Four women who were treated by rogue breast surgeon Ian Paterson may have died as a result of botched treatment at his hands as well as "systemic failings" within the NHS, an inquest heard.

Ian Paterson, 61, is serving a 20-year jail term for carrying out "needless" procedures on his victims between 1997 and 2011.

He left male and female patients significantly deformed, with one looking like a "car crash victim" after telling them they were at risk from cancer when they were healthy.

The butcher surgeon "played god" and “exaggerated or invented” risks of tumours so he could earn extra money and maintain his successful reputation.

He spent the money on homes and trips after duping patients, even telling a victim: "I have to pay for holidays somehow."

Disgraced breast surgeon Ian Paterson

His "experimental mastectomies" meant the disease returned in many of his patients - with 675 of the 1,207 who underwent the procedure later dying.

Now fresh inquests will examine the "unnatural deaths" of four women three years after Paterson was jailed for 17 counts of wounding with intent.

Deborah Hynes, 51, Yvonne Cordon, 39, Shionagh Gough, 73, and Marie Pinfield, 49, were all patients of Paterson before they passed away.

Birmingham and Solihull Coroner Louise Hunt opened and adjourned hearings into the deaths today (Mon) and said all the cases will be investigated together.

She said the inquests will examine whether the women's deaths may have been "caused or contributed to by acts or treatment provided by Mr Paterson."

Birmingham Coroners Court heard that other clinicians and hospital management will also be probed to check if "systemic failings" led to any of the fatalities.

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Mrs Hunt said: “Following preliminary investigations that have been undertaken by Birmingham and Solihull coroner’s office I have reason to believe that the deceased’s deaths may have been caused or contributed to by acts or treatment provided by Mr Paterson and potentially other clinicians.

“I anticipate that in the inquest the following issues will be addressed. The inquest will consider the care provided by Mr Paterson and other clinicians.

“It will also consider whether their deaths were contributed to by failings in the supervision of Mr Paterson by his clinical colleagues, hospital management, and corporate governance.

“Secondly whether there were systemic failings by the hospital management and corporate governance in relation to addressing concerns raised about Mr Paterson.

“Thirdly whether there were failings by regulatory authorities such as the Care Quality Commission, General Medical Council, Nursing and Midwifery Council and lastly failings in the recall of patients.

“The family of the deceased will be an interested party.

“Mr Ian Paterson will be an interested party and Spire Hospitals, University Birmingham NHS Hospitals Trust, the General Medical Council, the Care Quality Commision and the Chief Constable of West Midlands Police.

“We anticipate that there will be further cases to open in the following months.

"What we expect is that investigations will find generic issues common to all the cases.

“The most sensible way to investigate this number of cases is to investigate them all together.”

The inquest heard Yvonne Cordon, a cleaner from County Antrim, Northern Ireland, died on November 19, 2000 at John Taylor Hospital in Erdington, Birmingham.

Ian Paterson at court.
Ian Paterson at court.

Shionagh Gough, a purchaser, was born in Scotland but lived in Solihull, and was the wife of a retired doctor.

She died on June 7, 2006 and the cause of death at the time was given as metastatic cancer of the breast.

Divorced Marie Pinfield was a police officer from Birmingham and died in a Marie Curie hospice in Solihull on August 21, 2008.

Her cause of death was given as as metastatic melanoma of the breast and the same was given in the case of Deborah Hynes.

Paterson was employed by the Heart of England NHS Foundation Trust, but practised at Spire Hospitals in Solihull and Little Aston in the West Midlands.

An independent inquiry in February found "patients were let down over many years" by both the NHS and independent providers.

The damning report found Paterson was able to perform the damaging surgery due to a "culture of avoidance and denial" and a “wilful blindness” from staff.

It was found he may have harmed over 750 women during his time working with cancer patients at NHS and private hospitals in the West Midlands over a 14 year period.

Retired Bishop of Norwich Graham James, who chaired the inquiry, said patients were let down "on every level" due to "multiple individual and organisational failures".