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THE SURGEON WHO implanted unlicensed springs into three children during spinal surgery was “acting with good intent and in the absence of effective structures”, the Irish Hospital Consultants Association (IHCA) has said.
The organisation was commenting on the report on the use of the springs in children’s surgeries at Temple Street Hospital, which was published by the Health Information and Quality Authority on Tuesday.
The Hiqa report found that governance changes within Children’s Health Ireland (CHI) meant that a number of policies and safety checks “were not properly applied” in treating the children affected, “resulting in the springs being used inappropriately”.
Hiqa also found that the springs had not been approved for use by anyone in CHI, and that there was “no evidence of written records to demonstrate appropriate detailed discussions with parents to secure their consent for the use of the springs”.
The chair of the CHI Board, Dr Jim Browne, resigned following the report’s publication.
In a statement today, the IHCA said it recognises “the deep distress and hurt caused to the three children and their families”.
“The report highlights serious system-wide governance failures at CHI, particularly at Temple Street, where consultants were working under intense pressure with high patient care needs and workloads with inadequate support.,” the consultants body said.
“It is within this environment that a surgeon, acting with good intent and in the absence of effective structures, endeavoured to provide innovative care to children. These were children with complex life-limiting conditions—children who, without intervention, faced extremely poor outcomes and suffering.”
The IHCA said the Hiqa reported indicated that the surgeon “believed the devices to be medical-grade stainless steel, CE marked as suitable for use as surgical implants” at the time of the surgeries.
The report found that the springs implanted in the children were made of a material called non-alloyed spring steel, which is not used for surgical implantation.
The IHCA continued: “This was, and should have been, entirely preventable had proper policies and procedures been adhered to at the hospital.”
It said that Hiqa “recognised these actions as a well-meaning effort to prolong the lives and improve the quality of life of these patients”, but that the situation underscores “the urgent need for robust governance systems to ensure both patient safety and clinical accountability”.
“While individual accountability is essential, consultants do not work in isolation. They depend on functioning, transparent management structures and appropriate clinical supports. Failures in these systems increase the risk of poor outcomes, despite the best efforts of medical professionals.”
The body said that it supports the recommendations issued by Hiqa and called for their swift implementation.
During Leaders’ Questions today, Sinn Féin’s Pearse Doherty said that children’s lives have been “devastated by the litany of failures in healthcare”.
He said the Hiqa report, as well as the audit
Sinn Fein TD Pearse Doherty said the report into the implant of non-surgical springs in children, and the audit into potentially unnecessary hip operations on other young people, highlighted a pattern of “broken behaviour” in children’s healthcare.
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.
The Dáil previously heard that almost 80% of those operated on at National Orthopaedic Hospital Cappagh, and 60% of those at Temple Street, did not meet the threshold for surgery in that timeframe.
Doherty said parents were asking why they have been “kept in the dark for so long by Government”, after it emerged that former health minister Stephen Donnelly was briefed on the hip surgery matter in May last year, and his successor, Jennifer Carroll MacNeill, was briefed in February.
“Patients only received letters about the scandal in recent weeks,”he said.
“We are talking about the possibility of young children put under the knife and their bones being sawed into. It is traumatic surgery and it is happening to children between the ages of one year and seven years.”
Doherty said it was “beyond the worst nightmare” for families. He said the audit is looking at a period of two years and that “561 children have to be recalled”.
If this issue goes back as far as 2014 or 2016 we are potentially talking about thousands of children.
Taking Leaders’ Questions on behalf of the Government, Education Minister Helen McEntee said she was “utterly appalled” by the details of the spinal surgeries and said it was “unimaginable” that other children would be subjected to unnecessary hip surgeries.
She said the Government would do everything possible to support the families affected by the spinal surgeries, adding that the surgeon responsible has been suspended.
On the hip surgeries, McEntee said: “An audit is currently taking place. It is being carried out at the direction of the HSE and the Minister for Health.
“At the moment, there is no information to suggest that any patient safety incident has occurred. At the same time, I will not try to predict the outcome of the audit, nor can anyone else do so.”
She said contact is being made with parents and families of children who have had operations in recent years.
“I agree that if there are potentially more cases stretching back further and that families of children need to be written to, that is exactly what must happen. If proper procedures were not followed, we must understand why that happened.”
McEntee said the Government must ensure the board of CHI is still in place for the transition to the new children’s hospital.
“If changes need to take place, we must also understand why that is the case, but we cannot throw out the baby with the bathwater.”
She said a “knee jerk reaction” to sack the board would not help anybody.
Meanwhile, Aontú leader Peadar Toibin said figures his party had obtained through a parliamentary question show that CHI has cancelled more than 160 operations for children in Crumlin and Temple Street hospitals because of the lack of intensive care beds in the last three years.
“These are cancellations for very serious operations for children who are very sick. Nine of these cancellations were for heart operations for children, 10 cancellations were for children needing serious orthopaedic surgery,” he said.
“There are just 23 paediatric intensive care beds in Our Lady’s Hospital, Crumlin, and just nine in Temple Street.
“Many of these children and their families have waited years for what in some cases is life-saving surgery, only to get the heartbreaking news that the surgeries have been cancelled.”
With reporting from Press Association
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