Almost 500 children who had hip surgery in Dublin hospitals ‘should be recalled'
A final report of the audit was published by Children's Health Ireland (CHI) and National Orthopaedic Hospital Cappagh (NOHC) on Friday.
The clinical audit of dysplasia of the hips surgery in children found that a lower threshold was used at Temple Street and Cappagh hospitals.
An audit of paediatric hip dysplasia surgeries at CHI hospitals found that hundreds of children operated on between 2021 and 2023 did not meet the threshold for the procedure.
It has been discovered that almost 80% of those operated on at NOHC, and 60% of those at Temple Street, did not meet the threshold for surgery in that timeframe.
In its report, it stated that the first step should be to recall all 497 cases that underwent pelvic osteotomy at the hospitals between 2021 to 2023.
They should undergo a standardised independent clinical review and radiological assessment, the report added.
'X-rays should then be reviewed, with the history obtained, by appropriately experienced paediatric orthopaedic surgeons from a different institution to NOHC or TSH,' it said.
'Follow-up with a suitably experienced and independent paediatric orthopaedic surgeon may be required in some cases.'
According to the audit, 85 surgeries performed at Temple Street were examined, of which 51 did not meet the clinical criteria for surgery.
In Cappagh, 70 pelvic surgeries were examined, and 55 did not meet the criteria, meaning almost 80% of procedures were not necessary.
The audit examined 147 cases at both hospitals as well as Crumlin hospital, and involved 14 surgeons.
The report found that the threshold for procedures varied between Crumlin, Temple Street and Cappagh hospitals.
The group of affected patients will be contacted directly to explain what this means and the next steps for them, it said.
The CEO of Children's Health Ireland, Lucy Nugent, said: 'The care and wellbeing of children is our absolute priority in Children's Health Ireland, and I am sorry that impacted families were not offered one consistent and excellent standard of care across our DDH (Developmental Dysplasia of the Hip) service.
'I do not underestimate the stress and anxiety that families are rightfully feeling throughout this audit process.
'To one family in particular, whose child experienced complications during their care in Children's Health Ireland, I extend my heartfelt apology that we have let you down.
'I would like to give my assurance to all of the families affected, that they will be directly supported and are being contacted with follow-up information and the next steps.
'We are currently standardising care across all CHI sites, so all children receive the same high-quality treatment no matter where they are seen.
'Also, it is important that we now act swiftly to review DDH surgery patients to enable us to answer outstanding questions raised by this audit. This will be done openly and transparently.'
The CEO of NOHC, Angela Lee, said: 'The National Orthopaedic Hospital Cappagh apologises for the distress that today's published report may understandably cause to children who have had surgery in NOHC and to their parents.
'In recent years, Cappagh has worked with Children's Health Ireland to improve children's access to planned paediatric orthopaedic surgery.
'We are committed to implementing the audit recommendations. Some changes are already under way, with others planned and we will be communicating with all parents/guardians accordingly in the coming days.'
Minister for Health Jennifer Carroll McNeill said in a statement: 'I know that parents and young people themselves will have many questions when they read the report and that the findings of this report will lead to worry and uncertainty for them.
'In responding to this report, I am thinking first and foremost of the impact a surgery has on a child. I am also deeply aware of the worry that parents will face today and this is something that is sitting with me all the time.
'My immediate priority is to ensure that there is clinical follow-up and care for patients who have undergone pelvic osteotomy surgery. This follow-up will be in accordance with best practice and the recommendations of the report.'
