Inquest Hears Concerns Over Jailed Surgeon Ian Paterson’s Mastectomy Techniques

An inquest was informed that a colleague of the discredited breast surgeon Ian Paterson expressed worries that the mastectomies he performed on cancer patients were “not adequate,” yet this colleague did not report him to the General Medical Council (GMC). Fazel Fatah, who testified in one of 62 inquests concerning former patients, performed breast reconstructions on four occasions following mastectomies conducted by Paterson at Birmingham’s City Hospital. Mr. Fatah stated that he did not genuinely perceive it as his “role to report him to the GMC.” He indicated that two of the patients he operated on retained breast tissue and tumor remnants following their mastectomies. Mr. Fatah further explained that this observation caused him to conclude that Paterson’s method, which he completed in approximately half an hour—in contrast to the “meticulously” dissection and separation of the gland from the skin that required up to two hours for other surgeons—was insufficient for individuals with cancer. Paterson is currently serving a 20-year prison sentence for wounding 10 of his former patients, a conviction he received in 2017. This specific inquest, investigating the death of Melanie Chalklen, who passed away at 61 years old in 2017, represents the eighth in a sequence of 62 scheduled at Birmingham and Solihull Coroners Court. Mr. Fatah, a consultant plastic surgeon, stated that after operating on Paterson’s patients four times following Paterson’s surgeries, he requested to cease working with him. He informed the inquest, “The way Paterson did the surgery, he used quite a large scalpel.” “So instead of actually defining the tissue layer between the skin and breast tissue, he just created a layer with the knife which meant there was no separation of the two entities to make sure the breast tissue had been removed.” “It was a quick sweep of the knife round the top and bottom of the breast and lifting it off the muscle.” The inquest was informed that Mr. Fatah communicated his concerns to Martin Lee, the lead breast surgeon at City Hospital, leading to Paterson being prevented from performing surgeries at that facility. He additionally conversed with John Taylor, Paterson’s senior breast surgeon colleague at the trust where Paterson was employed, proposing an audit of the histology results from mastectomy specimens. The inquest heard that Mr. Taylor, who has since passed away, stated this would be unfeasible due to Paterson’s “aggressive nature” and the backing he received from the trust’s management. Mr. Fatah recounted: “Those were his exact words. I took it that, from a quantity point of view, he was more productive as a surgeon operating on a larger number of patients in the given time.” When questioned about his failure to report his concerns regarding Paterson’s practices to the GMC, the consultant responded: “I didn’t really feel it was my role to report him to the GMC, based on my limited experience and the views I had formed of him.” “I thought that was definitely the responsibility of management and colleagues that he worked with more at his trust.” The inquest remains ongoing.