Ireland’s unnecessary hip surgeries on children scandal
Between 2021 and 2023, a large number of children underwent pelvic osteotomy surgery for Developmental Dysplasia of the Hip (DDH) at Children’s Health Ireland (CHI) at Temple Street and the National Orthopaedic Hospital Cappagh (NOHC).
Concerns about the clinical justification for these surgeries were flagged, prompting an independent clinical audit commissioned by the HSE and conducted by Mr Simon Thomas, consultant paediatric orthopaedic surgeon at Bristol Royal Hospital for Children in the United Kingdom.
The independent clinical audit: Findings (May 2025)
The independent clinical audit, published in May 2025, reviewed 147 anonymised cases across three hospitals covering surgeries performed between 2021 and 2023.
The findings were stark
- CHI Temple Street: Of the surgeries reviewed, approximately 60% (about 3 out of every 5) did not meet the standard clinical threshold for intervention.
- National Orthopaedic Hospital Cappagh: Of the cases reviewed, approximately 79-80% (roughly 4 out of 5) did not meet the clinical threshold.
- CHI Crumlin: Surgeries were largely appropriate, with 98% meeting clinical criteria (meaning 49 out of 50 surgeries met the standard). These cases are considered outside the scope of the main review.
The findings suggest that many children at Temple Street and Cappagh underwent invasive surgery not warranted by the available clinical evidence.
These surgeries did not meet international standards for DDH treatment.
Children who did not need surgery were still exposed to the risks and recovery burdens of a major orthopaedic operation.
The External Expert Panel
In November 2025, the HSE announced the appointment of Dr Kishore Mulpuri as Chair of the External Expert Panel (EEP).
He is a consultant paediatric orthopaedic surgeon at BC Children’s Hospital and Chair of Orthopaedics at the University of British Columbia, Canada.
The 14-member international panel includes experts from Canada, England, Scotland, Ireland, the Netherlands, Singapore, India, the United States, and Brazil.
The review was pledged to begin no later than January 2026. However, as of March 2026, no case reviews had formally commenced. The panel was reported to be in a testing and validation phase.
The review is expected to take at least 12 months once formally underway.
- Scope: approximately 1,800 pelvic osteotomy surgeries performed between January 2010 and March 2025 at Temple Street and Cappagh
- The method includes reviewing only medical records, X-rays, ultrasound images, and radiology reports. There will be no clinic visits or physical examinations.
- Outcome: every child included will receive an individualised report; a public overall report will be published on the HSE website
- Exclusions include surgeries performed at Crumlin Hospital, as well as cases involving children with acquired hip dysplasia.
As of April 2026, approximately 500 children who had surgeries between 2021 and 2023 have been recalled for independent clinical and radiological review.
The broader EEP review covers a much larger population of cases stretching back to 2010.
Is my child affected?
Your child may be affected by the CHI hip surgery review if they underwent pelvic osteotomy surgery at Children’s Health Ireland, Temple Street or the National Orthopaedic Hospital Cappagh at any time between January 2010 and March 2025.
CHI and the National Orthopaedic Hospital Cappagh have written directly to the families of all children whose surgery falls within the review window.
If you received such a letter, or if your child attended a recall clinic at CHI, the concerns raised in the independent audit apply to your child’s case.
If you have not received a letter but believe your child underwent pelvic osteotomy surgery at one of these hospitals during this period, contact CHI directly to confirm your child’s inclusion in the review.
For families whose children have already been seen at a recall clinic, we understand that the process has raised serious questions about the necessity of the surgery and about the long-term consequences your child may face.
Pelvic osteotomy carries risks that may not become apparent until the child approaches skeletal maturity, generally between 14 and 16 years of age.
Surgeries performed in early childhood may therefore have consequences that only become evident years later.
Your legal rights: Grounds for an unnecessary hip surgeries claim in Ireland
If your child underwent hip surgery at Temple Street or Cappagh and the surgery is subsequently found not to have met the clinical threshold for intervention, your family may have legal grounds to bring a claim against the treating hospital and the HSE. There are two principal legal bases for such a claim in Ireland.
