Retired bank manager John Lawler loved to walk. He particularly loved to walk with his wife Joan. It made their children and grandchildren smile that they would still walk hand in hand, even after almost 60 years together.
Every day the pair, both in their 80s, would stride out around the racecourse near their home in York, or into town. Twice every day (there and back), they would walk past a chiropractor’s practice.
When, back in 2017, John, then 79, started to be irritated by a pain in his leg — not a chronic pain but one keeping him awake at night — his GP suggested he might benefit from a course of physio. Finding waiting lists for both the NHS and private physios, they made an appointment with a chiropractor. That chiropractor was Arleen Scholten. Dr Arleen Scholten, according to her website.
John Lawler, pictured with his wife Joan, died shortly after having an appointment with chiropractor Arleen Scholten near their home in York
‘I don’t think Mum actually knew there was a difference between a physio and a chiropractor,’ says their youngest daughter Clare, 49, an executive in a London publishing house. ‘I wouldn’t have been that aware of the differences either. I was only vaguely aware that Dad was going for a spot of physio.’
Joan certainly assumed that ‘Dr Scholten’ was a medical doctor. ‘You do, don’t you? Particularly that generation,’ says David, 55, the couple’s eldest child who works in finance.
‘You see certificates on the wall and you think, “These are people who know what they are doing.” You put yourself into their hands.’
With, in this case, utterly tragic consequences. For John Lawler’s treatment for an ‘achy leg’ ended in the most shocking way. His spine was broken as Mrs Scholten — who was not a medical doctor and was not even required to have a first aid qualification in order to practise as a chiropractor — performed a ‘drop table’ manipulation which involved giving the pensioner a sudden push while simultaneously dropping the table 2cm. He died the following day.
An inquest in York this week heard that John’s spine ‘snapped like a rigid stick’. It was not known at the time that he was suffering from a calcifying condition, common in old age, which meant his spine was more rigid. His family were present to hear expert testimony confirming that treatments on such a back would have been like ‘bending a spoon backwards and forwards’ until it broke in two.
Dr Arleen Scholten, pictured, gave Mr Lawler a ‘drop table’ manipulation which involved giving the pensioner a sudden push while simultaneously dropping the table 2cm. He died the following day
‘Maybe this treatment would have worked wonders for a 30-year-old rugby player,’ says David, who sat with his mum and his sister through all six days of harrowing evidence. But it should never have been attempted on my dad. He thought he was in safe hands and he was not.’
Joan, now 83, witnessed the injury. She was at his side — ‘like she always was, 24 hours a day,’ says David — even in the treatment room, sitting less than two metres from the table when John yelled out in agony that Mrs Scholten was hurting him and that he could not move his arms or his legs.
She witnessed Mrs Scholten trying to turn John over, and then, as she found him unresponsive, her frantic (panicked, the Canadian-born chiropractor admitted during the inquest) attempts to resuscitate him — attempts that the family claim made the already serious situation worse.
‘When she called an ambulance, she said she thought Dad had had a stroke, but to Mum she indicated that maybe he hadn’t, because his face was symmetrical.
‘We now know that Dad would had survived, had she done the thing everyone knows you should do when someone has had a spinal injury: keep them stable. Instead, she moved him.
‘Mum was there when she hauled him off the table like a rag doll and tried to resuscitate him.’
Mrs Scholten told paramedics she had been applying ‘gentle manipulation’ but did not tell them about using the drop treatment. She said she was in a ‘complete and utter state of panic’ and could not explain why she had not mentioned that element of treatment.
Crucially, believes David, the paramedics arrived thinking they were dealing with a stroke, rather than a spinal injury. ‘If they had known, they would have treated him like they would someone with a sports injury,’ he says. ‘Dad would have had a chance.’
Mr Lawlor attended a session at Chiropractic 1st in The Mount, York, pictured
Indeed the inquest heard that had John been immobilised immediately after the fracture he would have survived. He was taken to hospital but never regained any feeling from the neck down. His spinal cord had been crushed to the point where vital signals were not getting from his brain to his organs.
Clare says: ‘A junior doctor took us aside and said, “This is very bad. He will not recover from this.” It was so upsetting to see him lying there, with blocks on either side of his head. Dad couldn’t really speak but he did know me. The saddest thing was that we would hold his hand but he would not feel it. It was upsetting for my Mum. He couldn’t feel her.’
John died at 6pm the following day. Clare had to make the call to her elder sister Sarah, 53, who lives in Australia. ‘That was a terrible thing to have to do. It was devastating enough for us. Sarah didn’t even get to say goodbye.’
Mr Lawler, pictured, died at 6pm the day following his appointment with Dr Scholten
For two years the family have been desperate to have vital questions about John’s last hours answered, convinced that this was not just a freak accident but an avoidable tragedy — one that every patient should be aware of.
They had hoped that the coroner would record a verdict of unlawful killing. Coroner Jonathan Heath instead recorded a narrative conclusion that Mr Lawler suffered spinal injuries while undergoing chiropractor adjustment and died from respiratory depression.
However, he did say he would ask the chiropractic regulatory authorities to consider first aid training for chiropractors. He is also calling on the General Chiropractic Council (GCC) to bring in pre-treatment imaging, such as X-rays or scans, to protect the vulnerable.
