Hospital held organs of child post-mortem for 20 years due to 'ambiguity' over disposal rules

The Voice of Our Angels group protesting at Cork University Maternity Hospital, including Laura Kelleher who wants to know if the parents of babies at other hospitals highlighted in the audit report have been notified about their children’s organs. Picture: Larry Cummins

The organs of a child on whom a post-mortem examination was performed were held by a Dublin hospital for over 20 years due to “ambiguity” regarding how they should be disposed of.

An internal audit investigation by the HSE, the result of which has been seen by the Irish Examiner, has found that multiple public hospitals across the country have retained organs from post-mortem examinations for more than the one year specified in the HSE’s own policies.

The Children’s Hospital Ireland at Crumlin had retained organs from 24 post-mortem examinations for more than 12 months, with the oldest dating from the year 2000.

The audit of post-mortem practice and policies, which was commissioned after it emerged that the organs of the children of 18 bereaved couples had been incinerated contrary to their wishes at Cork University Maternity Hospital (CUMH) in March and April 2020, reported in February this year and made six high priority recommendations, each of which posed a “potentially systemic” risk if not implemented.

It found that the HSE’s policy for post-mortem examinations had not been updated for 10 years, despite a review having been scheduled for 2015, and did not specify guidelines or timelines for the disposal of organs “where issues arise” as to the final decision.

Fintan and Laura Kelleher, a Cork couple living in Australia, are among the 18 families affected by the incineration of organs of babies from CUMH.

They want to know if the parents of babies at other hospitals highlighted in the audit report have been notified about their children’s organs.

“This only makes me want to fight more. My main goal is to get the Human Tissue Bill in so that this can never happen to anybody again,” said Laura.

Another Cork mum, Katie Quilligan, said the latest revelation regarding organ retention by Irish hospitals is shocking.

“Why is it after taking our 18 babies at CUMH to highlight this?” she asked. 

Inappropriate organ disposal

The audit report noted further that inappropriate organ disposal was still in use at University Hospital Limerick (UHL) and Our Lady of Lourdes Hospital in Drogheda, where the incineration of organs continued between 2018 and 2021, the period under review.

It found issues exist regarding the retention of organs from perinatal — the weeks immediately preceding and following birth — post-mortem examinations on children “at a number of hospital sites”.

In particular, the report said “significant delays were noted in relation to the sensitive disposal of organs” from post-mortem examinations performed by one consultant, a retired perinatal pathologist, on whom the HSE is “overly reliant”.

Further, despite the 98% of the post-mortems taking place in Ireland being ordered by the Coroner’s Office, the relationship between the HSE and that office is nevertheless “not defined or documented”.

The audit found that Galway University Hospital had retained the organs of 28 children for more than one year between 2018 and 2021. All of the organs in question related to post-mortems performed by the aforementioned retired consultant, described as Consultant A in the report.

Other hospitals to retain the organs of children while waiting approval for release from Consultant A include Portiuncula in Galway, St Columcille’s in Dublin, Midlands Regional in Tullamore, and UHL.

The longest period those organs were retained was 55 months in Tullamore, or just under five years.

Meanwhile, the mortuary-transfer practice at Our Lady’s Hospital Navan was highlighted as involving an “outdoor element” 300m in length on trolleys “not designed for outdoor transportation”.

The probe recommended that the HSE’s post-mortem policy be updated and that it be determined whether “open disclosure” is necessary for instances of organ incineration at UHL, the Lourdes in Drogheda, and Connolly Hospital in west Dublin during the period under review.

Both UHL and the Lourdes were also informed of an immediate need for them to implement a change in their “sensitive disposal policy”, while poor record-keeping in terms of post-mortems was noted, with details of such operations at Portiuncula “communicated verbally”.

The report further recommended that the services provided by Consultant A should be reviewed.