The Blind Leading the Blind and Chiro “Stem Cell” Clinics
I get asked from time to time to review files of patients who believe they may have been harmed by stem cell clinics. In all of this work, I see an alarming trend occurring. Alternative medicine clinics that are ill-equipped to deal with complications making mistakes that produce bad outcomes. Let’s dig in.
Getting Involved in Malpractice
Prior to the bad events happening in the stem cell wild west, I had never been involved in any malpractice case. I had better things to do and had way too many balls in the air to want to take time to review a file when malpractice was suspected. However, with the Liveyon debacle, all of that changed. I was one of the only physicians sounding the warning bell about Liveyon way before they sold dozens of bacterially contaminated umbilical cord tissue to many clinics. So when those patients began to get sick, the attorneys did a simple Internet search on the company and soon realized that I knew all about why this had happened. While I had never agreed to be part of a malpractice case before, I made an exception for this one, as this was an opportunity to be part of one solution for cleaning up the stem cell wild west. Since then, when these cases happen, they still find me.
No matter how good you are or how carefully you manage a patient’s procedure, complications can happen. What separates a normal rare complication from malpractice is usually how the doctor reacts. Let’s dig in on that below.
A Composite Story
While I can’t discuss any specific case I’m working on, this is the most common storyline I see:
- An elderly patient is recruited during a hard sell event
- A chiropractic “Integrative Medicine” clinic hires a physician’s assistant or nurse practitioner (mid-level) to inject stem cells
- The mid-level provider comes into the chiro office to perform the injection of an umbilical cord or amniotic product
- The patient believes they are getting a stem cell injection procedure, which is false (these are dead on arrival cells)
- There is dramatically increased pain post-procedure
- The mid-level provider is not in the clinic, so the chiropractors are left to manage this issue
- Not understanding that dramatically increased pain after a procedure could indicate a joint infection, the chiros let the joint “cook” awhile with it infected
- The patient returns or phone calls are had back and forth. Rather than taking an early sample of the joint fluid and sending it off for culture, something the chiros can’t do without the expensive mid-level returning, the joint infection continues to advance
- Eventually, the patient gets so bad they go to the ER. Realize that many of these patients show up in fulminant sepsis (when the infection has spread into the bloodstream). The infection is then diagnosed and is treated in the hospital, but by this time the infection has also seriously damaged the joint.
What Should Happen?
As soon as a patient returns with severely increased pain after injection, the first thing that needs to be ruled out is infection. That means that if there is any indication of infection like swelling, redness, fever, or an increased white blood cell count, a sample of the joint fluid should be obtained and sent for culture and sensitivity. The patient can then be started on broad-spectrum antibiotics if an infection is suspected or monitored for a day or two until the initial culture results come back. However, this early culture sample allows a bug to be identified and the lab to determine which antibiotics can kill that infection. Given that these results can take 3-7 days, getting this sample to the lab early is critical. Hence, if the patient’s symptoms develop further and infection is confirmed, valuable time is gained on getting the right antibiotic.
The culture and sensitivity test does two things. First, it can confirm that the joint is infected. Second, it tests various antibiotics against that specific bug to find the right one that can quickly clear the infection.
What Usually Happens and Why
In the chiro clinic, there is nobody who can pull a sample of joint fluid other than the mid-level who comes in only periodically to perform injections. Hence, this is not an option. In addition, given that these clinics don’t manage these types of issues, they don’t even have the basic culture and sensitivity kit on hand or even an account with a local lab provider who could run the test.
In addition, the chiropractors and other alternative health staff are not trained to recognize an infection. This was NOT part of their schooling, so what looks infected versus what is likely not infected is not something they have ever been exposed to during their education.
Hence, rather than pulling that early joint sample and sending it off for testing, days or weeks of time are lost while the patient goes back and forth with clinic staff. There’s another problem as well. While a medical clinic could run an IV with broad-spectrum antibiotics if needed, this is not an option at the chiro clinic. In addition, the chiropractors can’t call in a script for oral medications.
Reducing the bad effects of a joint or other infection all depends on early recognition. Meaning, if an infection is identified and treated quickly, there is usually no harm to the joint. However, if the infection is not recognized quickly, then there are issues.
Umbilical Cord and Amniotic Stem Cell Fraud
All of the cases I have been on where a chiro clinic makes the situation worse by not recognizing the infection also have another big problem. They usually have documented in their records that they told the patient they were getting a stem cell injection, but that was clearly false. Meaning the product they injected had no viable and functional stem cells at all, hence, there is also a consumer fraud component which makes it all the more difficult for a malpractice defense attorney to try to defend the case. Incompetence is one thing, but add fraud to that as well and that makes a credible defense nearly impossible. To learn more about amniotic and umbilical cord “stem cell” fraud, see my video below:
The upshot? I know there are likely dozens of people every year getting harmed solely because the clinic where the procedure was performed was not capable of identifying or managing simple complications. We need chiropractic boards to step up to the plate and end the practice of mid-levels or other providers rotating in and out of chiro clinics to perform “stem cell” injection procedures.