If a chiropractic neck adjustment preceded a stroke, a vertebral artery dissection chiropractor lawsuit may be possible, and these cases have produced results ranging from a $250,000 settlement in the Katie May wrongful death matter to a $75 million verdict in the Buckelew case out of Georgia. Whether a specific claim succeeds turns on proof that the chiropractor failed to screen the patient, failed to warn of the stroke risk, or failed to stop and refer when symptoms appeared, and on expert testimony linking the manipulation to the injury.
What You Have to Prove
A vertebral artery dissection (VAD) claim against a chiropractor follows the structure of a standard medical malpractice case. The patient must show the chiropractor owed a duty of care, breached that duty by failing to screen properly, failing to obtain informed consent, or performing the adjustment incorrectly, that the breach caused the injury, and that the patient suffered compensable damages such as medical costs, lost income, permanent disability, or pain and suffering.1Becker Justice. Vertebral Artery Dissection
The breach piece is where most VAD cases are won or lost. Chiropractors are expected to evaluate a patient’s condition at every visit. When someone shows up with neck pain or headache, which are the two most common symptoms of a cervical artery dissection already in progress, the practitioner is expected to consider that the complaint may be a vascular event rather than a musculoskeletal one. Ignoring warning signs or skipping a thorough history is routinely cited as a breach of the standard of care, and if a dissection is suspected the chiropractor has a duty to withhold treatment and refer the patient for emergency evaluation, typically a CT angiogram.2Attorney at Law Magazine. Chiropractic Stroke Cases: The Standard of Care
The Duty to Warn You About Stroke Risk
The clearest appellate decision on a chiropractor’s duty to warn came from the Texas Supreme Court in 2012. In Aaron Felton v. Brock Lovett, D.C. (No. 11-0252), the court held that chiropractors must inform patients of the risk of vertebral artery dissection and stroke before performing cervical manipulations.3SCOTXBlog. Court Upholds an Informed Consent Claim Against a Chiropractor
Felton had suffered a vertebral artery dissection after an adjustment by Dr. Lovett, and a jury awarded him approximately $742,000. An intermediate appeals court reversed, reasoning that because Felton had unknown underlying conditions the dissection was not “inherent” in the manipulation itself. On November 30, 2012, the Texas Supreme Court rejected that logic and ruled that the risk of stroke is inherent in the procedure regardless of pre-existing conditions. The court called this “precisely the kind of information a reasonable patient would be expected to want to know before deciding whether to risk such severe consequences in order to alleviate neck pain.” Expert testimony at trial had established that an estimated 10 to 20 percent of all vertebral artery dissections are caused by chiropractic manipulation, and that safer alternative treatments exist.4Painter Law Firm. Texas Supreme Court: Chiropractors Must Inform Patients of Known Risk of Vertebral Artery Dissection
To win on an informed-consent theory under Felton, a plaintiff must show the chiropractor failed to disclose risks inherent in the treatment that could have influenced a reasonable person’s decision, that a reasonable person would have declined treatment had those risks been disclosed, and that the patient was injured by the very risk that went undisclosed.4Painter Law Firm. Texas Supreme Court: Chiropractors Must Inform Patients of Known Risk of Vertebral Artery Dissection
The duty is not uniform across states. In Connecticut, the Board of Chiropractic Examiners issued a 2010 declaratory ruling concluding that stroke and cervical artery dissection are not established risks of cervical spine manipulation, and that chiropractors therefore need not address stroke risk as part of informed consent. The Board relied primarily on a single 2008 population-based study, and a 2025 narrative review in the Journal of Contemporary Chiropractic argued the ruling is no longer supported by current evidence and should be revisited.5Journal of Contemporary Chiropractic (Parker University). The Connecticut Law on Chiropractic Informed Consent to Cervical Artery Dissection and Stroke
What VAD Lawsuits Have Paid
Buckelew v. Womack: $75 Million
