Law firm investigates who knew what about springs used in Temple Street Hospital spinal surgeries

The board of Children’s Health Ireland (CHI) has hired a top law firm to investigate claims that management was aware of the use of “unauthorised springs” in spinal surgeries at Temple Street Hospital.

It is understood the inquiry by lawyers from Arthur Cox got under way this year, with key witnesses interviewed by the team recently. It is expected to be end shortly.

The investigation is the third one relating to paediatric spinal surgeries at Temple Street since the controversy last September over the work of one surgeon.

At the time CHI revealed it had conducted two reviews of operations on 17 children with spina bifida and found a significant number suffered complications after surgery, 13 needed further unplanned surgery and one child died.

It said it subsequently learned the consultant had implanted unapproved springs, not intended for surgical use, in three children. The consultant, Connor Green, stopped all surgeries and was referred by CHI to the Medical Council.

Mr Green, a paediatric orthopaedic surgeon, was the lead consultant at Temple Street for children with spina bifida who often needed complex spine-straightening surgery.

A CHI statement this weekend said: “The board of directors of CHI commissioned Arthur Cox to review very specific matters. The board expects to receive and consider the final report on this review very shortly. The board will then share the report with relevant stakeholders.”

One key aspect of the Arthur Cox investigation is understood to be an allegation that Mr Green approached the outgoing chief executive of CHI, Eilish Hardiman, about his use of “off-shelf” devices at a meeting and in a subsequent follow-up letter.

Ms Hardiman told the Oireachtas Health Committee last year she remembered the meeting with Mr Green but could not recall any discussion about the use of unauthorised spring devices. She said she never saw and has no record of receiving what purported to be a follow-up letter from Mr Green, which was read into the Dáil record. In it, Mr Green asked her for guidance on the planned “off-label and experimental techniques using devices not designed for this purpose”.

​Ms Hardiman told the committee the use of the springs was “unprecedented”, “truly shocking” and not approved by her.

In an interview with the Sunday Independent last year, Professor Damian McCormack, who attended the meeting with Mr Green and Ms Hardiman, recollected that the “conversation” was about performing “bespoke surgeries” on children born with the condition SMA1, including the “spring technique”.

Prof McCormack, the lead paediatric orthopaedic consultant at Temple Street, also told the Sunday Independent that the use of the springs was known within the orthopaedic department. He said the springs were referred to the hospital’s clinical engineering department and were processed through the central sterile services department which is responsible for sterilising medical devices ahead of surgery.

Dr Ike Okafor, the clinical director at CHI, has also previously confirmed a number of clinicians and others in CHI were aware the uncertified implants were being used.

Health regulator Hiqa’s inquiry into the matter is almost done.

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