Unnecessary hip surgeries on children in Ireland

A draft report into 561 paediatric hip dysplasia surgeries on children operated on between 2021 – 2023 has found that a significant number of the surgeries at the National Orthopaedic Hospital, Cappagh, Dublin and Temple Street Hospital, Dublin did not meet the threshold for surgery, according to comments made by Pearse Doherty of Sinn Fein in a speech to the Dail.  This draft report or audit has recently been published in full on the Ditch website. The Government have said that the report is currently being subjected to clinical input and will, on completion, be shared with the relevant clinicians and hospitals at which time families affected by it will be contacted, informed and advised. 

What is paediatric hip dysplasia?

Paediatric hip dysplasia, also known as developmental dysplasia of the hip (DDH), is a condition where the hip joint doesn't form properly in babies and young children. It can range from mild instability to a complete dislocation of the hip joint.

In infants, DDH can occur due to factors such as breech positioning in the womb, family history of hip dysplasia, or other unknown causes. It's important to detect and treat DDH early because if left untreated, it can lead to long-term hip problems like pain, arthritis, and difficulty walking later in life.

Treatment options vary depending on the severity of the condition and the child's age, ranging from simple monitoring to using a harness or brace to help the hip joint develop correctly. In some cases, surgery may be necessary (osteotomy) to reposition the hip joint properly.

Regular check-ups and screenings by paediatricians are crucial for early detection and effective management of paediatric hip dysplasia.

What has happened?

Some staff at Children’s Health Ireland (CHI) alleged that Dublin hospitals were conducting unnecessary hip surgeries (osteotomies) on children. A outside consultant was instructed to prepare an audit on the surgeries and a draft report was delivered to the Government in January, 2025.  Anonymised medical records and X rays from Temple Street Hospital, Crumlin Road Hospital and the National Orthopaedic Hospital, Cappagh were provided to the expert consultant who was instructed to audit specifically the indications used and advised for osteotomies on children aged 1-7 between January, 2021 and December, 2023. The audit raised concerns about the indications for pelvic osteotomy in many of the cases at Temple Street and the National Orthopaedic Hospital but did state that some of the ostetomies were reasonably indicated. It recommended that all 561 cases should be recalled for ongoing follow up. 

What does this mean?

If the audit is correct, a large number of children have had osteotomies that were potentially unnecessary. Parents of affected children may not have given informed consent to such procedures. Skeletal maturity normally occurs at 14-16 years of age so it may be some time before the adverse consequences of such surgery (other than the surgery itself and its immediate consequences) are apparent. Pelvic osteotomy in such circumstances can, amongst other symptoms, carry the risk of symptomatic hip impingement and osteoarthritis. 

What can I do if my child has been affected?

If you have a child on whom unnecessary hip surgery (osteotomy) was performed, you may have a case of clinical negligence against the hospital involved.  Clinical negligence occurs when a healthcare professional gives a patient substandard care and as a result, the patient sustains injuries they would otherwise not have sustained. Healthcare professionals have a duty of care to all their patients to ensure they are treated properly and appropriately. Where substandard care has been given it is normally either a failure to treat the patient properly for their medical condition or a failure to get proper and informed consent from a patient or their parent for their medical treatment

In this instance, negligence could include carrying out unnecessary surgery and failing to get informed consent. If any unnecessary surgery has led to further medical complications then this is actionable as well. 

What should I do if I think there is a claim for clinical negligence?

You should see your solicitor. They will take instructions from you about the circumstances of your child’s treatment. They will then obtain all your relevant medical notes and records to ascertain precisely what treatment your child was given. After going through the records and ensuring their accuracy, they will instruct an expert physician with the relevant expertise in paediatric medicine to determine if the treatment given to your child was negligent. If the expert finds that the treatment given was below the standard your child was entitled to expect they will advise you accordingly and you can begin an action for compensation against the healthcare professional who was responsible for your child’s medical care.

How long do I have to make a claim?

Normally in personal injury law you have:

• two years from the date of your injury to make a claim
• If you are making a claim on behalf of a child, it can be made any time before the child reaches the age of 18. Once a child reaches the age of 18 and if they have the requisite mental capacity, they have a further two years to make a claim themselves until they reach the age of 20
• If the injured party does not have the requisite mental capacity then there are no time limits on when a claim can be made

In clinical negligence cases, the time limit (what lawyers call the “limitation period”) of two years will normally start either from the date of the act of negligence or from the date the patient knew or ought to have known that the injury or harm was due to an act of negligence. The date of knowledge can therefore be years after the negligent act. 

Time limits in clinical negligence matters can be complicated and you should seek legal advice immediately if you think you have a claim. Do not delay. 

How is compensation assessed?

We divide compensation into a number of headings:

• Compensation for pain, suffering and the effect the injury has had on a child’s life (what lawyers call “general damages”). The exact amount depends on the severity and extent of the injury and its impact
• In serious cases, loss of earnings into the future, (what lawyers call “special damages”)
• If someone has had to stop or reduce their work because it was necessary to look after a child then the claim will include their loss of earnings, past and into the future
• Cost of all medical expenses, past and future
• Cost of all therapy and rehabilitative treatment (including occupational therapy), past and future
• Cost of any nursing and domestic assistance, past and future
• Cost of any adaptions to property, vehicles or the cost of new housing

How long will my case take?

Clinical negligence cases are complex with a high level of legal expertise required. Expert reports from doctors are necessary and depending on the nature and severity of the injury, rehabilitative/care consultants and accountants may be instructed and such reports can take some time to prepare. Straightforward and smaller cases may be settled within a year or two. More complex cases will normally take 2-4 years to conclude.

Will my case to go to court?

The vast majority of cases that have a reasonable prospect of success are settled and do not go to hearing. This is the case even where court proceedings have been commenced.

How can Kearney Law help?

We appreciate that no amount of money can go anywhere near putting your child back to the position they would have been in prior to the substandard clinical care. What we can do is provide as much financial and other assistance as is possible to alleviate the burden of their loss. We will ensure that you and your child get the help you need now and into the future. Compensation will ensure they receive the best possible medical treatment, rehabilitation and care, both in the short and long term.

We are passionate about our work. We are easy to talk to and will keep you fully informed about the progress of your case. We are tech enabled and use software platforms to ensure your case is dealt with expeditiously and professionally. We are very experienced and have a team ready to deal with all aspects of your case.

We only do personal injury law and are experts at it.

For further assistance please ring us at 01 4853560 or email us on [email protected] or fill in our contact form

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