“We have a bone grafting problem here in Utah.” The quote is from an orthodontist in a ProPublica investigation into the treatment of cleft lips and palates in the state, which has a higher-than-usual number of such cases. The orthodontist is among critics who say that doctors at Primary Children’s Hospital in Utah are performing surgeries that are too risky on patients who are too young.

• “Among their allegations: Some doctors on the hospital’s cleft team were performing bone grafts on patients who were too young—around age 2—and using an off-label, controversial bone growth product that many doctors shun,” per the story. “They were performing intensive jaw surgeries—which require children to wear a large metal device screwed into their heads for months—so early that they risked some children needing to repeat the operation. And the team was performing surgeries some patients didn’t need.”
• “They just … overoperate,” says Lisa Morris, one of the cleft doctors who joined the state complaint.

A big question raised in the piece is whether parents were properly informed that the procedures were outside the norm of what is typically recommended in the rest of the country. (The piece interviews some parents who say they were not.) Of course, “innovating in surgery is a gray area,” notes the article. Dr. Dana Johns, director of the hospital’s cleft team, argues that just because the hospital’s practices differ from the norm doesn’t mean they are wrong. Johns believes that intervening earlier is better for the children in the long run, though critics say it’s too risky to perform surgery when bones still have so much growing to do. Meanwhile, Utah’s Division of Professional Licensing is investigating the complaints. (Read the full story, or check out other longform recaps.)