Martin: Non-medical grade spring use in child spinal surgeries ‘beyond belief’

By Cillian Sherlock, PA

The Taoiseach has pushed back against whether the Government was partly to blame for “a litany” of failures on the use of non-medical grade springs in child spinal surgeries.

The fallout is continuing following a report by Ireland’s health watchdog, the Health Information and Quality Authority (HIQA), into the use of “wholly inappropriate” springs in three spinal surgeries, ordered from an industrial machinery company.

No written approval from Children’s Health Ireland (CHI) was found in relation to what the report said was a “novel, experimental” surgical procedure carried out by a surgeon at CHI’s Temple Street hospital in Dublin.

The chairman of the board of CHI, Jim Browne, stepped down following publication of the HIQA report on Tuesday.

The report found the use of the springs was well-intentioned but “wrong” and also concluded the incident did not follow standard approval processes.

Speaking in the Dáil, Micheál Martin said there had to be ability as to why procedures were “byed”, but he pushed back against claims by Sinn Féin leader Mary Lou McDonald that the Government partly bore responsibility for governance failures at CHI.

We have published the report on our independent statutory review into governance and oversight of the use of surgical implants and implantable medical devices in Children’s Health Ireland (CHI), including at CHI at Temple Street.

Read here: https://t.co/pPqs2FEiTF pic.twitter.com/zN19RO4Xuh

— HIQA (@HIQA) April 8, 2025

She said: “This report is a damning litany of failure. Failure of governance, failure of management, abject failure by Government to act and ministers to do their job.”

Mr Martin said: “I understand where the deputy is going in of wanting to say it’s ultimately Government’s fault. I mean, there’s a limit to what anyone in this House can do in of how people conduct procedures in operating theatres.

“Let’s call a spade a spade here, we can be political about these things, but there are fundamental issues here that happened, that should not have happened, and there has to be individual responsibility.

“There has to be ability in that respect, there has to be management ability in of CHI and the board and so on, in of why the governance procedures were not followed and why they were essentially byed.

“The idea that you would use springs outside of (the) entire protection framework is beyond belief, and responsibility there, in my view, lies with the individual in the first instance.

“It’s as plain as night follows day, you do not use unauthorised devices on any child, that is at the heart of it.”

The report also said there was a lack of information provided to families on the new or experimental nature of the intended surgery, and therefore the request for consent from families was not in line with the HSE’s National Consent Policy.

Controls in place within CHI did not provide the necessary adequate safeguards at each stage of the process, including those required for the procurement, introduction, decontamination and use of the springs in operations.

HIQA found the orthopaedic service in CHI at Temple Street had been affected by “long-standing issues with communications and team dynamics” since 2019.

It believes this was a “significant factor” in the introduction of the springs because it meant important and relevant questions were not raised at various steps in the absence of a formal process also not being followed.

The HIQA report into Children’s Health Ireland published today reveals another catastrophic failure of children. Children and their families again bear the brunt of failures by successive governments and health ministers. This is a crisis that cannot be ignored—questions must be… pic.twitter.com/ixiR6ZtGgT

— Mary Lou McDonald (@MaryLouMcDonald) April 8, 2025

As a consequence, a number of key approval processes, policies or safety checks were not properly applied in treating the children, resulting in the springs being used inappropriately.

As a result of the failings, the report said children were not protected from the risk of harm.

Dr Browne said he wanted to convey his “sincere apologies” to those who had been failed.

In a statement, he said: “Following discussions over recent weeks with the Department for Health, I now wish to step down and provide for an orderly transition to a new chair to allow for renewed enthusiasm and ion to guide this great organisation.

“I wish to convey my sincere apologies to the children, young people and families that have been failed by the care they received, following the release of the HIQA report today.

“The HIQA review found that the use of the non-CE marked springs as surgical implants was wrong and not authorised by management.

“The HIQA review also found that while corporate and clinical governance arrangements were in place in Children’s Health Ireland, there were unclear lines of reporting and ability to ensure the safe introduction and use of new surgical implants and implantable medical devices.”

Dr Browne said he will work with the Department of Health, CHI’s executive team and board to ensure “a smooth transition to a new chairperson over the coming weeks”.

Health Minister Jennifer Carroll-MacNeill said she was “shocked by every element of this report”.

The minister said the families involved have had another difficult day following the publication of the report.

“To have gone through what they did with their children and with having non-surgical springs implanted into their little bodies, and the implication of all of that is just devastating,” she said.

Speaking to RTÉ’s News At One radio programme, Ms Carroll-MacNeill said the actions of the surgeon, however well-intended, were wrong because a series of processes were not followed.

“That’s a problem for him but it’s a much, much bigger problem for CHI, and for the governance of the hospital and for the governance of CHI more broadly, and that is an issue of culture, but it’s also an issue of process.”

She said the recommendations of the HIQA report will be implemented in full.

Pressed on whether there should be other resignations, Ms Carroll-MacNeill told RTÉ: “What I need to do is reflect on the board and reflect on the next chairperson and the steps that are taken towards that.

“That is something that I will do, but I am looking at the governance more broadly as we move to the new hospital, and how that works.”

Ms Carroll-MacNeill said she wants to ensure there is appropriate governance in place.

“What I want to make sure is that every consultant who’s employed in the Irish state in children’s health, and in everywhere else, knows that they are not a single fiefdom, that they work within a hospital system, that they are public servants paid by the taxpayer, and that they follow the rules set by us in an appropriate governance structure.”

She also said a new chief executive of CHI, Lucy Nugent, had been appointed earlier this year.

Ms Nugent has apologised to the affected families on behalf of CHI.

“We are deeply sorry that these children, young people and families did not get the care they deserved. This is unacceptable,” she said.

“Children’s Health Ireland sincerely regrets and apologises for the risks that were posed to three patients through the use of non-CE-marked spring implants in their spinal surgeries.

“We do not under-estimate the impact that this has had and is having on the families affected, and the distress that it has caused to all patients and families in the spinal service.”