An osteopath has been found in breach of the code of health and disability services consumers' rights for failing to provide safe and appropriate care to a woman with incomplete tetraplegia.

Deputy Health and Disability Commissioner Meenal Duggal released a report with her findings into the incident, recommending the osteopath audit his documentation.

She also recommended the osteopath arrange for regular mentoring and provide a written apology to the woman.

The woman had an accident in 2006 which resulted in the incomplete tetraplegia.

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In early 2016, she went to the osteopath after sustaining a lumbar sprain and a lower back injury she had two months later.

At the first consultation with the osteopath, the woman explained she had a spinal cord stimulator and a baclofen pump in situ.

She offered to show the osteopath X-rays of her spine to demonstrate the positioning of her indwelling devices and to show the extent of her scoliosis and pelvic obliquity, but the osteopath declined.

Duggal's report found the woman was treated four times without incident but within an hour of the fifth visit, she developed severe pain in her right sacroiliac joint and lumbar spine.

The woman got in touch with the osteopath who recommended acupuncture treatment and advised her to apply ice to the affected area.

Duggal found the osteopath failed to place enough emphasis on the provision of safe and appropriate care to the woman.

The osteopath did not refer the woman to her GP or hospital and failed to meet the standard required of an osteopath.

They also failed to undertake research to remedy his gap in clinical knowledge regarding treatment of patients with tetraplegia.

Duggal asked the Osteopathic Council to consider whether a review of the osteopath's competence was warranted.