The largest verdict connected to a chiropractic VAD involved Jonathan Buckelew, a 32-year-old Georgia man who suffered a catastrophic stroke in October 2015. Buckelew had seen chiropractor Dr. Michael Axt for neck pain, tinnitus, and visual disturbances. During a cervical adjustment he became disoriented and lost consciousness. Dr. Axt called emergency services, and Buckelew was transported to North Fulton Regional Hospital.6Expert Institute. $75M Verdict for Plaintiff With Locked-In Syndrome
Emergency room imaging showed signs of a vertebral artery dissection, but plaintiff’s attorneys argued the ER physician failed to communicate the chiropractic history and imaging findings to the rest of the care team, and the radiologist failed to appreciate an acute arterial blockage on the scans. Buckelew was initially diagnosed with encephalitis rather than stroke. By the time an MRI the following morning revealed a massive posterior circulation stroke, roughly 24 hours had passed. A blood-thinning drip failed, and Buckelew was left with locked-in syndrome, fully conscious but paralyzed except for eye movements.7Courtroom View Network. $75M Verdict in Med Mal Trial Over Stroke That Profoundly Paralyzed Patient
In October 2022 the Fulton County State Court jury returned a $75 million verdict, splitting liability between the ER physician (60%) and the radiologist (40%), with $29 million for medical expenses and $46 million for noneconomic damages. The chiropractor had been named in the original lawsuit but was dismissed before trial through what court filings described as an “amicable resolution,” and the jury assigned no fault to him.8PostGradDC. Chiropractor Standard of Care and Emergency Referral in the Buckelew Case The Georgia Court of Appeals affirmed the judgment on March 10, 2025.9FindLaw. Buckelew v. Womack, Georgia Court of Appeals
Katie May Wrongful Death: $250,000
Model Katie May died in February 2016 at age 34. The Los Angeles County Coroner ruled the death accidental, caused by a vertebral artery dissection resulting from a chiropractic neck adjustment.10CBS News. Katie May Death: Stroke After Chiropractor Visit In June 2017, Alex Maimon, the father of May’s young daughter, filed a wrongful death and medical malpractice lawsuit against chiropractor Dr. Eric Swartz and his Los Angeles practice in Los Angeles County Superior Court, alleging that “forceful” and “aggressive” neck manipulations caused bilateral vertebral artery dissections and a severed left vertebral artery.11People. Playboy Model Katie May Estate Wrongful Death Lawsuit Against Chiropractor The case settled in January 2021 for $250,000.12Chiropractic Economics. Expert Analysis: Did Cervical Spine Manipulation Cause the Death of Katie May
Other Verdicts and Settlements
- A $1,030,900 jury verdict for a client who suffered an ischemic stroke following a chiropractic adjustment and recovered physically but continued to suffer psychological effects.13Clare & Berry. Results
- A $900,000 verdict in September 2017, where jurors deliberated fewer than four hours and concluded that although the patient had a pre-existing condition, the chiropractor should have referred the patient to a medical provider before performing the adjustment.14NCMIC. Tales From the Claims Vault
- A verdict over $600,000 in a case involving patient Sarah Haack against Dr. Joseph Peterson, driven largely by credibility problems arising from the chiropractor’s “copy and paste” electronic medical records, which contradicted his trial testimony.15NCMIC. Copy and Paste Documentation
- A $450,000 settlement in 1996 for a 32-year-old woman who suffered a stroke from a left vertebral artery dissection following a 1993 cervical adjustment. The case settled through mediation three weeks before trial on allegations of failure to diagnose, failure to refer, and failure to obtain informed consent.16Kolpan Law. Chiropractic Malpractice Stroke $450,000 Settlement
- A $250,000 settlement in a case of bilateral vertebral artery dissection and ischemic stroke after cervical manipulation, where the client made a near-full recovery.13Clare & Berry. Results
Not every case ends in a plaintiff’s verdict. In one matter litigated over seven years, a court ruled in favor of chiropractor Dr. Talia Gossard after defense experts testified that the plaintiff’s vertebral artery clot was two to three weeks old before the final chiropractic treatment, undermining the argument that the adjustment caused the dissection.17NCMIC. Detailed Notes Help DC Win Stroke Case
Why Causation Is the Hardest Fight
Causation is almost always the most contested element of a VAD claim, and the medical literature reflects a genuine scientific disagreement that shapes courtroom battles.
