Temple Street surgery failings ‘extend well beyond malpractice if true’ - Taoiseach

Serious surgical incidents among children undergoing spinal operations at Temple Street hospital may be the result of failures of clinical governance, according to Taoiseach Leo Varadkar, rather than just the actions of one consultant.

The possibility there was a wider failure of clinical governance in the hospital is “something that will have to be investigated here”, he warned.

Responding to revelations about high rates of complications among children who were operated on by a consultant in Temple Street, Mr Varadkar said: “the more and more I read about it, the more concerned I am and the more bothered I am.”

“I do not want to jump to conclusions and this will have to be investigated thoroughly. And I know there is going to be an examination by the Medical Council as well.

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“If you have a child awaiting surgery, you think if they get the surgery that is going to make them better, not worse. It seems that some of these surgeries were performed incorrectly and children suffered and were harmed as a result. That is unbelievably serious.

“But the kind of things I am hearing about, and reading about, if true, extend well beyond malpractice. They are very, very serious indeed and children have been harmed as a result.”

Families of children needing spinal surgery have called for the independent review into services at Temple Street to be widened to include other hospitals performing this work.

The families have also called for the full publication of information collected for an earlier internal review of spinal surgeries at Temple Street, including the advice provided by experts from Boston children’s hospital.

A UK expert has been appointed to review surgeries carried out by an individual consultant at Temple Street after an internal review identified “serious spinal surgical incidents” in the service, the HSE announced on Monday.

The review identified a higher than expected complication rate among spina bifida patients undergoing complex surgery, with many requiring unplanned further surgery and the removal of metal implants, and suffering high post-operative infection rates. One child died after needing multiple further procedures.

A helpline has been opened for affected patients on spinal surgery lists, but only at Temple Street. Children’s Health Ireland (CHI) says staff are not in a position “at this time” to answer questions about dates for surgeries.

There are currently 54 children waiting for spinal surgery at Temple Street, but a total of 261 children on lists across three CHI sites - Temple Street, Crumlin and Cappagh hospital.

In a statement, CHI said three patients received surgery “with metalwork involved” and their families have been contacted. This refers to the use by the surgeon at the centre of the review of non-medical implants - compression springs - in these operations; two of these have so far required removal.

“In the unlikely event that any further issues arise relating to surgical implants, these patients will be contacted directly and urgently,” a spokeswoman added.

The Scoliosis Advocacy Network said it was shocked, upset and appalled by the revelations.

The internal review by CHI into spinal surgeries at Temple Street did not go far enough to give parents and patients assurances around clinical practices across the group, according to the parents’ group.

“We are concerned that the internal and external reviews carried out by Temple Street have not been published in full and show a further lack of transparency from CHI and the HSE,” said spokeswoman, Claire Cahill.

“As a result, we are calling for a full review of all scoliosis care across the CHI sites by an international expert. This is necessary to ensure that patients with scoliosis receive the highest standard of care and to restore trust in both CHI and the HSE to safeguard our children.”

Children with scoliosis have been failed by the state for many years, with long wait lists, a lack of access to timely care, broken promises and continued poor communication with patients and their families, Ms Cahill added.

Raymond Bradley of Malcolmson Law solicitors, which provides legal advice to scoliosis and spina bifida support groups, described the internal review published this week by CHI as “very limited”.

He said affected parents were “reeling” at the revelations about high rates of complications after surgery, and in particular over the admission that non EU-certified springs were inserted in the backs of three children.

Mr Bradley called for the publication of all details from the internal review carried out by CHI, rather than the amalgam of internal and external reviews published this week.

Delays in carrying out surgery meant some children had to be operated on by two consultant surgeons rather than one, due to the increased complexity involved, he pointed out.

Minister for Health Stephen Donnelly said he appreciated the external review will be a cause of great anxiety for patients and families.

He asked the HSE to ensure that the external review is completed as quickly as possible, for all patients and their families, and especially for those directly impacted.

The HSE says a risk assessment will be completed by the end of the year but has given no completion date for the review.