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
BreakingNews.ie
2 days ago
- BreakingNews.ie
CHI audit finds paediatric critical care units 'under strain'
An audit of the country's two paediatric critical care units, at Crumlin and Temple Street, has found that while they deliver high-quality care, the system is under strain. The number of children admitted to adult intensive care units doubled to 148 cases in 2023. Advertisement The National Office of Clinical Audit found high bed occupancy rates, that were above 95 per cent, and says more investment is needed. The Minister for Health Jennifer Carroll MacNeill has said that one of her major concerns is how waiting lists are managed which was why she had called for an overall audit of how waiting lists are managed 'across the board in CHI'. Speaking on RTÉ radio's Morning Ireland, Ms Carroll MacNeill said that as Minister she needed to ensure that the public system was working in the most productive way 'during the public hours that consultants are paid to do public work in a public hospital. 'What's not acceptable and what the concern is here is that those procedures are not happening quickly enough or in a sufficiently efficient way and that they're becoming such long waiters that NTPF intervention is required. Advertisement 'So my underlying issue is, how are those lists being managed? So what I've done is, Bernard Gloster and I have decided to have an overall audit of how are these waiting lists managed generally across the board in CHI in every discipline to ensure that that's not being replicated.' Ms Carroll MacNeill urged concerned parents to 'just sit with me and sit with the NTPF for a number of days, for a week or 10 days to allow the NTPF to do their work". 'This is something where the NTPF absolutely need assurance that this is being done correctly but what they also need is to make sure that there is no mismanagement of lists such that a child is waiting so long that they are required to be on the NTPF list where there could have been an earlier surgical intervention. 'And that is the bigger issue here. That is the bigger issue and that is what raises such particular concerns around the issues in this report but it also raises the broader patient safety concerns and what we need to do is make sure that that is happening in the most productive way in the public system in every discipline.' Advertisement The Minister said that in addition to the audit there would be a change to a centralised referral mechanism which would mean that if a child was referred to a consultant surgeon, they would not be referred to an individual surgeon, but into a central referral mechanism. 'Which means that the hospital can assess who has the shortest list, who has capacity to do this, rather than being sort of assigned to or stuck with an individual, who then has the capacity to do things at whatever pace, and some of them are doing very efficiently, and others less so.' 'We need to make sure and the NTPF need to make sure, and I need to make sure, Bernard Gloucester needs to and the CHI need to make sure that there are no perverse practices or no perverse incentives from the way in which waiting lists are managed. 'So I would ask parents to just sit with me just for a week or 10 days to allow the NTPF to get these assurances and to do their work. The NTPF have already assured that existing surgery scheduled will not be impacted but our concern is we need to make sure that this isn't happening anywhere else in the system.' Advertisement Ms Carroll MacNeill acknowledged that the NTPF had only recently discovered that there had not been a referral to the National Patient Safety Office. 'Let's not underestimate the impact of that, nor was there a referral to the department or a notification to any of us. So that's not a satisfactory way of managing that, and I expect that to be very, very different. There is no CHI without the state. The state is the funder of all of these services, and people who work in CHI, both at executive level, but let me be very clear, consultants in CH , and everybody who is in CHI is a public servant, and it is important that they understand that.'
BreakingNews.ie
28-05-2025
- BreakingNews.ie
Taoiseach ‘very worried' about email from clinical director at National Orthopaedic Hospital
The Taoiseach has told the Dáil he is 'very worried' about the suspension of a multidisciplinary team's oversight of hip surgery decisions at a Dublin hospital. Micheál Martin said there needs to be an 'exhaustive' review of unnecessary hip surgeries at two Dublin hospitals. Advertisement He was responding to People Before Profit-Solidarity TD Paul Murphy during Leaders' Questions in the Dáil on Wednesday. It comes after a clinical audit of surgeries for dysplasia of the hips in children found that a lower threshold for operations was used at CHI Temple Street hospital and the National Orthopaedic Hospital Cappagh (NOHC) than the threshold used at CHI Crumlin. The review discovered that in the period 2021 to 2023 almost 80 per cent of children operated on at the NOHC, and 60 per cent of those at Temple Street, did not meet the threshold for surgery. The 2,259 children who underwent hip surgeries in the three hospitals (NOHC, CHI Temple Street and CHI Crumlin) from as far back as 2010 will now be subject to clinical reviews. Advertisement Mr Murphy told Mr Martin about an email from a clinical director at Cappagh which ordered an end to multidisciplinary teams considering the cases of patients listed for pelvic osteotomies, instead deferring to the decision of the individual consultant involved. He said the senior management team at the hospital was also CCd (carbon copied) on the email in November 2023. He quoted: 'Recently, it has become apparent that many children listed for pelvic osteotomies are being cancelled or are having their surgery deferred at short notice thereby causing inefficiencies on surgical lists. 'Following a meeting today, I have decided that patients listed for pelvic osteotomies will no longer be discussed at the MDT Advertisement 'It will be up to the patient's individual consultant to review the X-ray and decide if they wish to proceed.' Mr Murphy said surgeries were being cancelled because other surgeons on the MDT thought they were unnecessary, adding: 'Instead of saying there was something wrong here, the clinical director said 'we'll stop discussing them at the MDT and it'll be fully in the hands of the original surgeon to decide'.' Mr Murphy also told the Dáil about the experiences of a a mother of two daughters, Amelia and Hannah, and a surgeon at Temple Street. He said the mother felt 'unduly and inappropriately' pressured by the surgeon ahead of two osteotomies on Amelia's hips. Advertisement Later, her younger sister Hannah was spotted by the same surgeon while she was in the hospital for an eye issue. Mr Murphy said the surgeon insisted that she also needed two osteotomies despite the family being told by a doctor at the Coombe that this was not necessary. The surgeries on Hannah did not proceed. He said this was a 'chilling example' of the experiences of parents. He questioned whether there was financial motivation as if the operations had been carried out under private health insurance, the surgeon would have made €1,500 for the first hip and €750 for the second. Advertisement He said this may have had a 'significant distorting effect' and was an 'example of the poisonous role of private profit in what should be a public health system'. In response, the Taoiseach said he did not know the reasons behind the decisions which were taken and cautioned that 'private does not mean unethical'. On the email read out by Mr Murphy, Mr Martin said he was not aware of who the clinical director was but described it as a 'serious issue'. 'That seems to be a shutting down of the multidisciplinary team and the multi-disciplinary approach is a safeguard against wrongdoing or poor practice or ill-informed decisions – because the collective can inform. 'And I've met many, many consultants who will say it's the collective approach as to whether we do surgery or not. 'Medicine is not an exact science, that's why the collective is important. He added: 'So I would be very, very worried about the suspension of the MDT team in respect of assessing the necessity for operations in this area.' Mr Murphy also asked the Taoiseach if he believed the surgeons who performed unnecessary operations should be suspended or at least prevented from carrying out osteotomies until an audit into the matter is verified. Mr Martin said Amelia and Hannah's mother should formally refer the matter to the Medical Council or the authorities in CHI. Ireland What's the story with Children's Health Ireland? Read More He said there was an onus on the Medical Council to be proactive on the issue as the professional regulator. He said the CHI also needs to satisfy itself that there is no danger to future patients and that the working environment is safe. Asked if there should not be an onus on parents to request a review, Mr Martin agreed and said there should be an exhaustive examination of cases.
