Source: Radio New Zealand
Lubomira Weyland, 3, is facing more surgery to fix her hip dysplasia, after it was missed as a baby and then the first operation failed. SUPPLIED
The parents of a 3-year-old Dunedin girl with hip dysplasia say she has suffered unnecessary pain and trauma from a delayed diagnosis and then being subjected to the wrong kind of operation.
They plan to take her to Europe for further treatment, saying they no longer have trust in the New Zealand health system.
Despite her ordeal, Lubomira Weyland rarely stops smiling, a limp is currently the only sign that things are not quite right.
It was a Plunket nurse at the five-month check who first noticed her hip creases were not even, and suggested her parents consult their GP.
Her father, Marvin Weyland, said the doctor consulted a specialist at Dunedin Hospital’s orthopaedics department in April 2023.
“The only thing he did was look at the photo and decide based on that photo and fact that her hips were checked when she was born, he assumed everything would be OK.”
If the problem had been picked up then, it could have been treated with a harness.
However, it was two years later that her pre-school teacher noticed Mira was limping.
An X-ray showed she had hip dysplasia, where the “ball” (femoral head) of the thigh bone does not fit snugly into the “socket” in the pelvis.
Without treatment, it causes uneven leg length, pain, early arthritis, dislocations and even necrosis, where the tissue in the hip dies.
In October 2024 Mira had a procedure called a “closed reduction” under general anaesthetic, where the surgeon manipulated the hip back into the socket.
Her mother Agnieszka Sieradzka had just given birth to Mira’s little brother, who spent several weeks in the neonatal intensive care unit after being born prematurely.
“It was also very difficult because Mira slept very badly in the cast and having also a little baby who on principle don’t sleep very well, the nights were very difficult. The whole time was difficult.”
Lubomira Weyland after a hip operation that, according to overseas experts, was the wrong kind. SUPPLIED
They took her for several follow up appointments at the hospital and she had another anaesthetic to change the cast.
“And they never saw anything wrong until we noticed she was limping again,” the father said.
“We had a second X-ray and again it was obvious that her hip was dislocated. So it looked exactly like before the surgery.”
The parents assumed this set-back was just bad luck – until they did some more research and consulted specialists in Europe, who told them a closed reduction would never have worked because Mira was already too old.
By the age of 2, an open reduction is needed.
Sieradzka said it was devastating that Mira went through surgery and spent months in a cast “for nothing”.
“It didn’t have any chance to succeed and everything we went through was… I don’t know, I can’t even express the feeling of that.”
Internal investigation
ACC has recognised the delayed diagnosis as “a treatment injury” and Health NZ has apologised to the family for the distress suffered by them because of that and the subsequent complications.
In a written response to RNZ’s questions, the Southern Group Director of Operations for Health NZ, Craig Ashton, said Health NZ “acknowledged the distress the family has experienced”.
“Our aim is always to provide excellent healthcare, and we take these matters extremely seriously.”
“Our staff work extremely hard to provide the best possible care for our patients.”
Health NZ had undertaken an internal investigation to understand what occurred and “establish any necessary procedural changes”, he said.
“We have shared review findings with the family.”
Scans showed surgery had failed
The report, which Mira’s parents have shared with RNZ, includes comments by two orthopaedic surgeons who reviewed the post-operative scans of Mira’s hip and could see the hip was not properly aligned.
“In retrospect, the imaging suggests that the hip may not have been perfectly concentrically reduced, which would increase the risk of treatment failure,” one noted, while conceding that interpretation of this imaging was “subjective and not an exact science”.
“Mr A [who did the surgery] who has significant expertise in this area, reviewed the imaging at the time and was satisfied that the hip was reduced.”
The other specialist said “on retrospective review of the arthogram, I am concerned that the femoral head was not sitting concentrically in the acetabulum and hence potentially not stable”.
Weyland said the surgeon who operated told them everything went perfectly but it should have been clear to him that it had not worked.
That specialist no longer works at Dunedin Hospital and did not take part in the review.
The review found the GP had not made a formal referral regarding Mira’s hip creases, but just sought advice.
The specialist said asymmetrical creases alone were “not a good indicator” of hip dysplasia, but if he had known there were other problems, he would have seen Lubomira promptly in clinic and he was “personally very sorry” for the impact the delay had.
Health NZ concluded there was no fixed age at which closed reduction surgery should no longer be done, and the treatment decisions in Mira’s case “appear to be consistent with appropriate clinical judgement at the time”.
Lubomira Weyland has been on the waitlist for corrective surgery for months. SUPPLIED
Family fundraising for overseas surgery
Mira has been on the wait list for corrective surgery at Starship Children’s Hospital since August.
However, her parents are planning to take her to Poland for treatment.
“Even the doctors at Starship don’t do the surgery often, they know one of several different techniques that might be necessary,” Marvin Weyland said.
“They also tell us that the surgery if they do it there will take five hours, whereas the overseas clinics, with them it takes two hours.
“That gives you an idea of the difference in experience.”
Sieradzka said she blamed herself for not asking more questions.
“It’s caused a complete failure of trust in the healthcare professions.”
The couple, who are both academics at Otago University, hope to take Mira to Poland for surgery in the next couple of months.
They are fundraising to help cover the cost of the surgery (about $50,000) plus travel and accommodation, which is likely to cost more than $20,000.
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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand