Almost 500 children who had hip surgery in Dublin hospitals ‘should be recalled’

By Cate McCurry, PA

Almost 500 children who underwent hip surgery in two hospitals in Dublin should be recalled, a report has said, after a clinical audit found a lower threshold for operations was used, leading to “unnecessary” procedures.

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 per cent of those operated on at NOHC, and 60 per cent 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.”