Inquest finds elderly patient’s mastectomy was unsuitable

Surgeon Ian Paterson, who has been disgraced, appeared at an inquest to defend his decision to remove an elderly woman’s breast, despite her poor health and cancer having spread to her lungs and bones. Gladys Currall, from Solihull, passed away in 1998 at the age of 82, five days after undergoing surgery performed by Paterson, who is currently serving a prison sentence for wounding offenses connected to his operations. Medical professionals who have reviewed Mrs. Currall’s case have contended that her life was shortened by the “inappropriate surgery”. However, while providing testimony at Birmingham and Solihull Coroner’s Court, Paterson asserted his belief that the surgical procedure represented the sole viable choice for managing Mrs. Currall’s illness. Her death marks the fourth among 62 fatalities of Paterson’s patients under investigation by a coroner, with the inquests thus far concentrating on procedures known as cleavage-sparing mastectomies and the potential role of residual breast tissue in cancer recurrence. Mrs. Currall, a mother of twin daughters, had been directed to oncologists following a weight loss of 8kg (1.2 stone) over three months, accompanied by feelings of lethargy and nausea that impacted her appetite. Additionally, she had a prior medical history of heart disease. Initially, Dr. John Taylor reviewed her medical notes, but they were subsequently transferred to Paterson with the aim of “reduce cancer surgery waiting lists”, as Judge Richard Foster was informed. During the proceedings, which experienced a four-hour delay, it came to light that Paterson commenced employment at the Solihull hospital on 23 February. Mrs. Currall passed away one month subsequent to this date. A mammogram revealed a substantial 7cm tumour, with no discernible breast tissue. She was subsequently prescribed a course of Tamoxifen, which Paterson affirmed to the court was a standard procedure for such diagnoses during that period. The documentation submitted to the coroner lacked proof that a test had been conducted to ascertain if Mrs. Currall’s tumour was oestrogen receptor-positive, a condition that would have responded favorably to hormone therapy instead of surgical intervention. When interrogated by Jonathan Jones KC, counsel to the inquest, regarding the choice to perform surgery, considering Mrs. Currall’s age and medical state, Paterson contended that a multidisciplinary team (MDT) had arrived at that determination prior to her referral to his practice. Participating through a video link from prison, he stated: ”Some process had to have happened for the patient to end up in my clinic rather than Mr Taylor’s.“The only sensible explanation is that the decision was made jointly, him, I and the MDT, and the inter-surgeon referral had been made.” However, Mr. Jones informed the court that no evidence existed to suggest the MDT had issued any recommendations. In reply, Paterson claimed the notes were “woefully inadequate” and asserted that certain records were absent. He informed the court: “There is a lot of evidence that, particularly in elderly ladies, removing an aggressive primary tumour allows better control of the secondary deposits.” When questioned regarding alternative courses of treatment, he responded: “The option to do nothing, would have been an alternative, but you shouldn’t treat an elderly patient any differently than you would treat a younger patient.”Obviously endocrine therapy was not an avenue open to us.” He conceded that he did not inform Mrs. Currall that foregoing surgery was a possibility. Notwithstanding her advanced age, medical history, and impending renal failure, Paterson maintained that a mastectomy did not constitute a major surgical procedure. Mrs. Currall underwent the surgical procedure at Solihull Hospital, which was then part of the Heart of England Foundation NHS Trust, performed by Paterson on 19 March 1998. Four days subsequent, her health worsened, leading to her transfer to Birmingham Heartlands Hospital, where she passed away early the next day, having experienced a perforated duodenal ulcer. Dr. Lee, a consultant who examined Mrs. Currall’s medical records, stated that the operation was not the correct clinical choice and that she ought to have persisted with hormone therapy medication and “not have been exposed to the stresses of surgery”. Paterson, who worked as a consultant surgeon from 1998 until 2011, provided treatment to patients at Solihull Hospital, then a component of the Heart of England Foundation NHS Trust. A merger within the NHS in 2007 integrated Good Hope and Solihull hospitals into the identical health trust. Paterson is presently serving a 20-year prison sentence, having been incarcerated in 2017 for 17 charges of wounding with intent and three charges of unlawful wounding, concerning 10 patients. The ongoing inquests are proceeding. For updates, follow BBC Birmingham on BBC Sounds, Facebook, X, and Instagram. Copyright 2024 BBC. All rights reserved. The BBC bears no responsibility for the material found on external websites. Information regarding our policy on external linking is available.