Medical Negligence: Failure to meet the standard of care
Under Irish law, a medical professional owes a duty of care to their patient. Where a surgeon recommends and performs an operation that was not clinically indicated, and that decision falls below the standard a reasonably competent orthopaedic surgeon would apply, this may constitute medical negligence.
The standard of care in Irish medical negligence law derives from Dunne v National Maternity Hospital [1989] IR 91, which requires that the treatment given meets the standard of a reasonably skilled practitioner in the relevant speciality.
Where the EEP confirms a surgery did not meet international DDH thresholds, this finding will be significant evidence in any medical negligence claim.
Lack of informed consent
Surgery performed without valid informed consent may give rise to a separate legal claim under Irish law.
Informed consent requires that the patient (or, in the case of a child, the parent or guardian) be given sufficient information about the nature of the proposed surgery, available alternatives, and material risks, so that they can make a genuine choice.
If a surgeon presented hip surgery as the only option without disclosing that watchful waiting or non-surgical management were clinically viable alternatives, the consent given by parents may not have been fully informed.
The Patient Safety Act 2023, which commenced on 26 September 2024, has strengthened the framework for open disclosure of serious incidents in Irish healthcare, making it mandatory for health service providers to notify patients and families of serious events.
Time limits for unnecessary hip surgeries claims in Ireland
Time limits are critical in any medical negligence claim.
Under the Statute of Limitations, a claimant usually has 2 years from the date they become aware of the injury to bring a claim.
The relevant date is when the claimant first knows, or should know, that the injury was likely caused by negligence.
- For adults: two years from the date of knowledge that the injury was caused by the negligent act or omission
- For minors, the limitation period starts on their 18th birthday and then runs for two years.
- Date of knowledge: Even where parents suspected an issue earlier, the legal clock may not begin to run until there is sufficient information to connect the injury to a specific act of negligence. For parents of children who received EEP reports confirming their child’s surgery did not meet clinical thresholds, the date of knowledge may run from the receipt of that individualised report.
It is important not to wait for the EEP report before taking legal advice.
While the EEP report will be evidentially significant, a family’s right to bring a claim does not depend on the review process being complete.
Taking legal advice now ensures that your family’s position is protected and that no limitation period is missed.
The High Court clinical negligence list
Serious medical negligence claims in Ireland are heard in the High Court. Practice Directions HC131 and HC132, which came into effect in April 2025, established a dedicated Clinical Negligence List to manage these proceedings more efficiently.
Cases on the Clinical Negligence List are subject to specific case management procedures, including early exchange of expert reports, structured discovery timelines, and early neutral evaluation.
Coleman Legal LLP has experience managing multi-party paediatric claims through the High Court, including acting for families in the CAMHS reviews in Kerry.
What should families do now?
If your child had hip surgery at Temple Street or Cappagh between 2010 and March 2025 and you have concerns about whether the surgery was clinically necessary, the following steps are recommended:
- Engage with the HSE review process: if your child has been contacted by CHI or Cappagh about an appointment or an EEP review, engage with this process to obtain the individualised report.
- Preserve all documents: retain all medical correspondence, discharge summaries, surgical consent forms, GP referral letters, and any communications from CHI, Cappagh, or the HSE.
- Request your child’s medical records: you have a right to request a copy of your child’s full medical records from the treating hospital under the Health Information and Quality Authority (HIQA) framework and Irish data protection law.
- Contact a solicitor specialising in paediatric medical negligence immediately. Prompt legal advice helps secure your rights and clarifies how the review process affects your potential claim.
- Do not accept any payment or sign any documents from the HSE or State Claims Agency without seeking independent legal advice first. Protect your legal position before making decisions.
How Coleman Legal LLP can help families affected by unnecessary hip surgeries
Coleman Legal LLP has acted for families affected by some of the most significant paediatric healthcare failures in Ireland, including the CAMHS Kerry reviews and CHI paediatric cases.
The firm’s paediatric negligence team has the legal experience and clinical insight to assess whether your child’s hip surgery fell below the required standard.
