Questioning the 'Standard of Care' at a Well-Known Children's Hospital

Dr. Devan Griner, a plastic surgeon, recently moved to Utah and soon realized that something was unusual about the way cleft lip and palate surgeries were being performed at Primary Children's Hospital. Griner, along with other local doctors, filed a complaint with the state, alleging that doctors at the hospital were performing certain surgeries at earlier ages than is typical and using a controversial bone product for bone grafts. They also alleged that some patients were undergoing unnecessary surgeries. There is broad consensus nationwide to time bone grafts to when a patient is getting certain adult teeth. Many patients treated at Primary Children's had undergone, or been advised to undergo, grueling and possibly unnecessary facial surgeries earlier than the standard of care recommended. The hospital stands by its protocol and informed its patients during appointments about how and why their care differs. Parents of some of the hospital's patients express remorse, feeling that their children were unwitting participants in a potentially risky deviation from evidence-based treatment. Experts said bone grafts done at such an early age could stunt facial growth, resulting in the upper lip looking pushed back and impairing basic tasks such as talking and chewing. The hospital says it is trying to advance care by fixing children's mouths at younger ages and in ways that could eliminate the need for surgery when they are older, but experts note that the full outcomes of the new protocol won't be known for years.

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