RAF veteran 'mutilated' by surgeon who made three mistakes in five days

Paul Tooth, 64, with his wife Sue, 62

Paul Tooth, 64, with his wife Sue, 62 - Credit: Joel Adams

A RAF veteran has been left depressed and suffering from life-changing injuries after a surgeon “mutilated his insides” during what should have been a routine gallbladder removal last year.

He is one of three patients harmed during similar operations by the same surgeon in a five day period last year. 

But Norfolk and Norwich NHS Hospital Trust - where the surgeon is still operating - has refused to publish even a summary of the independent report into the failings, nor allowed the three patients to communicate.

Paul Tooth, 64, from Norfolk, now has one tube leading from his abdomen to a medical bag and another tube leading back into his stomach via his nose and throat. 

He has to spend six hours a day pumping bile back into his body from one to the other to avoid contracting life-threatening sepsis, and has lost five stone in weight since the operation in January 2020.

His surgeon inexplicably took out not only his gall bladder, but vital ducts linking the liver to the intestines, as well as damaging his liver beyond repair.

The trust has accepted liability for his condition and his lawyer anticipates a “substantial settlement” once his long-term prognosis is finally known.

Paul Tooth has to recycle his body's bile back into his stomach every day

Paul Tooth has to recycle his body's bile back into his stomach every day - Credit: Joel Adams

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But Paul and his wife of 45 years, Sue, say it is “anyone’s guess” whether he even survives upcoming surgery to remove more of his now-rotting liver.

“The pain was 25 out of ten”

Paul started experiencing pain in his abdomen in February 2019, and after a CT scan, an MRI, and further exploratory procedures was diagnosed with gallstones that July.

This required an urgent gallbladder removal, and by January 27, 2020 he had finally reached the top of the six month waiting list.

But when he woke up after surgery he knew immediately something was wrong.

“As I woke up I was in pain beyond belief. I’ve had cartilage operations, and my appendix out, but this pain was off the scale.

“They asked me how bad the pain was out of 10 and I said 25. All I remember saying was ‘Pain! Pain!’

“My blood pressure was over 200. They gave me fentanyl, morphine, and ketamine and it still didn’t knock me out.”

He went back under the same surgeon’s knife the next day, who later told a report he saw nothing wrong at that stage.

“He had removed and mutilated my insides” said Paul. “How could he say he saw nothing wrong? 

Instead of simply taking out the gallbladder, the surgeon had removed his common bile duct, hepatic duct and had damaged a significant part of his liver.

Paul Tooth on the motorbike he has had to sell

In happier times Paul and Sue would criss-cross Europe on his bike, her riding pillion. But they have had to sell the bike which he is now to frail to ride. - Credit: Joel Adams

Paul analogised: “The gallbladder is like a car park, off a side road, near a motorway.

“He was supposed to demolish the car park, but instead he’s taken out the car park, the side road, the motorway and the nearest major junction too.”

A week after the initial surgery he was transferred to Addenbrooke’s for emergency treatment, where he stayed for six weeks. He has frequently had to return suffering bouts of sepsis.

Recycling bile

The consequences of the botched surgery for the former RAF engineer have been catastrophic.

His six foot four body still produces bile - up to a litre a day - but can no longer process it, so a plastic surgical drain snakes out of his abdomen and slowly fills a medical bag through the course of the day.

The human body needs bile to metabolise energy from fats, so every day Paul has to pump that bile back into his system - a process which takes from 4pm to 10pm just to be able to eat a bowl of porridge at 5pm.

He said: “I have been doing this constantly since last March, having to drain the bag every four to five hours.

“It means I can never get a full night’s sleep, and this is how it will be for the foreseeable future, if not for the rest of my life.

“I have been virtually housebound, often bedbound, and I have lost a lot of weight to the point where my grandchildren barely recognise me."

Paul and Sue pictured with their grandchildren, six years before his botched operation

Paul and Sue pictured with their grandchildren, six years before his botched operation - Credit: Joel Adams

His wife Sue said: “It’s been horrendous. I’m a nervous wreck, I’m constantly crying.

“I just feel that our lives have stopped since then. Our lives have finished. We’ve got nothing to look forward to any more, it’s really hard.”

Since Paul retired from full-time engineering operations on RAF Tornados two decades ago the couple have enjoyed touring Europe on a motorbike, Sue riding pillion.

But yesterday they sold their beloved motorbike, because Paul is no longer well enough to ride.

Sue said: “We used to have really wonderful lives. But it’s just so sad that we can’t do what we wanted to do. So many plans that can’t be done any more."

His new reality has taken a huge toll on Paul’s mental health, who says he has “no life” any more and is taking medication to combat depression.

Sue said: “It’s not nice to hear your husband sitting here and every single day saying he wants to die.”

“We’ve been kept in the dark”

Last summer the couple learned from doctors at Addenbrooke’s that they had performed surgery on another patient in the same week, for a similar condition following treatment by the same surgeon.

Paul said: “They tried to whitewash us. Nobody told us there were other patients until nine months after the event. The surgeon never reported the other two cases.

“He should have reported himself and stopped.”

He added: “We’ve been kept in the dark about each other. They won’t even tell me whether I was the first or second or third case.”

Paul was left needing surgical drains leading from his damaged liver to a medical bag

Paul was left needing surgical drains leading from his damaged liver to a medical bag - Credit: Joel Adams

In October, the trust’s medical director Professor Erika Denton revealed she had asked the Royal College of Surgeons to carry out a review “in light of the knowledge of three cases of potentially serious concern involving the same surgeon”.

She added: “All of the surgeries took place within a five-day period in January 2020.”

The RCS found some patients were waiting 18 months or more, with more than half being readmitted as emergencies while they waited.

She said the RCS had not identified wider concerns about Paul’s surgeon’s safety, but added: “They documented that [the surgeon] accepted that his recognition of the complications in your case had not been optimal and could have been quicker. In addition, there was also a failure to recognise that help or an alternative strategy was required.”

Prof Denton said there was nothing that would have alerted the trust to problems with the surgeon’s abilities before the incident, adding in the letter to Mr Tooth: “I appreciate this may be of little comfort to you and does not detract from the devastating and life-changing consequences that you have been left with and for which [the surgeon] offers his sincere regrets and apology.”

The Trust said the surgeon was now operating under supervision for bile duct related surgery but refused to say if he had ever been suspended.

A spokesman said: “All recommended actions and learning from the RCS have been fully implemented, including enhanced training and supervision following their independent review of internal processes. We will not be publishing the report publicly due to patient confidentiality and ongoing litigation.”

The Royal College of Surgeons said it would not publish its report but is actively monitoring implementation of its recommendations.

Guy Forster, the medical negligence expert at Irwin Mitchell representing Paul, said: “Whilst we appreciate that recommendations were made for improvements, we are concerned that these do not go far enough.

"We are seeking reassurances that there has been a comprehensive investigation into the circumstances of Paul’s injuries so that everything can be done as soon as possible to improve patient care and prevent anyone else from suffering the way Paul and the other two cases have.”

If you have suffered similar issues relating to NNUH please contact joel.adams@archant.co.uk . Your identity will not be published without your express permission.