Colleague Explains Reluctance to Report ‘Forceful’ Surgeon’s ‘Unusual’ Technique

During an inquest, a former colleague of Ian Paterson stated that he had the opportunity to report the disgraced breast surgeon’s “unusual” operating technique but “didn’t feel in a position to take things further.” This inquest, concerning Rosemarie Blake, is among 62 taking place at Birmingham and Solihull Coroners Court for individuals who were previously patients of Paterson. The 66-year-old surgeon is presently serving a 20-year prison sentence, having been convicted in 2017 for wounding 10 patients. At Wednesday’s hearing, Dr. Adrian Parnell informed the coroner that he was “surprised” around 2005 when he received requests to perform repeat mammograms. These procedures were for certain patients of Paterson who had previously undergone a complete mastectomy, with the purpose of checking for cancer recurrence. Dr. Parnell was employed at Good Hope Hospital in Birmingham and also worked alongside Paterson in private practice at the Spire Little Aston Hospital. Testifying, the radiologist indicated his belief that he observed residual lobular tissue on the repeat mammograms—an X-ray scan—he performed, a type of tissue that should typically be excised during a standard mastectomy. When Jonathan Jones KC, counsel to the inquest, inquired if he was concerned by the presence of potentially cancerous tissue, Dr. Parnell responded: “It certainly was unusual.” He further explained, “I wasn’t a surgeon and knowledge of changing surgical technique wasn’t available to me.” He added, “I was unaware what additional treatment these ladies were receiving. I didn’t feel in a position to take things further.” Dr. Parnell stated that this situation led him to conduct research, discovering that in the US, some patients who had previously undergone a complete mastectomy were indeed having mammograms, which made him feel it “didn’t seem completely unreasonable.” He noted that although it was an “extremely small number” of private cases for which he was asked to perform repeat mammograms, these requests exclusively came from Paterson’s patients, and he never received a comparable request from any other breast surgeon. In response to Mr. Jones’s question about whether a system existed in the private sector for him to escalate concerns regarding Paterson’s conduct, Dr. Parnell affirmed that he could have reached out to the consultant body responsible for overseeing practice at the hospital. When questioned about his reasons for not doing so, Dr. Parnell responded: “At the time I wasn’t sure why Paterson had decided to commence an unusual surgical approach and I didn’t have enough surgical training to know how exceptional his practice was at the time.” The inquest further revealed that Dr. Parnell maintained no close professional relationship with Paterson, whom he characterized as “forceful” and “strong-willed.” He mentioned that his encounters with Paterson were infrequent because the surgeon seldom visited the X-ray department. Dr. Parnell remarked, “All I could say is, many other clinicians, if there were doubts, would come down to the department to discuss the situation.” He added, “I can’t remember that ever happening with Ian Paterson.” He further stated that he was not privy to any concerns about Paterson’s conduct beyond “hospital rumours.” Dr. Parnell indicated his understanding that an inquiry had taken place at Heartlands Hospital, which had proposed recommendations for Paterson’s future practice, but there was a “feeling” of “uncertainty about whether they were being adequately enforced or implemented.” Nevertheless, he clarified that he possessed “no direct evidence” of this himself.