Ian Paterson: More inquests of patients of rogue breast surgeon could take place, hearing told

Inquests will be held into the deaths of at least 36 former patients of the rogue breast surgeon Ian Paterson, and dozens more could also be included, a hearing has been told.

Paterson is serving a 20-year prison sentence for carrying out needless operations on more than 1,000 breast cancer patients over a 14-year period.

The disgraced breast surgeon, who was jailed in 2017, practised in NHS hospitals which are part of the University Hospitals Birmingham NHS Foundation Trust as well as at private ones in Solihull and Sutton Coldfield.

An independent multi-disciplinary team of medical experts made up of consultant breast surgeons and consultant oncologists has been instructed to meet and review the patient records. 

At a pre-inquest hearing at Birmingham and Solihull Coroner’s Court on Friday it was confirmed that 417 cases of Paterson’s former patients, where breast cancer was listed as a cause of death in part one of their death certificates, had so far been reviewed.

Of those, Judge Richard Foster said 36 deaths have been confirmed as being subject of an inquest, a further 21 cases have been deemed likely to need an inquest after “preliminary” investigations, pending formal reports, with another 36 cases still to be reviewed.

Currently 27 inquests have been opened and adjourned, with a further nine to be opened in July - but there could be more.

Judge Foster said: “Additionally, there have been reported to HM Coroner 130 cases where breast cancer is included as a cause of death in part two of the death certificate.

“The multi-disciplinary team are considering a selection of those so as to inform me as to whether it would proportionate to review all those cases.”

Judge Foster, who was nominated by the Lord Chief Justice to oversee the inquests, also said that in some cases a patient’s death certificate could not be traced, meaning their cause of death was unknown, and so the judge urged any next of kin of Paterson’s former patients to come forward.

Paterson, who attended the hearing remotely from prison, was found guilty of 17 counts of wounding with intent and three of unlawful wounding, with his 15-year sentence increased to 20 years in 2018 by the Court of Appeal.

His 2017 Nottingham Crown Court trial heard how he carried out unapproved “cleavage-sparing” mastectomies on patients which left behind breast tissue, risking a return of cancer.

An independent inquiry found he carried out unnecessary operations in multiple hospitals on hundreds of patients, exaggerating or inventing cancer risks and claiming payments for more expensive procedures, and concerns were not acted on despite being raised by staff as early as 2003.

The inquiry report concluded that Paterson had been free to perform harmful surgery in NHS and private hospitals for years due to “a culture of avoidance and denial” in a “dysfunctional” healthcare system where there was “wilful blindness” to his behaviour.

Since July 2020, the inquests of 27 of Paterson’s former patients have been opened and adjourned in three groups.

The inquests of a further nine will be opened on July 14, and of those 36, 29 were NHS patients and seven were patients at Spire Parkway Hospital and Spire Little Aston Hospital.

The inquest will assess whether Paterson’s actions or wider systemic failures contributed to the deaths, and will review documents relating to Paterson’s training and monitoring, the handling of complaints about him from patients, staff and medical bodies, and the process of how his former patients were recalled to have their cases reviewed by the NHS and Spire.

Judge Foster said: “Systemic failings will form part of my investigations.

“My duty is to ensure that the relevant facts are fully, fairly and fearlessly investigated. It is also likely that I will be considering a report to prevent further deaths.”

Addressing the families of those who died, many of whom attended the hearing, he added: “Although much of today’s proceedings will focus upon the wider systemic issues, I want to reassure you that throughout you will always remain at the heart of my investigations, and I will leave no stone unturned in that endeavour.”

Judge Foster said a jury would not be needed at the inquests and suggested another pre-inquest review hearing could be scheduled for later this year.

The inquest is expected to begin formally in the autumn of 2024.

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