, and Stroke Incidents

In a recent incident involving Dr. Peters and a patient’s stroke, the complexities of chiropractic malpractice and the necessity of vigilant risk management come to the fore. This case serves as a crucial learning opportunity for healthcare providers, particularly in the chiropractic field, underlining the significance of comprehensive patient evaluation and the protective role of reliable malpractice insurance.

Incident Overview

Dr. Peters, while treating a patient suffering from severe neck pain, headaches, and nausea, encountered an unexpected complication. Despite the patient showing significant improvement with chiropractic adjustments, a subsequent stroke incident raised serious concerns. The patient, who had a history of using alcohol and daily morphine, presented with exacerbated symptoms on the day of the incident, leading to his referral to the ER and a diagnosis of vertebral artery dissection.

Risk Management Analysis

The incident illuminates several risk factors that chiropractors must be acutely aware of:

  1. Comprehensive Patient Evaluation: The absence of a vascular evaluations, such as George’s test, was a critical oversight.
  2. Red Flag Recognition: A detailed history, including understanding the patient’s use of substances like alcohol and morphine, is essential.
  3. Documentation and Communication: Proper documentation of all patient interactions, symptoms, and treatment responses is non-negotiable.

ChiroFutures’ Role

ChiroFutures Malpractice Insurance Program plays a pivotal role in such scenarios. They provide guidance on:

– The need for regular review of treatment processes and patient evaluation methods.
– Training and resources for chiropractors to enhance their practice standards, like the Vascular Mitigation course.
– Legal and ethical handling of post-incident communications and financial settlements with patients.

Key Takeaways for Practitioners

  1. Regular Training and Education: Continuous education in recognizing and managing potential risks is crucial.
  2. Vigilant Patient Screening: Initial and ongoing screenings for new or worsening symptoms must be a standard practice.
  3. Robust Documentation: Meticulous record-keeping of every patient interaction safeguards against potential legal issues.
  4. Effective Communication: Open, transparent, and ethical communication with patients can prevent misunderstandings.

Vicarious Liability: Understanding Its Implications in this Case 

In the realm of chiropractic care, the concept of vicarious liability becomes particularly significant, especially in cases involving practice owners and their employed chiropractors. The case involving Dr. Peters and his employer, Dr. Jones, provides an insightful example. Here, we delve into the nuances of vicarious liability and its implications for practice owners and their employees.

What is Vicarious Liability?

Vicarious liability refers to a situation where one party (in this case, the practice owner) is held partly responsible for the actions of another party (the employed chiropractor). This legal principle asserts that employers can be held liable for the negligence or misconduct of their employees committed during the course of their employment.

Scenario Analysis

In the incident involving Dr. Peters, the patient suffered a stroke alleged to be linked to the chiropractic treatment. Although Dr. Jones, the clinic owner, did not directly treat the patient, he could still be held vicariously liable for Dr. Peters’ actions, as they occurred within the scope of his employment at the clinic.

Key Considerations for Practice Owners:

  1. Employee Training and Supervision: Practice owners must ensure that all employed chiropractors are adequately trained and supervised. Regular audits of treatment methods and patient handling can mitigate risks.
  2. Standard Operating Procedures: Establishing clear, standardized protocols for patient care, especially for high-risk cases, is essential. This reduces the likelihood of malpractice and, by extension, vicarious liability.
  3. Compliance and Documentation: Practice owners should enforce strict compliance with documentation standards to protect against legal repercussions.

For Employed Chiropractors:

  1. Awareness of Legal Responsibilities: Employed chiropractors must be aware of their legal obligations and the impact their actions could have on their employers.
  2. Adherence to Clinic Protocols: Following the established protocols of the clinic is crucial to ensure consistent and safe patient care.

Legal Protection and Insurance

Both practice owners and their employees should have appropriate malpractice insurance. In this context, ChiroFutures’ role becomes invaluable as they offer guidance and support in managing such risks. They can assist in:

– Providing tailored malpractice insurance policies covering both the practitioner and the employer.
– Offering legal advice and representation in the event of a lawsuit.


This case stresses the importance of comprehensive patient care and the value of having a supportive malpractice provider like ChiroFutures. They not only offer protection in the face of legal challenges but also provide vital resources for improving patient care standards. For chiropractic practitioners, this incident is a reminder of the constant need for vigilance, ongoing education, and the implementation of rigorous risk management strategies to ensure the highest standard of patient care.

Understanding vicarious liability is crucial for both chiropractic practice owners and their employees. While it emphasizes the need for stringent practices and protocols, it also highlights the importance of a supportive and comprehensive malpractice insurance provider like ChiroFutures. By fostering a culture of responsibility, continuous education, and adherence to ethical standards, chiropractic practices can navigate the complexities of vicarious liability effectively, ensuring the safety and well-being of their patients and the legal protection of their practitioners.