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Audit reveals newborn screening anomalies

An audit of Waikato District Health Board’s newborn hearing screening programme has revealed anomalies in some of the results of babies screened between 2008 and early 2012.

This follows the findings at six other district health boards last year that showed some screeners had not carried out screening according to the Universal Newborn Hearing Screening and Early Intervention Programme protocol. This led to an offer to rescreen about 2000 babies nationally because of the small possibility hearing loss in some babies may have been missed.

Waikato DHB will offer 377 toddlers a rescreen.

Audiology clinical leader Emma-Jane Ward said the district health board was confident the chance testing missed picking up a baby with congenital hearing loss was extremely low.

“We believe offering retesting to babies affected by the screening anomalies is the safest and most responsible option.”

Mrs Ward urged parents or caregivers concerned about their child’s hearing to consult their GP, regardless of any previous hearing or screening tests.

International evidence shows that the incidence of moderate to severe permanent congenital hearing impairment is about 1 in 1000 live births in most developed countries.

Waikato DHB will finalise the number of babies for recall by mid February and would send letters out to parents offering a rescreen.

Mrs Ward said the priority was to complete the manual matching as quickly as possible so the DHB could reduce any anxiety or concern parents were experiencing.

Waikato DHB regretted that the irregularities in the screening programme may have missed an opportunity to identify hearing loss at the earliest possible stage, but it was sure it could now quickly identify those children that needed rescreening, she said.

The audit had followed a rigorous process, which had taken some time to complete. Now the audit of the data was complete, it needed matching against the individual children concerned to filter out those children who needed rescreening.

Questions and Answers Newborn Screening Programme

Why has it taken Waikato DHB longer to determine numbers affected?

Waikato DHB has followed a rigorous process. The auditor has had to review four years of data. This has been a tightly run review of a complex problem that  now requires a manual check of the data which will then need to be  individually matched against the child concerned.

What has happened to the staff member who did the screening?

The staff member left Waikato DHB before this issue became known.

How long will it take before parents are offered a rescreening?

Letters will go out to parents in the next few weeks asking parents to call Waikato DHB to set up a time to have their child rescreened.

What should parents do if they think their baby has a hearing loss?

We are encouraging all parents who receive a letter to make an appointment to have their child’s hearing rescreened.  If at any stage a caregiver is concerned about their child’s hearing they should make an appointment to see their general practitioner.

Is Waikato DHB doing anything to stop this from happening again?

Waikato DHB is working with the National Screening Unit on implementing the recommendations in the report into the incident. Work is already well underway to develop and put in place a process, which will reduce the likelihood of a reoccurrence.

How did this happen?

It was identified that one aspect of the screening programme was not being performed correctly. A number of improvements have been made to ensure that any protocol or system issues are identified early in future. The risk of a hearing problem being missed is very low.

What is the likelihood that these infants will have a hearing impairment?

In all cases, babies have been identified as ‘well babies’ with no risk factors. This means that the babies screened were healthy and well, with no family history of hearing loss.

International evidence shows that “the incidence of significant permanent congenital hearing impairment (PCHI) is about 1 in 1,000 live births in most developed countries” (UK National Screening Committee).

The probability that a baby or infant has a hearing loss in a cohort of patients this size is extremely low, but there is still a possibility that this may occur and therefore Waikato DHB will offer rescreening.

The fact that babies and infants are seen by other health agencies at various stages in their early months is also positive because assessment of development is being made on a regular basis (e.g. via their GP or Well Child Provider).

How do you know you have captured all the infants that may have received sub-optimal screening?

We are systematically and manually working through the record of each baby that received screening.

A number of babies were correctly referred onto the second stage of hearing screening, and will be excluded from the recall.

Do I have to pay for the rescreen?

No, this is a free service. The test is painless for your baby and takes only about 20 minutes to complete.

Can I take my baby to the doctor to be rescreened?

No, this is a specialist screen that requires equipment not available at medical centres. We will ask to bring your baby to the clinic listed in the letter that will be sent to parents who need to have their child rescreened.

How can I tell if my baby can hear?

The National Screening Unit has a number of resources that will tell you more about the Newborn Hearing Screening Programme, as well as what signs you should look for to determine whether your child can hear.
Go to: www.waikatodhb.health.nz/newbornscreening to access a hearing screening checklist.


General media enquiries
Mobile: 021 671 239
Email: news@waikatodhb.health.nz

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