A retrospective search of postmortem examination reports indicates that death following chiropractic neck manipulation in Australia appears to be a rare event.

The aim of this study was to review the deaths associated with chiropractic treatment in Australia. The National Coronial Information System (NCIS) was searched for cases in Australia for which chiropractic treatment was determined to have contributed to death. Closed, completed Australian cases between 1 July 2000 and 31 December 2019 were evaluated (approximately 356,000 cases). This revealed only one case in which chiropractic treatment was considered to have contributed to death. The case was that of an adult male who died from a dissected left vertebral artery following chiropractic manipulation for neck pain. In addition, postmortem records at Forensic Science SA (FSSA) were searched for similar cases over the same time period (approximately 30,000 cases). No cases definitely attributable to chiropractic manipulation of the neck were found, but a case with thrombus in the left vertebral artery would not be entirely excluded as being related to chiropractic treatment. Deaths associated with chiropractic manipulation in Australia therefore appear rare. Although there is a reported incidence of stroke associated with vertebrobasilar artery system occlusion following chiropractic manipulation, stroke associated with vertebrobasilar artery occlusion has also been observed following a visit to a primary care physician. This could be explained by vertebrobasilar artery pathology causing neck pain that initiated consultation. Thus, the present study only demonstrates a rare temporal, but not causal, relationship between attending a chiropractor and vertebral artery dissection causing death. Non-lethal injuries were not assessed.