Belfast Telegraph
28-05-2025
- Belfast Telegraph
Taoiseach ‘very worried' about email from clinical director at Cappagh
Micheal Martin said there needs to be an 'exhaustive' review of unnecessary hip surgeries at two Dublin hospitals. He was responding to People Before Profit-Solidarity TD Paul Murphy during Leaders' Questions in the Dail on Wednesday. It comes after a clinical audit of surgeries for dysplasia of the hips in children found that a lower threshold for operations was used at CHI Temple Street hospital and the National Orthopaedic Hospital Cappagh (NOHC) than the threshold used at CHI Crumlin. The review discovered that in the period 2021 to 2023 almost 80% of children operated on at the NOHC, and 60% of those at Temple Street, did not meet the threshold for surgery. The 2,259 children who underwent hip surgeries in the three hospitals (NOHC, CHI Temple Street and CHI Crumlin) from as far back as 2010 will now be subject to clinical reviews. Mr Murphy told Mr Martin about an email from a clinical director at Cappagh which ordered an end to multidisciplinary teams considering the cases of patients listed for pelvic osteotomies, instead deferring to the decision of the individual consultant involved. He said the senior management team at the hospital was also CCd on the email in November 2023. He quoted: 'Recently, it has become apparent that many children listed for pelvic osteotomies are being cancelled or are having their surgery deferred at short notice thereby causing inefficiencies on surgical lists. 'Following a meeting today, I have decided that patients listed for pelvic osteotomies will no longer be discussed at the MDT 'It will be up to the patient's individual consultant to review the X-ray and decide if they wish to proceed.' Mr Murphy said surgeries were being cancelled because other surgeons on the MDT thought they were unnecessary, adding: 'Instead of saying there was something wrong here, the clinical director said 'we'll stop discussing them at the MDT and it'll be fully in the hands of the original surgeon to decide'.' Mr Murphy also told the Dail about the experiences of a a mother of two daughters, Amelia and Hannah, and a surgeon at Temple Street. He said the mother felt 'unduly and inappropriately' pressured by the surgeon ahead of two osteotomies on Amelia's hips. Later, her younger sister Hannah was spotted by the same surgeon while she was in the hospital for an eye issue. Mr Murphy said the surgeon insisted that she also needed two osteotomies despite the family being told by a doctor at the Coombe that this was not necessary. The surgeries on Hannah did not proceed. He said this was a 'chilling example' of the experiences of parents. He questioned whether there was financial motivation as if the operations had been carried out under private health insurance, the surgeon would have made 1,500 euro for the first hip and 750 euro for the second. He said this may have a 'significant distorting effect and was an 'example of the poisonous role of private profit in what should be a public health system'. In response, the Taoiseach said he did not know the reasons behind the decisions which were taken and cautioned that 'private does not mean unethical'. On the email read out by Mr Murphy, Mr Martin said he was not aware of who the clinical director was but described it as a 'serious issue'. 'That seems to be a shutting down of the multidisciplinary team and the multi-disciplinary approach is a safeguard against wrongdoing or poor practice or ill-informed decisions – because the collective can inform. 'And I've met many, many consultants who will say it's the collective approach as to whether we do surgery or not. 'Medicine is not an exact science, that's why the collective is important. He added: 'So I would be very, very worried about the suspension of the MDT team in respect of assessing the necessity for operations in this area.' Mr Murphy also asked the Taoiseach if he believed the surgeons who performed unnecessary operations should be suspended or at least prevented from carrying out osteotomies until an audit into the matter is verified. Mr Martin said Amelia and Hannah's mother should formally refer the matter to the Medical Council or the authorities in CHI. He said there was an onus on the Medical Council to be proactive on the issue as the professional regulator. He said the CHI also needs to satisfy itself that there is no danger to future patients and that the working environment is safe. Asked if there should not be an onus on parents to request a review, Mr Martin agreed and said there should be an exhaustive examination of cases.
