Two stood down as QLD health investigates cochlear crisis

“I want to assure families whose children have been fitted with cochlear implants that the health service is prioritising this investigation.”

– Queensland’s Minister for Health and Ambulance Services, Yvette D’Ath.

The Townsville Hospital and Health Service announced that a proactive investigation into paediatric audiology services delivered by Townsville University Hospital is currently underway.

The health service was alerted to a pattern of ‘unexpected findings’ in the assessment of babies referred for diagnostic audiological testing after their screening at birth.

As a result, the health service has been working systematically with Children’s Health Queensland through the Healthy Hearing Program to conduct a full audit of 341 test results conducted on babies who were born after 1 January 2020. Although the audit is continuing, due to the results so far, the Townsville Hospital and Health Service has made the decision not to wait for the review to be finalised but instead to contact affected families in parallel with the audit. So far, 91 cases have been reviewed with eight infants requiring urgent follow-ups.

Townsville HHS has also taken proactive steps to look at cochlear implant programming in children at Townsville University Hospital, following recent cases in South Australia where cochlear implants have been mapped incorrectly. Since 2014, 59 children have received cochlear implants in Townsville. So far, 31 cases have been reviewed, with concerns around six. This review is complex and must be done on a case-by-case basis and is expected to be complete by June. Families of affected children were being contacted.

Queensland’s Minister for Health and Ambulance Services, Yvette D’Ath said, “I want to assure families whose children have been fitted with cochlear implants that the health service is prioritising this investigation.

“The health service has also taken steps to ensure that the ongoing delivery of paediatric audiology services for North Queensland children has the highest levels of scrutiny and governance.

“I can confirm two staff members have been stood down at this time while an investigation is conducted. It is important we do not pre-empt the investigation’s findings.

“The health service and Children’s Health Queensland are well aware of the impact this could have on the development of these young Queenslanders, and their priority is now focused on giving these young patients and their families all the support they need.”

Families whose child has been fitted with a cochlear implant and have concerns for their child’s care can contact (07)44337902. All other families who did not require a follow-up assessment following a routine hearing screen are not impacted. Those that are will be contacted by the health service or Queensland Health. However, families who still have concerns can contact 13HEALTH.

Symptom of a systemic failure?

In March, it was learned that 30 children at Adelaide’s Women’s and Children’s Hospital had their cochlear implants programmed incorrectly.

The families of the 30 children affected are calling for an independent investigation, with the cause of the problems still unclear nearly a year after the hospital was alerted to the issue.

Audiologist Nicole Eglinton alerted the hospital and health regulators last April. “The first child that came through, we thought that might be an anomaly,” she said. “This is not something we see often and we were alarmed and really in disbelief.”

“Our initial testing has shown that they didn’t have the important access to all of the sounds that they needed to learn to listen or speak. Critical periods are between zero and three years to learn and develop spoken language. Many of these children have missed this opportunity.”

The Adelaide Women’s and Children’s Hospital said it was “a very complex” investigation and could not discuss whether compensation would be paid to the affected families and whether the review’s findings would be released publicly.

How does it affect the children?

Cochlear implants are designed to provide auditory input to individuals with severe to profound hearing loss, allowing them to perceive sound and develop speech and language skills. Proper mapping – fitting and adjustments – of the cochlear implant is crucial to optimise the delivery of electrical stimulation to the auditory nerve, which then transmits sound information to the brain.

If cochlear implants are not properly mapped, it can result in reduced or distorted perception of sounds, including speech sounds, which can negatively impact speech acquisition. Here are some ways in which poor mapping of cochlear implants can affect speech acquisition:

  • Reduced speech perception: The individual may have difficulty perceiving speech sounds accurately, leading to reduced speech perception ability. This can impact the individual’s ability to understand spoken language, follow conversations, and acquire speech and language skills.
  • Delayed speech production: If the individual with a cochlear implant is not able to accurately perceive speech sounds due to poor mapping, it may result in delayed or inaccurate speech production. This can affect the development of speech production skills, including articulation, pronunciation, and intonation.
  • Language delays: Language development is closely linked to speech perception and production. If cochlear implants are not properly mapped, it can result in language delays, as the individual may have difficulty understanding spoken language and expressing themselves verbally.
  • Reduced speech clarity: Improper mapping of cochlear implants can result in degraded sound quality or distorted perception of sounds, including speech sounds. This can lead to reduced speech clarity, making it challenging for the individual to articulate speech sounds accurately, resulting in reduced speech clarity and intelligibility.

Deafness Forum Australia’s recommendations:

First and foremost, our thoughts are with the children and families affected.

We offer the following recommendations to the Queensland and South Australian Health departments:

  • open disclosure with all people affected.
  • immediate interventions are initiated to assess the impact on children affected and a program is commenced to address the deficiencies as much as possible.
  • immediate offer of support to parents in the form of expert, independent advice and counselling.
  • families can contribute to the investigation and are informed of the recommendations arising and actions taken or planned to prevent recurrence and improve the safety and quality of the service.
  • families must be satisfied that the hospital has taken the matter seriously, has investigated thoroughly and that steps would be taken to ensure that a similar incident won’t happen again.
  • the hospital learns from the investigation and from the perspective of the families and shares its learnings throughout the health system.

This is also the time for organisations in all states and territories that provide services to children with cochlear implants to review to ensure their services comply with health care quality and safety policies/procedures/processes.