This medical negligence claim against a chiropractor is a reminder of the way that memory changes and shifts over time, the critical importance of thorough clinical notes, and a further warning about the dangers of spinal manipulation for certain patients.
You can read the full judgment of Boothman v George [2024] WADC 26 here.
While the following case is a Western Australian case, there is a broader application to many medical negligence cases regardless of jurisdiction.
BACKGROUND TO THE INJURY
On 4 May 2019, Mr Ronan Boothman strained his back while he was surfing.
In the 2 weeks that followed that back strain, he did not notice his back pain worsening and took no medication for pain.
He went to see his regular chiropractor, Dr Chris George, on 18 May 2019.
DISC BULGE AFTER TREATMENT PROVIDED BY THE CHIROPRACTOR
Mr Boothman did not feel that Dr George's treatment that day made him feel any better and, in fact, said it made him feel worse. He felt sore as he walked home after the treatment and was unwell that afternoon and night.
The next morning, Mr Boothman was unable to bear weight on his right leg and had no feeling in it. He had significant pain in his buttocks, and he was unable to control his right foot properly. When he tried to get out of bed, he fell over.
An MRI showed a serious disc bulge in his lower back.
Just under a week later, Mr Boothman saw neurosurgeon Mr Mark Lam, who recommended immediate surgery, which was performed the next day.
ALLEGED MEDICAL NEGLIGENCE
Mr Boothman was left with substantial ongoing back problems, which he alleged were caused by negligent treatment provided by Dr George.
The precise nature of the treatment that Dr George provided to Mr Boothman on 18 May 2019 was in dispute.
Additionally, Dr George disputed that the treatment provided to Mr Boothman had caused a worsening of his pre-existing back pain and problems.
COURT'S OBSERVATIONS DURING THE MEDICAL NEGLIGENCE TRIAL
Mr Boothman gave evidence that Dr George had asked him to lay on his left side before twisting his right leg over his body and pushing twice "vigorously" and that he heard a pop during the treatment.
This account was strongly contested by Dr George.
Dr George attempted to argue that because of his significant pre-existing back problems, it was inevitable that Mr Boothman would have come to a disc injury requiring surgery with or without chiropractic manipulation. This was rejected by the Court because of a lack of expert evidence introduced by Dr George.
In analysing the factual dispute about what occurred, the Court observed that Mr Boothman generally had a better recollection of events and that the evidence of both parties might have been unconsciously affected by time and the events following the treatment (including the expert evidence in the litigation).
Further, the Court found that as Dr George had no independent recollection of the consult with Mr Boothman, the evidence he gave in Court was really evidence about his usual practice in relation to treating patients such as Mr Boothman.
The limited notes of Dr George were in issue when he was cross-examined in Court by the lawyers for Mr Boothman.
The Court found that while Dr George initially declined to perform a side-lying manipulation because of Mr Boothman's neurological symptoms (significant pain in his buttocks), he subsequently relented and performed the manipulation.
There was a further dispute about how much force was applied by Dr George in conducting the manipulation. The Court resolved this in favour of Mr Boothman, finding that the manipulation involved a "forceful twisting action".
COURT FINDS CHIROPRACTOR NEGLIGENT IN HIS TREATMENT
The Court found that because of the back problems that Mr Boothman presented with, it was not appropriate to offer to perform a manipulation.
While it was also argued that Dr George should have warned Mr Boothman of the risks of a manipulation and that an MRI should have been offered – the Court determined that because a manipulation of Mr Boothman should not have been offered or performed, any lack of consent or further investigation was not a key determinant of the Court's findings.
By performing the manipulations on Mr Boothman in circumstances where the treatment was not appropriate, the Court agreed that Dr George had been negligent.
It was also established that the manipulation, which had caused increased pressure on the disc of Mr Boothman's lower spine, was a necessary cause of the disc bulge and the worsening of his symptoms, leading to surgery and his ongoing symptoms.
Mr Boothman was successful in his claim, and awarded $176,644.43 in compensation for his injuries and their effects.
GET HELP FROM A MEDICAL NEGLIGENCE LAWYER
This decision underpins the crucial importance of medical practitioners maintaining accurate and thorough clinical notes for all patients. It is also good practice for medical negligence claimants to keep detailed notes of their own. Memories fade (this case was four years after the negligent treatment) and facts are often in dispute when it finally comes to court.
If you're considering a medical negligence claim, having an experienced personal injury lawyer early on can make a significant difference to the likely success of your claim. We offer a free initial consult and run cases on a "no win, no fee" basis. So, it costs you nothing to find out where you stand.
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