‘We’ve since discovered that some chiropractors won’t treat patients of Dad’s age, or certainly not without doing scans first. He had a history of degenerative disease, too. He’d had some rods inserted in his lower back in 2009. He should not have been treated, quite simply.’
The family tragedy will be a wake-up call for the chiropractic profession, medicine’s more contentious cousin
David was horrified to hear how the treatment was conducted. ‘It wasn’t like an hour-long session, a one-to-one. There were other patients, with a low wall separating them, and the chiropractor would come round them all, doing the manipulations.
‘For one, she used a stick, an “activator”, which is a small hand-held device that delivers a force to the spine. We heard the sound it would make during the inquest. It was like a thud. There was a sense that a lot of it was for show.’
Yet it was the table-drop treatment which did the damage. This wasn’t the first time John had had it. At an appointment the previous day (he’d had five sessions, although only three were ‘hands on’) Mrs Scholten had carried out this procedure, too. David adds: ‘Dad was shocked by that. Mum was shocked by it. They didn’t like it at all but they went off after with no ill effect, so Dad assumed it must be doing some good.’
The tragedy that has befallen this dignified family cannot be overstated. John had five grandchildren, aged from ten to 22, and ‘infinite patience with them’.
The family tragedy will be a wake-up call for the chiropractic profession, medicine’s more contentious cousin.
The industry, which has been beset by claims of other injuries, has long been vulnerable to accusations of quackery.
‘I’m sure there are plenty of chiropractors who do amazing work,’ says David. ‘But some of it is bonkers. Too much of it is wrapped up in quackery. Some chiropractors claim they can cure everything from the common cold to digestion problems, and that every ill has come about because the spine needs to be manipulated. You can believe that or not. You could regard it as just an alternative therapy like homeopathy. But it’s not like homeopathy. If this goes wrong, people can die. Those in the industry say it’s impossible but it happened to Dad.
‘Now I don’t particularly want the chiropractor who treated him to go to prison but I do think that she and other chiropractors should be properly regulated and investigated when things go wrong.’
Astonishingly for the family, Arleen Scholten is still working as a chiropractor. It must be stressed that there have been no findings of any wrongdoing against Scholten
Astonishingly for the family, Arleen Scholten is still working as a chiropractor. It must be stressed that there have been no findings of any wrongdoing against Scholten.
She was arrested immediately after John’s death, and one of her bail conditions was that she could not practise until the police inquiry was complete. No charges were brought, however, and she was free to practise again.
An inquiry by the GCC was also launched but has yet to be completed. An earlier interim suspension hearing, which David had expected to attend, having complained to them about his father’s treatment, was conducted in private so as to avoid the risk of prejudicing ongoing inquiries. Mrs Scholten was not struck off the register.
He says: ‘Suspension hearings are normally open to the public but, on the day, they said I couldn’t be there. I find that unacceptable. This is a different world. It seems to be a little self-regulatory chiropractic bubble, where chiropractors regulate chiropractors.’
After the inquest, she expressed deep regret about what had happened. A representative said: ‘Arleen Scholten wishes to express her deepest sympathies to the family of Mr Lawler for their loss’
The GCC issued this statement: ‘These are sad circumstances. It has been difficult hearing the testimony of those affected and our sympathy goes to the whole family. Since the tragic events the GCC has sought to keep the family informed about our actions.
‘The Investigating Committee of the GCC met in September 2017 to consider imposing an Interim Suspension Order against the chiropractor’s registration. The committee decided to hold its proceedings in private — it considered that not prejudicing or jeopardising important external inquiries relating to the matter outweighed the public interest in holding the hearing in public.
‘Following the completion of the inquest we are now in a position to resume the investigation opened in 2017 following the death of Mr Lawler.
‘The case is being prepared for consideration by the GCC Investigating Committee for it to decide whether a hearing into the chiropractor’s fitness to practise be held. We will progress this matter as swiftly as possible.’
The inquest heard Mrs Scholten had since completed a first aid course, and had made clear on her website that she was not a medical doctor (she has a BSc and a Doctor of Chiropractic degree from Northwestern College of Chiropractic, dating from 2001).
After the inquest, she expressed deep regret about what had happened. A representative said: ‘Arleen Scholten wishes to express her deepest sympathies to the family of Mr Lawler for their loss.
This was an extremely rare and unusual incident, which has been thoroughly investigated by the coroner during the court of the inquest. She will take on board the coroner’s findings and has already made changes to her practice since the incident.’
On the website of her company, Chiropractic1st, Mrs Scholten says she loves nothing more than hearing the ‘hundreds of testimonies of patients young and old enjoying life more because of chiropractic care’.
Two-and-a-half years on, Joan no longer lives in York, having moved south to a retirement complex to be closer to her children and further from unbearable reminders. Clare says: ‘You can have post-traumatic stress after witnessing what mum did, and I think she had something like it. She didn’t want to be in the house without him.
‘She wants the narrative to be known, and she wants to make sure this cannot happen again.’
The last photographs they have of John were taken a few days before he died, on his 80th birthday. The family went out for a meal and walked home together. ‘Mum and Dad were in front of me, and I remember they were holding hands,’ says Clare. ‘Even at the time, I thought that was lovely.’
