By james art 
PA MediaA breast surgeon who carried out an unapproved mastectomy was a “nightmare” to work with, an inquest has heard.
Consultant surgeon Ian Patterson was jailed for 20 years in 2017 after being convicted of 20 counts of wounding.
More than 60 investigations have already been launched into the deaths of his former patients since July 2020.
Giving evidence on Wednesday, one of Patterson’s former colleagues and consultant radiologist at Solihull Hospital, Dr Chris Fletcher, said the pair had a “frosty” relationship at times.
Speaking at the inquest into Elaine Turbill, 63, the second of 62 to be heard over the next eight months, the doctor said they worked together between 1998 and 2011.
Mrs. Turbil was subjected to the so-called cleavage-sparing Paterson mastectomywhere part of the breast is left in place but the risk of the cancer returning is increased.
She later died of metastatic cancer.
Dr Fletcher told Birmingham and Solihull Coroners Court that reviewing mammograms from Patterson’s patients made up at least “90%” of his workload at both the NHS and private Spire hospitals.
He said their relationship was “complicated” and “difficult” because of the way Patterson worked and ended up complaining about him.
“He was a nightmare,” he said.
“He was quite aggressive and quite demanding in a way I had never encountered before.”
He said multidisciplinary meetings between NHS colleagues to discuss their patients’ treatment were “always difficult”.
“[Paterson] always tried to run the show,” Dr Fletcher said.
“We had a period where he was overwhelming me with work and I was struggling to cope.”
Growing concerns after the tumor was discovered
Their relationship soured further after Dr Fletcher signed a letter, along with other colleagues, raising concerns about Patterson.
The medical professional said he initially believed the jailed surgeon was simply an “efficient and competent surgeon”.
But he begins to worry about the way he performs mastectomies when he discovers a tumor on a patient’s mammogram that Patterson missed when he operated on them.
“He was arrogant and just did what he wanted and hadn’t looked at the mammogram,” he told the inquest.
“We were all a bit shocked and embarrassed by it.
“No one ever marked him as perhaps he should have been marked.”
On October 21, Judge Richard Foster ordered Patterson to testify at all 62 inquests after his legal team filed a motion to quash a subpoena instructing him to testify.
Patterson agreed to give evidence remotely from prison during Ms Turbill’s inquest on Thursday.
The first investigation into the death of Chloe Nikitas, 43, was adjourned to October 24 until a date to be determined.
Ms Turbill’s investigation is ongoing.