'This could happen elsewhere': how a hospital messed with hearing implants for 17 years (2023)

The full extent of a cochlear implant failure is only now becoming apparent, after more than 15 years of going undetected at a major public children's hospital.

TotalSo far, 30 children have been confirmed to have been adversely affected by having their implants timed incorrectly.på Adelaide Women's and Children's Hospital (WCH).

A further 178 children are known to have received care through the same program since 2006.

But amid the fallout from a scathing review and threatened class-action lawsuit, it appears the problem is far from confined to WCH, with the state's health minister raising the possibility that the mistakes behind the failure are being replicated elsewhere in the country.

Below is how the problem occurred, how it went undiagnosed, and how widespread similar problems can be.

How was the problem discovered?

Earlier this year, an independent external review was launched at WCH after it was revealed that as many as one in four cochlear implants were not being mapped correctly, meaning the devices were not working (and children were not developing) as they should .

HeThe review, published yesterday, makes clear that the error only came to light after the hospital repeatedly ignored the parents' concerns..

"Parents told [the external review team] they were made to feel it was their fault their child could not hear," the report said.

"One parent summed this up, describing it as feeling judged because she personally wasn't doing enough with her son and that because of this he wasn't getting where he needed to be. Parents reported being "tricked" and ignored . when they expressed concerns about progress even after reporting specific details about their child's lack of response to loud sounds and lack of progress in speech."

Health Minister Chris Picton said it was this part of the report that made the reading "most shocking".

"When people spoke or raised issues they were basically dismissed," Picton told ABC Radio Adelaide this morning.

“You see parents trying to raise these issues and the system wouldn't listen to them and that's a big problem.

"If that had happened, it's possible that the outcome here would have been very different."

The report confirms that the problem can go back "an astonishing 17 years," Picton said.

Lisa Selby's nine-year-old son was affected by the defect, but an independent audiologist had to identify her son's problems.

"The audit takes a deeper look at children outside the 30 identified [and] we don't want others to be in the position we found ourselves in when we found out from an outside source, despite being given to know our child was not affected," Mrs Selby said. saying.

How widespread is the problem?

The full extent is currently unknown, but the South African government has indicated that it may extend well beyond state borders.

Yesterday's report highlighted problems with WCH's approach to charting or planning cochlear implants, finding there were inconsistencies in procedures, as well as a "long history of tension" between the hospital and outside providers.

"Cochlear implants provide auditory sensations by electrically stimulating nerve fibers in the inner ear. It is important that the correct amount of electrical stimulation is used, otherwise the sound heard may be too soft or too loud," he said.

"Prior to 2023, the charting approach at the [hospital] was not well defined, documented or consistently applied, and some practices were considered ineffective and did not reflect contemporary charting approaches."

Picton has said that some of the problems at WCH revealed in the report could also occur at "other audiology services across the country" and that he would discuss this possibility with his interstate counterparts.

"This can happen elsewhere," he said.

“We need to look at how audiologists are accredited, which currently does not have a strict process.

"We have already raised this with the federal health minister, Mark Butler, [and] we will raise it with all other state and territory ministers."

Earlier this year, aAudiology review at Townsville University Hospital identified errors in the programming of cochlear implants received by children at that site.

The cases of 341 infants and children who underwent follow-up tests between 2020 and 2022 were reviewed amid concerns about the accuracy of the tests and the potential for misdiagnosis.

59 of these patients were recalled for further testing and 20 required urgent follow-up.

As a result of the Queensland review, members of staff were sacked, an outcome Picton said could be replicated in South Africa.

"The board will now look at this in relation to the hospital staff," he said.

Lawyer Peter Jackson, who is acting on behalf of the SA claimants in a class action, said yesterday's report raised a number of issues not necessarily limited to SA.

"No one has really established a framework for exactly what the configuration [of implant mapping] should be," he said.

“Right now I have a number of parents of plaintiffs who say, 'we keep coming in and saying, wait, my son can't hear.

"No one at the hospital seemed to pay attention when the issues were raised and it wasn't until they went to independent audiologists...suddenly these things started to come out."

What compensation is available?

The independent review was launched only after an earlier internal review failed to reveal the extent of the problem or the steps needed to fix it.

South Australian opposition leader David Speirs described the failure as "equal parts shocking and heartbreaking" and said the government had been slow to act.

"The first time he came to a ministerial desk was Chris Picton's desk in August 2022. It took questions in parliament to bring this out," he said.

"The government was in no rush to act at all and every step of the way the children continued to suffer from their inaction and I think that is inexcusable."

The State Government said yesterday it would offer families of children who were "under-charted" an initial payment of $50,000, which does not rule out the right to full compensation.

He said families of children who have not been under-charted will be eligible for $5,000 to recognize the stress the error has had on families.

In Queensland, the issue of compensation remains unclear, but Health Minister Shannon Fentiman said in April she was committed to releasing the results of an investigation when the panel issues its recommendations in October.

Jackson said for families in Adelaide, determining compensation would be a matter of determining the impact, the full extent of which might not be seen for years.

“In their early years (one, two, three, four) a lot of that development takes place, and those are the years when they've had hearing loss, and as a result, we don't know how the kids are going to feel. " said.

“We won't know until they're much older.

"It's something we're going to look at, probably realistically, five, six or seven years down the road."

Jackson said $50,000 was a good starting point, but could be a "drop in the bucket" compared to what it would take to meet the needs of all children.