Dr. Clum:
Yeah, that's the arteriopathy that I made reference to earlier, and you're right. The idea that the work that was done previously by Hertzog that looked at the forces that were introduced in the process of delivering a surgical spine adjustment in an age group that reflects very closely Ms. May's age, there was the force that were introduced at the level of the vertebral artery were a fraction of what was necessary to damage the artery. The conclusion was that it was very hard to conceive if not impossible to conceive that a typical cervical adjustment in otherwise healthy vertebral artery would have the ability to cause damage to the artery. The situation that you're talking about changes that ballgame in that if the person has an underlying arteriopathy or a pathology in the artery, does that change the calculation? Does that change the forces necessary? That's absolutely the case. There's no question. We know conditions like Marfan's disease or osteogenesis imperfecta 1 or versions of Ehlers-Danlos syndrome or fibromuscular degeneration, all cause changes in arterial walls that cause them to be far more susceptible to dissection, and there are all sorts of other types of ill-defined types of arteriopathies and irregularities in collagen formation, in elastin distribution and so on that would cause an artery to be more susceptible to dissection, and in this case of a person who is otherwise healthy, otherwise fit, midlife, et cetera, and with a bilateral dissection, you have to look at an underlying arteriopathy as a part of this to really fully appreciate the circumstance. Well, we've gone through this to such a great extent for our doctors at this point, and one of the things I want to just mention, please don't call us about the show. We're putting as much information out as we possibly can. Don't hesitate to call for anything that you need, but in terms of the show, please watch it rather than calling us and asking questions. I want to ask you, is there anything else you want to add to this scenario for today's purpose for the doctors to walk away with? I think that the main takeaways that I had hoped we could convey to the listeners today Stu is that we have received the report, the autopsy report, it does very little. It does nothing to say, "Aha, the chiropractor was at fault." Quite to the contrary, it introduces questions that we thought were otherwise answered. Was there a fall? Wasn't there a fall? It brings in the question the line of reasoning that the coroner used to come to a conclusion he did, again, using low level data, a case report, and misquoting the citation or the reference in the case report and extrapolating it to the incidence to bilateral vertebral artery dissection, and that's simply wrong. I mean, it's factually wrong. If the conclusion, relative to the injury in the vertebral artery being the result of the chiropractic adjustment or the chiropractic manipulation in his language, that really does come into more question today than it did when we just had the news reports when we understand the basis upon which the coroner used to get there. There's no final answer. There's no definitive end to this discussion as a result of this, but it is another aspect of it that we want people to be aware of and to understand what's out there. Don't get into any conspiracy theory discussion and all, what it means and what I means. The gentleman misquoted the literature and he used a
Dr. Hoffman:
Dr. Clum:
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