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Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Was Ms Hardiman ever asked for her advice, as CEO, by consultants, orthopaedic surgeons or surgeons in relation to the approval of off-label or experimental techniques?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: My question was whether Ms Hardiman was ever approached for advice about those from professional orthopaedic surgeons or consultants.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Does she have any recollection of being informed of the potential use of these devices in operations on children?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Have any other techniques or pieces-----

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Ms Hardiman is not in a position to approve experimental techniques. Was she ever asked to approve or made aware of experimental techniques using devices that were not devised for the purpose for which they were subsequently used?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Was Ms Hardiman ever informed of the use of those techniques, alternative techniques or off-label advices by consultants or orthopaedic surgeons?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: I have a piece of correspondence here. I do not mean to grandstand without naming the individual, but as Ms Hardiman has said everybody is entitled to privacy. It does seem that outside the use of the MAGEC rod, which is mentioned, other techniques were mentioned. It is specifically addressed to Ms Hardiman. The final line of the correspondence reads that, as CEO, "we needed to make you...

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Ms Hardiman first became aware of what?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: It is dated 21 February 2020 and is addressed to Ms Hardiman.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Okay. The copy I have is dated 21 February 2020 and is addressed to Ms Hardiman. Is she saying she did not see it until August of this year?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: There is no record of Ms Hardiman having received it-----

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: -----in Temple Street.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: I have a few other specific questions. I am told that in August 2019 a multidisciplinary team of doctors, not just one surgeon, discussed implanting this spring implant with Ms Hardiman, as CEO. In the correspondence dated 21 February 2020, it is suggested that in the clinical director's office, two surgeons from the same multidisciplinary team told Ms Hardiman about the spring implant device.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Ms Hardiman is saying that did not happen.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: I am not pointing the finger. The most the important point Ms Hardiman made in her opening statement was on the complexity of this space and the operations that are necessary, the high-risk nature of them and the space in which surgeons are operating. I do not mean the space in which they are physically operating but the environment in which they are operating. Certainly, some of the...

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: I will ask one or two more questions first. Again, I am left with the impression that occasionally surgeons approached Ms Hardiman in her role as CEO for advice and guidance because they were not sure how to proceed.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: I do not mean to interrupt but it strikes me that there must be an urgency about this sometimes that does not allow for-----

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Before he comes in, I will ask a final few questions. Does CHI Temple Street have a register to monitor implant performance in children in case of problems? Apparently, there is an electronic register for hip and knee replacements. I wonder if there is a register other than putting a sticker in a chart for implants.

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: How can records of problems with implants be found?

Joint Oireachtas Committee on Health: Spinal Surgery Issues at Children's University Hospital Temple Street: Children's Health Ireland (28 Sep 2023)

John Lahart: Is it always?

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