Subsequently, she presented to see the Sinai Emergency Room in Los Angeles. She was recognized very soon and very quickly as being in the process of a stroke and tPA was administered in the hospital. tPA as you recall is what peo- ple know as the clot busting drug in hopes that the medication could dissolve the clot and prevent brain damage. She was diagnosed with having bilateral vertebral artery dissections. Next slide, please. In the fullness of time, we know that the tPA didn't work but the clot busting drug did not have the effect that it was hoped to have. Today, we're now dealing with the next phase of this pro- cess as it unfolds. With the release of the coroner's report from the Los Angeles county coroner's office on the death of Ms. May where again at a significant disadvantage be- cause to our knowledge, no one in the profession has had a chance to review the coroner's report. We are reacting to what has appeared in the press. The article that I made reference to before from the Pittsburgh Post-Gazette quotes the coroner's report as saying, the primary cause of death was infarc- tion of the brain. A secondary cause of death was vertebral artery dissection. In response to the question of how the injury occurred, the coroner reported, "neck manipulation by chiropractor." Also in this same report from the Post-Gazette, it was reported that Ms. May experienced bilateral vertebral artery dissections with the left being more se- verely dissected than the right but the right dissection being more recent than the left. As we know, Ms. May succumbed to the effects of the infarct on Feb- ruary 4, 2016. Next slide, please. What is yet to be learned about this case from our perspective as chiropractors and as individuals concerned about the care that we provide and the response to our patients? First and foremost, we do not know at this point how Ms. May presented for care in January 27. We don't know what symptoms she presented with. We don't know how they changed over the ensuing days. We don't know what was done by the chiropractor to assess Ms. May when she did present for care. As a result, we're at a very significant disadvantage understanding this fully in relationship to the chiropractic interface because we know so little about how she presented, what she presented with and what was done to her on assessment. Next slide. We also don't know what care was provided to Ms. May. We understand what the reporters wrote on October 23 of high-velocity low-amplitude, low-velocity low-amplitude and mechanical traction but we really don't know what that means. We don't know what type of adjustments. We don't know what type of traction, procedures and so on. We don't know how she responded to care each day as she went through this sequence of 3 visits.
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