Coroner rules Zavaroni died of 'natural causes'

The death of Lena Zavaroni, the child singer who suffered from anorexia for most of her life, was not a result of the brain surgery for depression she underwent three weeks earlier, an inquest heard yesterday.

The death of Lena Zavaroni, the child singer who suffered from anorexia for most of her life, was not a result of the brain surgery for depression she underwent three weeks earlier, an inquest heard yesterday.

At the inquest in Cardiff,Lawrence Addicott, the coroner who recorded a verdict of death by natural causes, said he could not link the operation to the onset of pneumonia, which Ms Zavaroni contracted shortly before she died.

She said shortly before her death that her life could not get any worse, having attended countless clinics to treat her eating disorders without any real success, In a last-ditch attempt to recover, she begged surgeons to perform radical neurosurgery on her brain, threatening to kill herself if they refused, the inquest heard.

For a while the operation last September seemed to have worked. But three weeks later, the 35-year-old singer, who weighed just three-and-a-half stone, was dead, having been too weak to fight off a bronchial pneumonia infection.

The court heard that, shortly before she died, Ms Zavaroni had been recovering well and asked doctors if they thought she would return to the stage.

Brian Simpson, the consultant neurosurgeon who carried out the operation at the University Hospital of Wales said: "She was brighter and making eye contact with people, which she had not been doing before. The nurses said she was asking about their families." He said that her chest infection did not seem to be related to the operation. The singer was so severely malnourished that she would have struggled to fight any infection, he said.

Her father, Victor, and sister, Carla asked Mr Simpson at the inquest why he had agreed to perform the surgery when Ms Zavaroni was so frail. "I am sure if Lena was desperate for the operation she would have agreed to put on half a stone first," her father said.

"We had discussions about the risk and she said she was desperate for the surgery and saw it as her only hope.... Putting on a bit of weight would not have reversed the long-term problem," Mr Simpson said. "She convinced me that if she did not have this operation she would kill herself."

The courtroom was a far cry from the stage career Ms Zavaroni began when she won Opportunity Knocks in 1974 when she was nine, singing "Ma' He's Making Eyes at Me". She was born in 1964 in Rothsay on the Isle of Bute,where her family ran a chain of fish and chip shops. She attended the Italia Conti Stage School in London where she was a classmate of fellow child prodigy Bonny Langford.

But the girl who sang with Frank Sinatra and Liza Minnelliat a Royal Variety performance was unable to cope with her sudden fame. She began her first crash diet at the age of 13. Her condition worsened at 17 when her mother, Hilda, committed suicide.

By 20 she had almost retired from the stage. She married five years later but the relationship lasted only 18 months. Her ex-husband, Peter Wiltshire, blamed her anorexia and accompanying depression. "It wasn't a real relationship" he said recently. "I had to go - it was self preservation. She was starving herself to death and there was nothing I could do."

Ms Zavaroni ended up living in a high rise flat in Hertfordshire, living off Income Support.

The court heard that her friend, Ray Dexter, had written to the hospital to inquire about the brain surgery, back in 1998. In July of the same year, she was referred to the hospital for treatment for her disorder.

Mr Simpson told the court that, under the requirements of the 1983 Mental Health Act, surgeons and psychiatrists had to be satisfied that all other possible treatments had been tried before they resorted to the brain surgery. A certificate of permission was issued in August 1999, and the operation was carried out on 7 September.

The procedureuses keyhole surgery to partially interrupt the nerve pathways that control emotions. A hospital spokesman said that the operation was not a lobotomy, nor was it an operation for anorexia, for which there is no known cure.

Mr Simpson, who has carried out 36 similar operations, said the one-and-a-half hour procedure passed "uneventfully". A brain scan confirmed the operation had been successful. He said Ms Zavaroni suffered mild confusion afterwards, which was a normal side effect, but that it had cleared up quickly. "She seemed surprisingly cheerful," he said. "But a few days later her condition worsened and she lost 20 per cent of her body weight, taking her down to three-and-a-half stone.

On 29 September she contracted bronchial pneumonia and her condition deteriorated. She did not respond to intensive treatment and died on the evening of 1 October. Mr Simpson said he was surprised by her sudden weight loss and the infection. "By that stage she was getting better. She was just about to be transferred to another hospital for rehabilitation. This came out of the blue."

Recording his verdict, Dr Addicott said Ms Zavaroni had understood the risks of surgery and still wished to proceed. "There is no distinct and definite connection with the operation. In conclusion I would say it was natural causes."

Ms Zavaroni's family refused to comment following yesterday's verdict.