One DC took on the role of chiropractor, counselor, dietician and physician — and it didn't end well for his young patient.
Posted in Case Studies on Wednesday, February 25, 2026
Fourteen-year-old Jon Phipps had been complaining to his father about increasingly severe headaches. Mr. Phipps made his son an appointment with David Delvecchio, DC, who was known locally for his easy rapport with children.
The family was new to the area, and during their initial consultation, Mr. Phipps advised Dr. Delvecchio that they did not have a family physician in their new town, nor had they been under the care of a family physician in their previous place of residence. Accordingly, Dr. Delvecchio assumed the role of primary care physician to Jon, his father, and his sister.
A complete medical history was taken and showed nothing out of the ordinary. However, a more thorough discussion about Jon’s social and family life revealed some details that would later become relevant: Jon was homeschooled and had made no friends or acquaintances outside the home. Additionally, Mr. Phipps was a single dad, and the family’s meals consisted primarily of takeout or prepared foods.
Initial Treatment Period (March–July 2019)
Dr. Delvecchio began treating Jon in March 2019. The first period of treatment lasted four months and consisted of eight treatments involving spinal adjustments using diversified technique. On the last two visits, Jon complained of left eye pain. This new complaint was noted by Dr. Delvecchio, who nevertheless made no attempt to determine its cause.
Second Treatment Period (January–June 2020)
Approximately six months later, Jon returned with complaints of nervousness, depression and stomach cramps. Eye pain was not mentioned; however, Jon did complain of blurry vision.
Dr. Delvecchio conducted a long discussion with Jon and his father, where he learned that Jon had taken a part-time job, which caused him anxiety, and he had not begun to interact socially with people his age. In addition, Mr. Phipps had entered into a serious relationship with the widowed sister of a co-worker, and this unfamiliar woman was quickly becoming part of the family.
Dr. Delvecchio suspected food sensitivity, so Jon’s treatment over the next four months involved dietary restrictions in addition to chiropractic care and psychological counseling. Dr. Delvecchio adjusted only C1 and C2, and he continued to see Jon twice monthly until June.
Third Treatment Period (May 2021)
Following Jon’s final June visit, Dr. Delvecchio didn’t see him again for almost a year. In May 2021, Jon visited twice in one week after complaining of blurred vision and stomach cramps. He was again given advice about diet and stressors in his home life.
Dr. Delvecchio found Jon to be extremely bothered by his father’s recent marriage; it seemed the new stepmother was uncomfortable with children, resented the time Mr. Phipps spent with his son and daughter, and made no effort to build a relationship with Jon or his sister.
Fourth and Final Treatment Period (July–November 2021)
In July 2021, Jon began his fourth period of treatments, which became the most intense and most critical.
During this final treatment period, Dr. Delvecchio manipulated the cranium, C1 and C2. During the remainder of the summer, the doctor also used the prior protocol to treat Jon for stomach cramps and nervousness.
On the fifth visit, Jon complained of blurred vision and intense head pain with a throbbing sensation that increased or decreased depending on the position of his head.
On the eighth visit, in late October, Jon reported little change in the severity of his head pain; he also complained of occasional dizziness, intermittent nausea and vomiting, and continued blurred vision. Dr. Delvecchio responded with changes in his dietary restrictions, and a meeting with Mr. Phipps to restrict all food additives and the use of a special tea to cleanse the blood.
In November, Jon reported less head pain but continued dizziness, vomiting and blurred vision. Dr. Delvecchio’s attempts at psychological counseling indicated Jon needed time alone with his father, a matter that the doctor proceeded to discuss with Mr. Phipps. The doctor also requested that Mr. Phipps more closely supervise Jon’s prescribed diet.
Over the next six weeks, Jon was seen weekly with little change in his condition except for a complaint that his sense of smell seemed to be diminishing. During the seventh week, Jon reported increased pain and decreased ability to smell. During the next visit one week later, Jon reported a total loss of his sense of smell, increased head pain, and continued blurred vision. Emotional responses indicated continued difficulties with his father and stepmother, who remained impatient with Jon and his health problems.
The next week, Jon indicated problems with dizziness; however the head pain had decreased. He missed his next scheduled treatment, and Dr. Delvecchio’s next contact regarding Jon was an angry phone call from Mr. Phipps one month after Jon’s final treatment.
Mr. Phipps informed the doctor that two weeks earlier, Jon had lost consciousness in the shower. The boy was subsequently diagnosed with a brain tumor and had undergone surgery.
The Lawsuit
Six months later, Dr. Delvecchio was served with a lawsuit alleging he had failed to assess and evaluate the cause of the headaches; failed to refer Jon for a consultation; and failed to diagnose a brain tumor. The suit further set forth that Jon sustained blindness and brain damage, for which the family sought $2 million.
NCMIC retained defense counsel for Dr. Delvecchio and began the discovery process in the lawsuit.