- Initial case assessment: reviewing your child’s clinical records and surgical history to identify whether grounds for a potential claim exist
- Expert medical evidence: instructing independent orthopaedic experts to assess whether the decision to operate met the clinical standard required by Irish law
- Multi-party coordination: where multiple families are pursuing similar claims, Coleman Legal LLP is experienced in coordinating group or multi-party actions against the HSE
- High Court and Circuit Court proceedings: medical negligence claims in Ireland are exempt from PIAB under Section 3(d) of the Personal Injuries Assessment Board Act 2003 and are issued directly in the High Court or Circuit Court without any PIAB authorisation
Interaction with the EEP: advising on how the EEP’s individualised report can be used as evidence in a legal claim, and what it means for the strength and valuation of your case
What compensation may be awarded?
Compensation in medical negligence cases involving unnecessary surgeries may include the following categories.
- General damages: An award for pain and suffering arising from the surgery itself, including post-operative pain, recovery period, and any ongoing orthopaedic or physical consequences. Where the surgery has resulted in long-term or permanent physical effects, the general damages award reflects the impact on the child’s quality of life and future physical function.
- Psychological impact: Awards may include compensation for the psychological harm caused by unnecessary surgery to both the child and the family. The distress of learning that a surgical procedure may not have been clinically warranted is significant, and this is a recognised head of damage in Irish medical negligence law.
- Special damages: Recovery of financial losses incurred as a result of the surgery, including medical expenses, travel costs, costs of care during recovery, and any costs associated with future treatment or intervention.
- Future loss: Where the surgery has caused or is expected to cause long-term physical consequences, a claim may include provision for future medical treatment, rehabilitation, or care costs.
Each case is different. The value of a claim depends on the specific circumstances, the severity of harm caused, and the evidence available.
Your solicitor will provide a realistic assessment of your position after reviewing the medical records and expert evidence.
About Developmental Dysplasia of the Hip
Developmental Dysplasia of the Hip (DDH) is a condition in which the ball of the hip joint does not sit properly in the socket.
It varies greatly in severity. Mild cases can often be managed through observation or bracing, particularly when detected early. More severe cases may require surgical intervention.
The standard clinical pathway for DDH in young children involves non-surgical management as the first approach wherever possible.
Surgery, including pelvic osteotomy, is reserved for cases where the hip remains unstable or dysplastic despite appropriate non-surgical management and where the clinical indicators clearly justify intervention.
The CHI audit identified that, in a significant proportion of cases reviewed, this threshold was not met.
Children were operated on when, according to the independent assessment, non-surgical management should have been pursued first.
For more information about DDH claims in Ireland, including cases arising outside the CHI review, visit our page.
Keith Rolls: Partner, Coleman Legal LLP
Keith Rolls is a Partner at Coleman Legal LLP, based in Tralee, Co. Kerry, and represents clients in Munster and throughout Ireland.
He heads the firm’s paediatric medical negligence team and currently acts for a significant number of families whose children were subjected to unnecessary hip surgeries in Ireland.
Keith also represents families in the CAMHS South Kerry Review, the CAMHS North Kerry Review, and the CAMHS National Audit.
Keith qualified as a solicitor in 2016 and is admitted to practise in both Ireland and England and Wales.
He is recognised for his ability to guide families through complex, multi-party medical negligence litigation while maintaining a personal and compassionate approach.
Keith’s direct experience in paediatric orthopaedic negligence claims means he understands the clinical and legal issues at the centre of cases involving unnecessary hip surgeries.
For further information on the background to this issue, the legal framework for families, and the review process, visit our dedicated pages:
Frequently Asked Questions
What is an unnecessary hip surgery claim in Ireland, and who can bring one?
In Ireland, an unnecessary hip surgery claim is a medical negligence claim brought by a family whose child underwent pelvic osteotomy surgery for Developmental Dysplasia of the Hip (DDH) at a time when the surgery was not clinically indicated.
Following the independent clinical audit conducted by Mr Simon Thomas (published May 2025), it has been established that a significant proportion of surgeries performed at CHI Temple Street and the National Orthopaedic Hospital Cappagh between 2021 and 2023 did not meet the standard clinical criteria for intervention.
Parents or guardians may bring a claim on behalf of their child; once the child turns 18, they may bring the claim in their own name.
