Child’s death flagged as CHI management urged resumption of operations

During tense discussions this March, Temple Street management urging surgeons to resume spina bifida surgeries had to be reminded that certain surgeries were suspended because of alarmingly high rates of post-operative complications – including the death of a child.

Just more than a month later health minister Stephen Donnelly said in the Dáil that pressure to resume surgeries wasn’t an issue.

The discussions were held amid serious concerns about complication rates at the hospital and during an external review of certain spinal surgeries, which remain suspended. The HSE on Monday announced another external review of surgery at the hospital, following The Ditch’s report last week concerning allegations of the use of unlicensed implants at the hospital.

Pressure from management

This review follows two earlier probes, the second of which was conducted by a group of clinicians from Boston Children’s Hospital who delivered their findings to management at Temple Street in July.

During this review and despite the concerns that led to it, Temple Street management sought to have surgeons at the hospital resume complex spinal surgery in spina bifida patients.

The surgeons rejected this, citing safety concerns and previous serious incidents, including the death of one young patient. Hospital management then dropped the suggestion.

One senior source at the hospital told The Ditch that problems at the hospital have been systemic.

“Does knowledge of the failings go as high as the clinical director? If they didn’t know, they should have known because this is a serious problem. If management say they didn’t know, I don’t think that’s good enough, because they should,” they said.

People Before Profit TD Paul Murphy in April this year asked minister for health Stephen Donnelly “if he was aware of any external or internal pressure being placed on clinical staff at Temple Street to restart spina bifida-related surgeries”.

According to Donnelly, who answered in May, “Children's Health Ireland is not aware of any internal or external pressure on clinical staff to restart kyphectomy surgeries”.

Though kyphectomies are the most complex spina bifida-related spinal surgeries, all types of spinal surgery at Temple Street have recorded high complication rates.

Despite that denial from Donnelly, sources at the hospital insist that in March this year a member of senior management was pressuring staff to increase the rate of surgery at Temple Street.

On Monday, the HSE announced another external review, this time to be led by Selvadurai Nayagam, a consultant in orthopaedics and trauma, and head of the Limb Reconstruction Unit at the Royal Liverpool University and Royal Liverpool Children’s Hospitals.

Parents of spina bifida patients at Temple Street have demanded the right to participate in this review after they were denied access to the Boston review until Monday this week.

Pádraig Ó Meiscill

Pádraig Ó Meiscill