No clinical concerns about spinal surgery outcomes at Crumlin, health bosses say

There are no clinical concerns about outcomes from complex spinal surgery carried out at Crumlin children’s hospital, health bosses say.

A review of complex spinal surgery outcomes at Crumlin will be published “in full” by Thursday morning, according to Children’s Health Ireland (CHI).

Advocacy groups for patients with scoliosis and other orthopaedic conditions have called on CHI to publish the review, amid concerns the problems identified in spinal surgery services at Temple Street children’s hospital may not be confined to that site.

Last week, a review of the Temple Street unit found high levels of postoperative complications and infection, including two serious incidents and the death of one patient. One consultant has been referred to the Medical Council and the care of children on waiting lists is being transferred to Crumlin.

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The Scoliosis Advocacy Network, representing children awaiting spinal surgery, called on Minister for Health Stephen Donnelly top publish the review immediately, given children were already being transferred to Crumlin.

In a statement, CHI said that as part of its internal quality assurance processes, Crumlin had undertaken a clinical review of complex spinal surgery outcomes for children with spina bifida.

“It was approved by the site-based directorate team in September, and is currently going through the required governance process. It will be published in full as soon as these internal processes are completed, by Thursday morning.”

“Members of the CHI executive team have seen the report and are assured by the results. In addition, and important to note, no clinical concerns about spinal surgery outcomes have been raised in CHI at Crumlin to date.”

After the two serious incidents in Temple Street in 2022, the consultant involved ceased doing spinal surgery last November.

Since then, patients needing urgent treatment have been transferred to the lists of other doctors, according to CHI.

“As of last Friday, there were 14 spinal surgery patients remaining to be transferred. Management of these patients is in progress with the most clinically urgent patients in the process of transfer to CHI at Crumlin and active planning is ongoing for all of this group.”

Mr Donnelly is holding meetings with individual patient advocacy groups this week, starting on Wednesday. He and Taoiseach Leo Varadkar are expected to meet all the groups at a meeting on Friday.

A spokesman for Mr Donnelly rejected claims he had offered only virtual meetings with groups, or that they were limited to 30 minutes.

“The Minister’s office invited all advocacy groups to individual meetings with the Minister. Two have accepted. One group requested a virtual meeting and the other requested an in-person meeting. Neither of these meetings has been limited to 30 minutes.”

Meanwhile, People Before Profit TD Paul Murphy has told the Dáil that he asked the Minister for Health whether all implants used in paediatric spinal surgeries were appropriately licensed last May.

Mr Murphy also said he received responses from CHI that month to say “to the best of its knowledge all spinal implants were CE approved and licensed appropriately”. He said he asked the same question again in June and got a similar response from CHI.

Speaking during Leaders’ Questions on Tuesday, Mr Murphy said he had subsequently asked Mr Donnelly on July 13th how many spring implants had been used in Temple Street hospital, how many had been removed and how many had failed in situ.

Mr Murphy said he had also spoken with the Taoiseach in relation to the issue on July 5th and that Mr Varadkar said at the time he did not know but would inform Mr Donnelly it had been raised in the Dáil.

[ HSE chief ‘seriously concerned’ about Temple Street hospital’s oversight of surgery-springs purchase ]

“I heard the allegation that unlicensed implants were being used in April so I did what is appropriate and asked the Minister if it was happening,” Mr Murphy said.

“The response I got twice from CHI stated it was not happening. I went back to the person who was alleging this to me with more specifics. I came forward with specific parliamentary questions on July 13th about how many spring implants had been used, how many had been removed, how many had failed in situ and so on.

“At the very latest, the Government or the Minister knows about it on July 13th. That is at the very latest. What does the Government do at that point?”

Mr Donnelly later told the Dáil that Mr Murphy’s parliamentary questions were initially “vague” but those submitted in July were more specific and CHI were “able to identify what he [Murphy] was pointing to”. The minister said he was informed about the unauthorised spring implants used in patients on August 4th.

Mr Varadkar said his understanding was that when parliamentary questions were submitted by Mr Murphy in July, the Department of Health was not aware of this at the time and passed on queries to the Health Service Executive.

“That was how the issue came to light,” he said.

The Taoiseach also said that he first heard “definitively” about non-medical devices being used in surgery only in the past week or so and was “shocked”.

Mr Varadkar said if the external review was to be extended with all surgery happening in all three sites, “it would take a very long time”.

“We are talking about appendixes and minor surgery, I am not sure if that actually is the right approach,” he said.

“This is about spinal surgery and, as far as we know, one surgeon. If we were to expand it out to every surgery done by every surgeon in all three big paediatric hospitals, we would not be coming back here with an answer for perhaps years and I am not sure that would be the best approach but of course I am not going to rule it out at this point.”

The Fine Gael leader added that invitations had been issued to advocacy groups to meet him and the Minister for Health later this week.