Records received from the neurosurgeon and the hospital confirmed head pain, visual disturbance and loss of smell approximately two months prior to Jon’s collapse in the shower. The ER physician found a complete loss of vision in the left eye and severely diminished vision in the right eye. Upon admission to the hospital, CT scan and MRI were performed and showed a large left frontal brain lesion.
Jon underwent an immediate craniotomy for removal of a cystic tumor positioned near the left optic nerve. Pathology determined the tumor was a pilocystic astrocytoma. Post-surgery, Jon remained sightless in the left eye and regained some sight in the right eye, which enabled him to read.
Expert Review and Defense Findings
NCMIC retained several chiropractors to review the case and provide expert testimony regarding the insured’s care. The chiropractors felt that the insured strayed too far from chiropractic treatment and into other areas, such as professional psychological counseling. These chiropractors opined that Dr. Delvecchio should have focused more on the physical symptoms, such as blurred vision, positional head pain, and dizziness. He had not suggested diagnostic studies such as CT or MRI, or recommended a consultation with any type of specialist.
It was felt that the plaintiff’s loss of smell was clearly indicative of the possibility of a brain tumor, which warranted an immediate referral. No chiropractor who reviewed the matter could be supportive of the insured’s case should the matter proceed to trial.
Fortunately for Jon, an astrocytoma is relatively slow-growing and has a high cure rate. Such characteristics are unfortunate for the defense of a case. The neurosurgeon with whom NCMIC consulted felt the presenting symptoms were somewhat diffuse and contradictory. Nevertheless, it was felt that earlier surgical intervention would have resulted in little or no vision loss in the right eye. The tumor was positioned so near the left optic nerve that left-eye vision would have been lost regardless of the timing of surgery.
Settlement
Dr. Delvecchio's limit of liability on his NCMIC policy was $200,000. Although Mr. Phipps initially demanded $2 million, the opinion of the neurosurgeon retained for the defense enabled NCMIC to effectively argue that Jon's damages were limited to some degree of vision loss in the right eye; pain and suffering; and a portion of the medical expenses incurred for treatment rendered to him subsequent to Dr. Delvecchio's care.
With that said, The Phippses still were not inclined to accept Dr. Delvecchio's $200,000 to settle this action. Dr. Delvecchio was advised by both NCMIC and his defense attorney that due to his personal exposure in this case, it would be prudent for him to retain personal counsel.
Dr. Delvecchio did retain a personal attorney. Based on that attorney's advice, as well as the fact that Dr. Delvecchio's local bank extended a line of credit to him, this case ultimately settled for NCMIC's $200,000 policy limit along with an additional $10,000 contribution from Dr. Delvecchio.
What Can We Learn
The fact that the family never had a family physician should have raised a red flag for Dr. Delvecchio. It is so highly unusual in the United States for a family not to have had contact with a medical physician that Dr. Delvecchio may well have noted this fact in his management of this particular case.
Dr. Delvecchio, rather than suggest other professionals to help, undertook to manage the total complexity of this young man’s problem — physical, emotional, nutritional, and dietary. Taking on this entire aspect of the care provides a significant responsibility that was not well considered by this doctor.
The lack of additional diagnostic testing or consultation was a major problem in the defense of this case. Over the time span of several years, this young man was seen and his symptoms increased in complexity and severity, but nothing was suggested by Dr. Delvecchio to provide a more comprehensive diagnostic evaluation. Had this been executed, his condition possibly could have been detected sooner. Had nothing been found during this consultative phase, the defense of Dr. Delvecchio would have been enhanced by doing the proper referral and testing as suggested by Jon’s lack of response.
Continuing to treat despite a lack of positive response demonstrates a clear warning sign of potential future problems. This fact poses significant issues for chiropractic experts because they clearly have no basis upon which to state the care was consistent with appropriate case management. The consultation, additional diagnostic testing, referral and appropriate case management provide the expert witnesses with the ability to state within reason that Dr. Delvecchio acted appropriately by referring.
The importance of having adequate coverage cannot be emphasized too strongly. The coverage limits doctors should purchase should be adequate to meet a significant demand. Low limits do not provide options for settlement in the event the case is weak and the demands are high. Doctors should review their policy limits and determine the limits that best meets the needs of their practices.
Dr. Delvecchio, in his role as primary-care provider, assumed the responsibility for the care of this young man. In that capacity, he was responsible for managing and assessing all complaints in light of the fact that no other provider was involved. Thus Dr. Delvecchio assumed the complete coordination of care. In that role, the expectation on the part of Jon and family is increased, and in this particular case, the end result was an allegation of malpractice for failure to diagnose.
In this case, records, examinations and care were not brought into question. The issues revolved around failure to refer and to diagnose the condition of a patient who was not responding appropriately to the care administered. Doctors utilizing outcome assessment tools in their offices can monitor patients’ progress (or lack of progress) by these tools, which are valuable in the global management of patient care. The ready availability and reliability of these outcomes-measurement tools should be considered as another option in the management of patients. They will be invaluable for patient care and will help provide defense experts with evidence that the care rendered was monitored.
Although this case study is based on a real case, names, dates and details have been changed to protect patient and doctor privacy.