The Health Service Executive (HSE) has concluded its review of an incident where water containers used in one of its dental clinics were contaminated with diluted drain cleaner.
The HSE has said however that the investigation was ‘inconclusive’ as far as establishing exactly how the incident occurred.
The incident, in early October 2017 at the HSE’s Dental Clinic in Ennis, resulted in the HSE issuing an advisory notice along with an apology to the public.
Five of the facility’s six dental surgeries were in operation at the time of the incident and were closed once the issue was identified.
When the health scare was detected, staff at the facility commenced the process of contacting the parents of children who might have been affected.
The HSE later confirmed that 15 of 43 children identified in the aftermath of the incident experienced some level of adverse symptoms and the HSE made appropriate efforts to support and keep all families involved informed.
The HSE confirmed this evening that it had concluded its review of the incident.
Kate Duggan, Head of Primary Care with HSE Mid West Community Healthcare said: “Our investigation as to exactly how this happened is inconclusive but it is obvious to us that four incidental findings will now greatly reduce if not eradicate the possibility of this happening again, as we have acted on those findings.”
The four findings of the investigation are that “internal security within the Dental Clinic is poor” and that “domestic cleaning products are not stored securely in the Dental Clinic.”
The review also found that “staffing in the CSSD room is not adequate to ensure safe work practices” and that there is a “lack of written standard operating procedures (SOPs).”
“Senior Management have arranged to meet with both the Dental Department Staff and the Parents of the children to provide them with an overview of the findings of the investigation and a copy of the Report of the investigation team,” the HSE confirmed.
“All of the findings are being responded to and new processes being put in place and monitored,” the spokesman added.