Update on ongoing review of paediatric orthopaedic surgical services at CHI and NOHC

The independent expert conducting a review of elements of the Paediatric Orthopaedic Surgical service at Children’s Health Ireland (CHI) and the National Orthopaedic Hospital, Cappagh (NOHC), Mr Selvadurai Nayagam, has completed the first phase of his review, which was a risk assessment. Mr Nayagam is a retired Consultant in Orthopaedics and Trauma and was Head of the Limb Reconstruction Unit at the Royal Liverpool University and Royal Liverpool Children’s Hospitals.

This review concerns the practice of an individual consultant and the environment in which they operated in at CHI and the NOHC. The review was commissioned by the HSE following a number of serious incidents arising from certain orthopaedic spinal surgeries at CHI. The review is ongoing.

As part of this first phase, Mr Nayagam reviewed the care provided to a sample of 91 children whose surgery was carried out by the individual orthopaedic consultant. He has recommended that 62 of these children receive further clinical follow-up, and the families of those children have been contacted.

Mr Nayagam considered that the remaining children whose cases he reviewed did not require additional clinical follow-up arising from his work.  The clinical team caring for these children will continue to make the necessary decisions about their care in consultation with their families.

According to Dr Henry: “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. In some cases, it may be too early to make that assessment, in which case the relevant children will be reviewed again in future to ensure everything continues to progress as expected.”

The HSE has now 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.  It will include all spinal, limb reconstruction and surgical dislocation of the hip, but not surgeries in the area of trauma and general orthopaedics. Details of how this lookback will be implemented are under consideration.

Lucy Nugent, Chief Executive of Children’s Health Ireland said: “I know that news like this will understandably cause worry and concern for families, and I want to acknowledge that sincerely. CHI and our current 16 consultant orthopaedic surgeons are fully committed to supporting every element of the look-back process and to being 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.”

Angela Lee, CEO of National Orthopaedic Hospital Cappagh added, “We acknowledge the understandable worry caused by today’s correspondence and are in the process of scheduling follow-up review appointments for patients impacted by this review.  The majority of the patients are already in a follow-up process, and we are committed to supporting patients and families in every way we can.”

Supports are available for families who have been contacted and they have been provided with a dedicated telephone number. More generally, if anyone who believes they may be affected or has any questions or concerns, they can contact the dedicated helpline.

Freephone: 1800 807 050

From outside Ireland: 00 353 1 240 8706