Pathologists missed clues in death
Blood pressure not chiropractic to blame, MD says
John Deverell
Staff Reporter
We were wrong.

Those three little words summarize a dramatic day as pathologist Dr. Michael Pollanen told the Lana Dale Lewis inquest that he had changed his mind last fall about her 1996 stroke. It was, he concluded, not caused by chiropractic neck adjustment.

Lewis in all likelihood succumbed in a normal way to stroke arising from atherosclerotic disease, or hardening of the arteries, her death brought on at the relatively early age of 45 by chronic high blood pressure, he told the jury.

Pollanen said he and his supervisor, Dr. John Deck, missed some important clues while performing the autopsy on Lewis in 1996 and in early 1997. In April, 1997, they jointly signed a warrant attributing Lewis' death to a chiropractic treatment 17 days before.

Coroner's counsel Tom Schneider pushed Pollanen to explain how two top-notch University of Toronto pathologists had strayed so far from scientific orthodoxy.

Deck, a professor and consultant to the coroner's office for three decades before his retirement two years ago, has already endured days of cross-examination at the inquest during which he often shifted ground in his evidence.

He adhered consistently, however, to his 1997 conclusion that the chiropractic adjustment was to blame.

Pollanen, Deck's protégé, has been recognized at the inquest as an expert witness. An associate professor at U of T, he won a Governor-General's gold medal for his Ph.D. dissertation in neuropathology in 1995 and became an M.D. in 1999. He has published frequently in medical and scientific journals since 1987.

Last fall, Pollanen reviewed the whole Lewis case, including an examination of parts of Lewis' vertebral artery that he and Deck missed the first time. He found no evidence of arterial splitting or dissection outside the skull, which is the recognized signature for chiropractic injury.

Instead, he found more clotting and hardening plaque or atherosclerosis inside the skull and, for the first time, a "big ticket item" — an internal split in the diseased left vertebral artery inside the skull, which he estimated occurred about three days before Lewis' fatal stroke.

In November, 2001, Pollanen wrote a report to the coroner withdrawing his original conclusion and substituting a finding of death by natural cause.

"If I had it to do over again, I would do several things differently," he said of the original investigation and conclusion.

But he did not abandon completely his earlier work with Deck. Pollanen said Deck's theory of subtle arterial injury inside and outside the skull from chiropractic manipulation remains "a possible explanation." However , when pushed hard by Schneider, he characterized that hypothesis as "improbable."

"I am not aware of any finding which cannot be explained by atherosclerosis," he said.

The inquest continues.

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