05 December 2023 , 18:53
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A leading surgeon performing a "routine" operation on a nurse who later died after developing cancer has admitted that she could have survived.
Giving evidence to an inquest at Ruthin, North Wales via video link from the US state of Arizona, consultant gynaecologist Dr Eric Njiforfut said that the death of Catherine Jones, 35, was "wholly avoidable" if hospital bosses had spotted the signs of cancer four years earlier.
He said he he didn't recall seeing a senior colleague's handwritten annotation on a scan report made seven or eight months earlier, meaning he hadn't suspected any malignancy on the day of surgery. If there had been any suspicion he would have expected Ms Jones, of Hawarden, near Chester, to have been seen earlier within a fortnight. "It wasn't unusual to have this lag. This was a case where at the time there wasn't a suspicion of malignancy," he remarked.
On Monday senior gynaecological oncologist Philip Toon said he had recommended the patient's right ovary and fallopian tube should be removed when reviewing her case in November 2012. He feared a cyst on one of her ovaries may be cancerous.
The inquest heard the cyst was removed at Wrexham Maelor Hospital the following July. Mrs Jones had died in November 2016. The inquest heard the Betsi Cadwaladr University Health Board accepted a biopsy taken in 2013 was reported wrongly as "benign" when it had been "borderline" cancerous.
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A family lawyer has called her death "wholly avoidable." Mrs Shweta Joshi, at the time a speciality trainee doctor, said she too hadn't seen the note of Mr Toon.
In her evidence Mrs Joshi agreed there was no up-to-date scan in July 2013 and Mrs Jones hadn't been seen in a clinic. She would have told Dr Njiforfut the history, the witness said.
Earlier senior coroner John Gittins said he didn't feel it necessary to further examine the circumstances which led to the biopsy sample being "wrongly classified." Barrister Daniel Rogers, for the health Board, said :"The Board accepts the histopathology sample was wrongly classified. Treatment would have been different had it been classified differently as a borderline tumour."
But he said :"It's not proportionate for this court to further investigate that which has been admitted."
Yesterday the coroner also said :"To record a short-form conclusion which could only be natural causes would be wholly inadequate. To describe how Catherine came by her death the likelihood is there will be a narrative conclusion."
On Monday, now retired Mr Toon agreed with Louis Browne KC, for Mrs Jones's widower David and family, that "something has broken down in the chain of communication between 2012 and 2013." Mrs Jones might have survived, had the procedure he'd identified been carried out.
In June 2016 Mrs Jones had a full hysterectomy and a 2.5kgs cancerous cyst was removed. He said there were no other signs of the disease afterwards. Susan Corness, Mrs Jones's mother, said in a statement that her life "fell apart" following the death of her daughter.
After surgery in 2016 she was given the all-clear. But a follow-up check in September found the cancer had returned in the left abdominal cavity. The next month Mrs Jones was brought back to hospital by her mother "in pain" and "bleeding." She contracted an infection in hospital at Wrexham and was there until her death.
The inquest continues.