Hundreds of children who underwent surgery by an orthopaedic surgeon during an eight-year period will be reviewed as part of a wider look-back at the consultant’s practice.
On Wednesday, the Health Service Executive (HSE) provided an update on the ongoing report on paediatric orthopaedic services. The report was carried out by retired orthopaedic consultant Prof Salvaduri Nayagam.
The review was commissioned in 2023 after concerns about high rates of post-operative complications, infections in orthopaedic surgeries and the use of unapproved springs in surgeries.
The first phase of the review, which examined the work of consultant Connor Green, has been completed. Green, who has been on extended leave since 2023, was contacted for comment through his solicitors.
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The second phase, which will examine the wider systems of governance and capacity in orthopaedic services at Children’s Health Ireland (CHI), is expected to be completed at the end of this year, at which point the full report is expected to be published.
Following the completion of the first phase, the HSE said it has decided to carry out a “wider look-back at the individual consultant’s practice”.
“The lookback will involve a review of the patients on whom the individual consultant performed surgeries between 2016 and 2023,” the HSE said in a statement.
“It will include all spinal, limb reconstruction and surgical dislocation of the hip, but not surgeries in the area of trauma and general orthopaedics.”
It is understood that hundreds of patients will be reviewed as part of this process, which will be separate to the ongoing Nayagam review. Details of how it will be implemented are “under consideration”, the HSE said.
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Dr Colm Henry, chief clinical officer at the HSE, said there were “protracted” legal issues in relation to the first phase of the report due to it focusing on one individual.
However, the HSE announced 62 of the 91 patients examined as part of this process will be followed up for clinical review, adding that this was as a precaution.
“These follow-up appointments do not arise from any identified urgent risk or concern about individual patients but are intended to check on the patients’ clinical progress. The purpose is to determine if the intended benefits of these children’s surgery have been achieved,” Henry said.
Affected families have criticised the lack of answers provided in Wednesday’s briefing, stating it was “deeply disappointing” that 2½ years after the report was commissioned, they had only received a “holding position rather than meaningful action”.
In a joint statement, the Spina Bifida and Hydrocephalus Paediatric Advocacy Group and the Scoliosis Advocacy Network said the latest update “did nothing to reassure families about changed culture within CHI”.
“In fact, it reinforced our concerns and the concerns of other advocates in the room,” they said, adding that their patience had been “stretched to its limit”.
Lucy Nugent, chief executive of CHI, said the organisation would fully co-operate with the look-back review and will be “open and transparent with families throughout”.
“I want to reassure parents and caregivers that safe orthopaedic care is delivered in CHI every day, by highly skilled and dedicated professionals whose priority is always the wellbeing of children,” she said.
Following a number of reports highlighting issues within the service, the Government has pledged to hold an inquiry into spinal care for children.
Speaking on Wednesday, Minister for Health Jennifer Carroll MacNeill said they had identified a mediator, agreed terms with this person to carry out the inquiry and a business case was with the department.
