The organs of dead children and adults were sent for incineration after post-mortem examinations at Our Lady of Lourdes Hospitals in Drogheda and University Hospital Limerick, a scathing new HSE audit has found.
The audit also revealed widespread other violations of care and dignity, with several hospitals holding onto the organs of people who had been the subject of autopsy for years.
The HSE audit, obtained by the Irish independent Under freedom of information legislation, revelations followed that the organs of deceased children of 18 relatives had been sent for incineration by Cork University Maternity Hospital twice in March 2020 and April 2020.
The parents had consented to the disposal of the organs, but had the clear expectation that this would involve burial or cremation.
This led to a broader evaluation of the practices by the HSE, which was carried out by the internal audit department.
Following the organ retention scandal that came to light in 1999 and 2000, a set of recommended standards and guidelines was drawn up in 2012 regarding cremation, burial or return of organs to next of kin.
The latest audit reveals improper disposal of organs at Our Lady of Lourdes Hospital in Drogheda and University Hospital Limerick.
At the Our Lady of Lourdes hospital in Drogheda, the hospital policy until 2020 was to burn organs.
Records identified three adult organs and one perinatal organ that was discarded during the 2018 to 2020 assessment period.
The same policy applied to the Limerick site. An inquest of the autopsies identified two postmortems who have used this disposal method since 2019.
Separately, no data was available to verify the method of removal associated with one organ at Connolly Hospital, Dublin, in 2019.
The audit points out that current policy does not specify the process for the eventual removal of organs where the next of kin choose not to have contact with the hospital or where other issues arise where sensitive removal occurs.
It is unclear who will make the final decision and this has led to organs being kept longer than the one year limit set in the guidelines in many hospitals.
The findings reveal:
- Organs kept in Crumlin Children’s Hospital for over a year from 24 separate autopsies.
- Ten organs were kept for over a year at St Columcille’s Hospital in south Dublin – the oldest dating back to 2017.
- Ten organs were kept for over a year at St Vincent’s Hospital, Dublin.
- At Midland Regional Hospital Tullamore, eight organs were held for over a year – some dating back to 2010
- Small numbers of organs were held for over a year at Limerick University Hospital, Waterford University Hospital and Midland Regional Hospital Portlaoise.
With regard to perinatal post-mortem examinations, the audit found organ retention in several hospitals.
At Galway University Hospital, perinatal organs were held for more than a year in 28 cases. Some were held for 32 months. All related to one advisor.
At Portiuncula Hospital, in Ballinasloe, County Galway, two separate postmortems resulted in organs being held for 18 to 26 months
At St Columcille’s Hospital, Louglinstown, Co Dublin, 16 organs from six perinatal postmortems were stored for up to 32 months.
Organs were held at Tullamore Hospital for between 19 and 55 months, and organs from five perinatal postmortems were held for between 24 and 42 months at University Hospital Limerick.
The audit found a general lack of perinatal pathology counselors during on-site visits, which necessitated the appointment of retired specialists, in particular two working on an ad hoc basis.
It also noted that there was no registry for organ preservation at Dublin’s Coombe Hospital.
At Our Lady’s Hospital in Navan, Co Meath, bodies being transferred from the hospital to the morgue are transported through the parking lot. It is a 300 meter journey and trolleys are not designed for outdoor transportation.
At Portiuncula Hospital, in Co Galway, details about the autopsy are being communicated orally and the hospital is in the process of producing information booklets about the post-mortem examinations in adults.
The Sint-Vincentius Hospital generally carries out all cremations provided by the hospital in batches once a year.
But in 2019, the volume was lower and some organs were held until 2020, after the one-year time limit.
The audit found that in 32 percent of the sites visited, there was no consent policy to cover all aspects of the post-mortem process.
There was also a lack of coherence with regard to transport policy.
The audit also revealed how the relationship between the HSE and the coroner has not been defined and documented.
There are differences and inconsistencies in practices, communication and responsibilities between different districts. In some cases, coroners only give oral consent for autopsy, while others give written consent.