Surgeon stays silent on claims
Gardaí say they are not investigating the events at CHI, Temple Street, as key questions remain unanswered
THE consultant at the centre of the Temple Street Hospital surgery scandal has refused to answer questions about the damage caused to young children in his care.
Orthopaedic surgeon Connor Green also refused to speak about the use of non-medical standard compression springs implanted in young patients.
Approaching Mr Green at his Dublin home this week, the Irish Mail on Sunday asked the Health Service Executive (HSE) consultant what he ‘had to say to the children hurt by the unauthorised implants put inside them’.
‘I can’t talk about it,’ Mr Green replied.
The surgeon’s refusal to speak follows a week of shocking revelations and mounting anger from families affected about the way the authorities have so far dealt with concerns about poor surgery outcomes at Temple Street Hospital.
Mr Green’s work is now the focus of a HSE and Children’s Health Ireland
(CHI) investigation into how unauthorised medical devices came to be implanted into children.
The probe will also focus on the consequences suffered by other children who underwent spinal operations at Temple Street Hospital between 2018 and 2022.
These surgeries have already been the subject of internal and external reviews concluded in May and July respectively.
Those two reports – one internal and one carried out by experts from Boston Children’s Hospital – were commissioned by Children’s Health Ireland (CHI) after concerns were raised about outcomes for children receiving complex spinal surgery at Temple Street, including two serious incidents in July and September 2022.
They reviewed the cases of 17 children with spina bifida who the surgeon had operated on, going back to 2018. One of these children, 10-year-old Dollceanna Carter from Trim, Co. Meath, died on September 29, 2022, after suffering complications following surgery.
The HSE confirmed in its statement: ‘Of these 17 children, one child sadly died since, and a number of other children suffered significant post-operative complications.’
The internal review, which looked at 16 patients, found that 13 children required further unplanned surgery. It said 12 had developed wound complications – infections – requiring further surgery. And it found that nine of the 16 cases required ‘removal of metalwork’.
One child had to have 33 further visits to the theatre.
The external report recommended various improvements to the hospital’s governance procedures.
But neither of the reviews, which remained unpublished until this week, made any mention of nonmedical grade devices being implanted in children.
Separate to the reports, which were completed in May and July, the HSE said it ‘became aware more recently that unauthorised devices were used in a small number of spinal surgery procedures’.
These were low-grade steel springs, not intended for use as medical implants and not CEmarked – the EU’s standard for health and safety.
Two children who had the springs implanted later had them removed, while a third child is being assessed. The surgeon at the centre of the reports and upcoming further review was later named as Mr Connor Green by online news site The Ditch, who had published a story about the springs three days before Monday’s HSE announcement.
Unhappy with the Government’s reaction this week, parents of children on orthopaedic waiting lists are now threatening to boycott a fresh external review promised by
‘Post-operative complications’
Children’s Health Ireland (CHI) and the HSE unless their demands are met for a wider probe.
Meanwhile, Mr Green is no longer conducting surgeries and his work has now been referred to the Irish Medical Council.
The use of non-medical devices in Temple Street surgeries has also been notified to the Health Products Regulatory Authority (HPRS).
But as yet no criminal complaints have been made and no Garda investigation has commenced.
Now aged 44, Mr Green attended St Andrew’s College – a private feepaying school in Dublin’s Blackrock – before graduating from UCD medical school in 2004. After spells at Croom Orthopaedic Hospital in Limerick and St Vincent’s University Hospital in Dublin, he was awarded a travelling fellowship in surgery by the Royal College of
Surgeons in Ireland in 2014. In 2016 he completed a second fellowship at the Texas Scottish Rite Hospital for Children in Dallas.
Since 2016 Mr Green has been a consultant paediatric orthopaedic surgeon at Temple Street Hospital and at the Cappagh National Orthopaedic
Hospital and lives with his wife and family in South Dublin.
But it has now emerged concerns about the use of unauthorised devices during spinal surgeries have been present for up to two years – as the HSE only now moves to investigate. The matter was
raised in a November 2021 Oireachtas Health Committee meeting at which Mr Green appeared as a witness. Inquiring about the use of unauthorised devices, Fianna Fáil TD Cathal Crowe raised the case of spinal rods with no CE mark being used in spinal surgery.
In his response, Professor Damian McCormack, a colleague of Mr Green at Temple Street, was critical of regulatory standards.
‘Yes. It is an American implant. The problem with surgical implants in this country is they are not regulated,’ he said.
Professor McCormack added he had never allowed this device to be used in Temple Street, but warned of the risks of unregulated medical devices. Dr Green was also specifically asked at the committee about the Irish regulatory regime for medical devices, but did not directly answer the question.
But in his opening address to the committee, Mr Green displayed his frustration with the deficiencies of the Irish health system.
‘I can tell the committee that you would not find better colleagues anywhere in the world than the group of colleagues I have in Temple Street and in Cappagh,’ he said.
‘This is across nursing, therapy and my medical peers. We hold ourselves to an exceptionally high standard. You must go abroad for international training for two years before you have an opportunity to be a paediatric anaesthetist or a paediatric orthopaedic surgeon.’
However, Mr Green warned the ‘elite’ team he formed part of would leave if conditions in the Irish health system do not improve.
‘All of this goodwill has dried up. If we do not act now this elite standard of care in this country is definitely going to reduce itself to “yellow pack”, because people will not go abroad to train,’ he said.
‘We are not asking for much. We are asking to be allowed to do our job. We are asking that when we come to work there is enough staff and that we will not have to fight every morning to get a bed for our patient, so we can come in and operate. As surgeons, we are asking that we have an operating room to go to. I know it sounds ridiculous, but I was appointed as surgeon with no operating room.
‘In Temple Street, our clinical director has been fighting hard for one operating theatre to be delivered by the end of next year. Why is it not two? Why are we waiting until next year? The American Army can set up a hospital in desert overnight, so why can we not have two operating rooms sooner?’
Mr Green also displayed a weariness with the health system, saying he was not sure how much longer he could keep letting patients down.
‘I fight one day at a time and I try to get to Friday, and I try to spend some time with my family,’ he told the committee.
‘My job is to look after children and I cancelled two clinics to be here today to advocate. Because we are here advocating today, 60 children are not being seen today.
‘Also, I do not know how long I can continue doing this. The reality is that I am the one who has to go up and tell families that their operations are cancelled. I have asked management to do that and they will not do it. Why should I have to say that the hospital has failed to get them a bed?’