24-05-2025
'Who am I to question the doctor?': Mother fears son's hip surgery may have been unnecessary
"You do what the doctors say," said the mother of one child who had hip surgery with Children's Health Ireland (CHI), but now she, like thousands more, is wondering was that the right option.
More than 2,200 families including 1,800 from just two hospitals are being contacted by CHI in the wake of critical findings on Friday in an audit of surgery for children with Developmental Hip Dysplasia (DDH).
The audit 'raises concerns' about reasons given for surgery 'in many of the cases' in CHI at Temple Street and the National Orthopaedic Hospital, Cappagh, the report states.
Some 147 surgeries under 14 surgeons were analysed. It found 98% of CHI at Crumlin surgeries were for reasons which matched criteria retrospectively applied by the audit.
However, it found 60% at Temple Street did not meet this criteria, and 79% at Cappagh did not meet this threshold.
Many of these are expected to be found unnecessary with the HSE commissioning an external panel of experts to next assess children 'to determine if their surgery was necessary'.
Áine Gladney Knox is anxiously waiting to see if her son Archie will be included, having already received a check-up invitation in March.
He had hip dysplasia surgery aged just three in 2022 at Crumlin.
'When you're brought up in a family where what the doctors says, you do. And you go with what they're saying,' she said.
'If that's what they're advising, you feel 'who am I to question the doctor?''
She was not reassured by the report.
'I'm frustrated, I'd love to put this to bed now and have clear answers,' she said, adding they were originally told Archie would get follow-up when he is older.
He experienced complications after his surgery. Archie was treated in their local hospital in Kilkenny and then rushed by ambulance back to Crumlin, she explained.
He was in so much pain, he was screaming 'help me mammy.' It was one of the hardest things for us to go through.
She feels the surgery is being minimised by people unfamiliar with it.
Ms Gladney Knox, a Sinn Féin candidate for Carlow-Kilkenny, called on CHI to share more information.
'It's really stressful for parents, you're your child's advocate, especially at that age,' she said.
Another mother whose daughter had surgery in Temple Street told RTÉ's Liveline: 'We were just devastated to think we may have put her though a massive surgery that potentially she did not need.'
She recalled being told by a doctor her daughter would not have received this surgery if she were at Crumlin hospital.
She echoed Ms Gladney Knox's sentiments, saying: 'We trusted the professionals.'
These issues were only picked up on after a whistleblower made a protected disclosure on their concerns to the hospitals.
In the report, audit lead Simon RYW Thomas from the Bristol Royal Hospital for Children said he spoke with the surgeons. They gave reasons for recommending additional surgery in all the cases sampled.
However, he said his conclusions and recommendations did not change from a draft report published online last year.
The audit raises worrying questions for parents as to whether their child's surgery was really necessary.
The report says: 'Declaring that the criteria I have set were not reached in certain percentages of pelvic osteotomies does not prove that none of them were indicated.
"It is well known that there is worldwide variability between surgeons in their recommendations for pelvic osteotomy in DDH.'
HSE chief clinical officer Dr Colm Henry said the surgeons believed 'earlier intervention at a lower threshold was appropriate in order to prevent complications'.
He did not clarify why differences and unnecessary surgeries were not picked up earlier, noting only Temple Street consultants published a paper on this less invasive technique in 2010.
Around 1,800 patients of Temple Street and Cappagh since 2010 will be monitored until they reach 12 (girls) or 14 (boys). Picture: Sasko Lazarov
The audit does not identify the surgeons.
On Thursday, responding to questions at the Public Accounts Committee, CHI clinical director Ike Okefor and CEO Lucy Nugent confirmed a doctor referred to as 'Surgeon A' in a Hiqa report on spinal surgeries is one of the 14 surgeons.
Around 1,800 patients of Temple Street and Cappagh since 2010 will be monitored until they reach 12 (girls) or 14 (boys).
From Crumlin, some 447 children will be followed up.
Ms 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 service.'
Dr Henry acknowledged another review of spinal surgeries is on-going.
'It's obviously independent, but once we have it we'll obviously be examining it very closely for any parallels or messages that align with this [audit],' he said.
CHI Helpline: Freephone 1800 807 050 or 00 353 1 240 8706 from outside Ireland
