Mastectomy on 82-year-old woman by Paterson ‘inappropriate’, inquest told
The surgery by rogue surgeon Ian Paterson may have shortened the life of cancer patient Gladys Currall, an inquest into her death has been told.
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Your support makes all the difference.A mastectomy performed on an elderly breast cancer patient by rogue surgeon Ian Paterson was “inappropriate” and may have shortened her life, an inquest has been told.
The fourth of 62 inquests being held into the deaths of patients of Paterson, who is serving a 20-year sentence for wounding, heard 82-year-old Gladys Currall died at Birmingham Heartlands Hospital on March 24 1998, days after undergoing a mastectomy.
Mrs Currall, who was married, had twin daughters and lived in Solihull. She was referred for investigation after visiting her GP in January 1998 complaining of unexplained weight loss, lethargy, nausea and a loss of appetite.
A mammogram on February 6 that year found she had a “huge” 7cm carcinoma in her left breast and the cancer had spread to her lungs and bone.
Paterson, 66, carried out a mastectomy on Mrs Currall on March 19 1998, but her condition deteriorated after the operation. She suffered a perforated duodenal ulcer and cardiac arrest and died four days later.
A multidisciplinary team of doctors who reviewed Mrs Currall’s medical records to assist coroner Richard Foster with the inquest concluded that she should have been offered endocrine therapy instead of a mastectomy, saying: “It seems highly probable that her life was shortened by inappropriate surgery.”
He undertook surgery which led to her early death
They also claimed Paterson had failed to discuss the treatment options for Mrs Currall, who the day before the mastectomy was described as being dehydrated and in “impending renal failure”.
They added: “He undertook surgery which led to her early death. Endocrine therapy was the most suitable and appropriate treatment combined with referral to an oncologist.
“The MDT concluded that it was very clear in this case that the decision to operate had led to this patient’s demise.”
Giving evidence at the inquest at Birmingham Coroners Court via videolink from prison, Paterson denied carrying out the procedure without consulting his colleagues at the time and said a mastectomy was the best option for her.
He also said the doctor who recorded that Mrs Currall was in impending renal failure was being “dramatic” and that she was probably just a bit “dry” before she was given IV fluids.
Asked by counsel to the inquest Jonathan Jones KC whether it was possible there had not been a multidisciplinary meeting before Mrs Currall’s surgery to discuss her treatment with colleagues, Paterson said: “The lady was (breast surgeon colleague Dr John Taylor’s) patient.
The decision must have been made for her to have surgery for her to end up in my clinic
“He had a considerable waiting list of people who had breast cancer waiting for treatment, so I suspect he said to me ‘please can you take her on’ and I said yes.
“The decision must have been made for her to have surgery for her to end up in my clinic.
“There are no MDT notes here where we should have discussed whether to proceed with removing this large cancer.
“The fact she was transferred to me suggests, and we are speculating, that the MDT decision was that she be offered local control surgery and because of Taylor’s waiting list, she was transferred to me.
“We would have had an MDT but the notes are woefully inadequate. Everything that I have seen so far is missing vital pieces of evidence.”
Asked by Mr Jones if there was any evidence there had even been an MDT before Mrs Currall’s treatment, Paterson said: “There is no evidence of a lot of things in this disclosure. I’m giving you a perfectly plausible clinical scenario.”
Paterson said there “aren’t many alternatives” that he could have offered Mrs Currall and that it was “really surgery or nothing”.
He said: “There’s a guideline that you shouldn’t treat the elderly any different to a young patient – you treat them like a person and offer the same intervention that you would offer a younger person.
“Obviously endocrine therapy was not an avenue open to us.”
When asked by Mr Jones if he agreed with the experts that it was “highly probable” Mrs Currall’s life was shortened by the surgery, Paterson said: “I can’t get from a short, light, general anaesthetic, from which she recovered, to a perforated duodenal ulcer.
“It is possible she had the duodenal ulcer before surgery and it may have had nothing to do with the mastectomy.
“She made an uneventful recovery up until this point, but she developed abdominal pain and deteriorated from that point.”
Paterson also denied that a mastectomy was a “significant” operation for someone of Mrs Currall’s age, saying: “I’m not trying to trivialise it, I’m not playing down a lady losing her breast, that is terrible, but it is a superficial organ and it is not a major operation for an 82-year-old to undergo.
“She would have recovered within 36 to 48 hours of the operation. She was fine post-op, she was only still in hospital because her drains were still in.”
The inquest continues.