Coleman Legal LLP advises families throughout Ireland on these claims.
How long do I have to make a claim for an unnecessary hip surgery in Ireland?
In Ireland, under the Statute of Limitations (Amendment) Act 1991, a medical negligence claim must generally be brought within two years of the claimant’s date of knowledge.
For children, the limitation period does not begin to run until their 18th birthday, meaning a child’s claim can be brought up to two years after they turn 18, regardless of when the surgery took place.
For parents bringing a claim in their own right for any separately recognised loss, the two-year period runs from the date of their knowledge.
It is strongly advisable to take legal advice as early as possible rather than waiting for the EEP review to conclude.
Do I need to wait for the HSE External Expert Panel report before making a claim?
In Ireland, a family does not need to wait for the External Expert Panel (EEP) report before taking legal advice or commencing proceedings.
The EEP review and a legal negligence claim are entirely separate processes.
While the EEP’s individualised report will be a valuable piece of evidence, it is not a prerequisite for bringing a claim.
Indeed, waiting for the report before taking legal advice may create time limit risks if the date of knowledge is calculated from an earlier point.
Coleman Legal LLP can advise on how the EEP intersects with your legal position.
What hospitals are included in the unnecessary hip surgery review in Ireland?
In Ireland, the External Expert Panel (EEP) is reviewing pelvic osteotomy surgeries performed between January 2010 and March 2025 at CHI Temple Street and the National Orthopaedic Hospital, Cappagh.
Surgeries performed at CHI Crumlin are not included in the EEP, as the independent clinical audit found that 98% of Crumlin surgeries met the clinical threshold.
Children with acquired hip dysplasia associated with conditions such as cerebral palsy or spina bifida are also excluded from the EEP scope.
Families uncertain about whether their child is within scope should seek legal advice.
What compensation is available for a child who had unnecessary hip surgery in Ireland?
In Ireland, compensation in a successful medical negligence claim for unnecessary hip surgery can include general damages for pain, suffering, and loss of amenity experienced as a result of undergoing an unnecessary surgical procedure, and special damages covering all financial losses, including costs of revision surgery, rehabilitation, psychological support, and any ongoing care needs.
Where the surgery has caused long-term orthopaedic effects or affected the child’s development, the compensation award may be substantial.
The State Claims Agency manages medical negligence claims against public hospitals on behalf of the State; Coleman Legal LLP has extensive experience resolving such litigation.
What does informed consent mean in the context of an unnecessary hip surgery claim?
In Ireland, informed consent in a medical context requires that a patient (or, for a child, their parent or guardian) is given sufficient information to make a genuine choice about whether to proceed with a proposed procedure.
This means being told about the nature of the surgery, the available non-surgical alternatives, and the material risks of each option. If a surgeon recommended hip surgery without disclosing that watchful waiting or bracing was a clinically viable alternative, the consent provided by parents may not have been legally valid.
A claim based on lack of informed consent is a recognised cause of action in Irish law and can be pursued alongside or independently of a standard medical negligence claim.
Has the Patient Safety Act 2023 changed anything for families affected by these surgeries?
In Ireland, the Patient Safety Act 2023 commenced on 26 September 2024 and introduced a mandatory open disclosure framework for serious patient safety incidents in Irish healthcare.
Under the Act, health service providers are now legally required to notify patients and families of serious incidents and to provide an explanation of what happened.
For families affected by unnecessary hip surgery, the Act strengthens the obligation on CHI and the HSE to communicate openly about what occurred.
Records of any open disclosure communications made under the Act may also be relevant evidence in a legal claim.
Can Coleman Legal LLP advise families outside Dublin on unnecessary hip surgery claims?
Yes. In Ireland, Coleman Legal LLP represents clients from all counties in claims for unnecessary hip surgery and paediatric medical negligence.
Keith Rolls, who leads the firm’s paediatric team and regularly acts for families throughout the country. Consultations can be conducted in person, by telephone, or by video call. Families can contact Coleman Legal LLP at 84 Talbot Street, Dublin 1, by telephone at 01 531 3800, or on 1800 844 104.
