Outcomes for children undergoing spinal surgery will improve, says CHI director

Vivienne Clarke

The clinical director for Children’s Health Ireland, consultant paediatrician Dr Ike Okafor has said that outcomes for children undergoing spinal surgery will improve.

Dr Okafor was speaking on RTÉ radio’s News at One following the publication of further reviews by Children’s Health Ireland into spinal surgery cases at Temple Street hospital.

The number of cases in which there were problems were a small cohort of “really, really complicated cases,” he said.

“Last year we did over 500 spinal surgeries, that's probably the average of what we do each year. So you're looking at over the period that was reviewed, we've probably done about 2000 spinal surgeries and we're looking at a small cohort of children. We have 13,000 children who get surgery in CHI every year.

“So this is a small number of really, really complicated cases. And yes, I know there is room for improvement, but also we have to put the proportion into context. And we have a group of fantastic spinal surgeons. Outcomes are good. There are hundreds of patients who get surgeries in our hospitals. So we have to bear that in mind.

“We have a willing team of nurses, of anaesthetists, they are a very good, highly trained and dedicated group of health care people in the hospital that are willing and ready and happy to work on these children. And our outcomes will improve for the spina bifida group.

Dr Okafor said the next review will include families who had not been involved in previous reviews. He also pointed out there was false information circulating on social media about the spring medical devices implanted in some children.“There is currently an investigation in place to look at the process around how they were procured and how they were used.”

The devices had not been purchased from a company being named on social media, he said.

When asked when CHI was made aware of the use of the surgical springs in the small cohort of children, Dr Okafor said that there were people in CHI who knew, and that would form part of the investigation.

“The information came to us at the end of June, early July. And that's how we became aware that there were none authorised. There were people in CHI who knew that they were being used when they were being used. There were clinicians who knew that they were being used.”

This would be a separate investigation to the external review ordered by the HSE this week, he said.

“It's being is being overseen by the HSE. And they are going to get an entirely external group to CHI to look at the process.”

The investigation process would examine if CE marks were recorded when surgical devices were implanted in children, there was a process during surgeries that should be followed, he explained.

“We haven't seen evidence so far to say that that happened, but again, it is under investigation. Once we know more, we will be able to tell you and I have fed back to the families when we were able to identify which children were affected. And we told the families involved that the process is currently being investigated and that we would let them know once we get a report.”

Dr Okafor said that surgeries were continuing. While the most complex type of surgeries had been suspended, other surgeries were still ongoing at the hospital’s sister site in Crumlin hospital.

“We are working hard currently to ensure that children who are waiting for surgeries get their surgeries done. And we are looking at all options.

"We are currently doing these surgeries in Crumlin and we are following the recommendations from the Boston Review. We are hoping that as time goes on, children who are waiting will be expeditiously managed by our team of spinal surgeons.

“We are increasing our surgical capacity, we have our fifth theatre opening next week in Temple Street, and we are creating extra capacity in Crumlin and we are opening the additional beds that were funded from the ministerial funding from last year.

"We have a new spinal surgeon starting. We also have a new spinal surgeon who started, we have reconfigured hours for the one existing surgeon. And we are looking at all options both within CHI and also in the private sector. We have a large group that is working on this implementation plan.”