The chiropractic profession points to research suggesting that cervical manipulation does not generate enough force to damage a healthy artery. A 2022 cadaver study published in the Journal of Manual and Manipulative Therapy found that vertebral artery length changes during manipulation were less than the amount of arterial slack present, meaning arteries were not stretched to the point of mechanical injury.18American Chiropractic Association. Vertebral Artery Dissection: An Evidence Review A 2016 systematic review and meta-analysis found a small statistical association between chiropractic care and cervical artery dissection but rated the overall evidence quality as “very low,” arguing the association likely reflects that neck pain, the chief symptom of an existing dissection, is the same reason people visit a chiropractor. Patients with vertebral artery dissection were found to be just as likely to have visited a primary care physician as a chiropractor before their strokes.19National Center for Biotechnology Information. Systematic Review and Meta-Analysis of Chiropractic Care and Cervical Artery Dissection
A 2024 review of 10 recent case reports acknowledged that nine showed no convincing evidence manipulation caused the dissection, but one case involving a patient with ankylosing spondylitis did provide convincing evidence of causation precisely because the patient’s pre-existing cervical spine pathology made the manipulation contraindicated. The authors concluded that practitioners have a duty to exclude cervical spine pathology before performing manipulation to avoid catastrophic injury in vulnerable patients.20National Center for Biotechnology Information. Cervical Spine Manipulation and Cervical Artery Dissection: A Review of Recent Case Reports
Those nuances drive courtroom strategy. The defense argument in many cases is that the dissection was already underway before the patient walked in, so the chiropractor could not have caused it. The plaintiff’s response is often that even if the dissection pre-existed, the manipulation worsened it or dislodged a clot, and that the chiropractor should have recognized the warning signs and referred the patient for medical evaluation rather than proceeding with treatment.2Attorney at Law Magazine. Chiropractic Stroke Cases: The Standard of Care
What Makes or Breaks a Case
Timing of Symptoms
The timeline between the adjustment and the onset of symptoms is central to causation. If ischemic symptoms appear within seconds of the manipulation, a causal link is easier to argue. If the patient reports symptoms only minutes, hours, or days later, proving the manipulation rather than a pre-existing condition caused the stroke becomes much harder.2Attorney at Law Magazine. Chiropractic Stroke Cases: The Standard of Care
Documentation
Chart quality can decide the outcome. The $600,000-plus verdict in the Haack case turned substantially on the chiropractor’s electronic records, which had been copy-and-pasted between visits and contradicted his trial testimony.15NCMIC. Copy and Paste Documentation A signed consent form acknowledging the discussed risks is considered part of the standard of care, and its absence or inadequacy becomes a focal point for the plaintiff.2Attorney at Law Magazine. Chiropractic Stroke Cases: The Standard of Care
Expert Witnesses
These cases typically require experts on both the medical and chiropractic sides. Physicians, particularly neuroradiologists and neurosurgeons, testify about whether imaging shows evidence of vascular trauma and the physiological cause of the stroke. Chiropractors testify about whether the technique met the profession’s standard of care and whether the practitioner responded appropriately when symptoms appeared. In one defense verdict, the chiropractor’s team of a neuroradiologist, a neurosurgeon, and a chiropractor prevailed by demonstrating imaging showed no evidence of vascular trauma.21NCMIC. It’s Not Who Did It, But What Caused It
How Long You Have to File
Statutes of limitations vary by state. In New Jersey, for example, the deadline to file is two years from the date the patient knew or should have known that malpractice occurred, though exceptions exist.22Nagel Rice. Common Types of Chiropractor Malpractice Injuries Because expert testimony is typically required to establish both the standard of care and how the chiropractor deviated from it, and because the medical records and imaging that make or break causation need to be preserved and reviewed quickly, anyone considering a claim should consult a malpractice attorney in their state well before the deadline runs.