A Brighton hospital has become the focus of a medical inquest following the death of a 77-year-old patient who underwent surgery conducted by a senior colorectal specialist at the Royal Sussex County Hospital.

Arthur Brooke Craig passed away on June 26, 2024, several days after undergoing a surgical procedure performed by consultant surgeon Marc Lamah.

The operation was intended to address a tumour identified in Mr Craig’s abdomen.

Proceedings at Horsham Coroner’s Court heard that during the operation, Mr Lamah altered his surgical approach.

Rather than proceeding with the planned laparoscopic procedure, he elected to remove Mr Craig’s colon entirely.

Evidence presented indicated that the surgeon did not obtain a secondary opinion before making this significant change to the operation.

He also failed to inform Mr Craig prior to surgery that removal of the colon might become necessary.

Additionally, testimony revealed that Mr Lamah did not thoroughly review the patient’s complete medical documentation before commencing the procedure.

The initial certificate recorded the cause of death as sepsis resulting from a perforated bowel.

During the operation, two separate malignant growths were identified.

When questioned about his clinical decision-making, Mr Lamah characterised his failure to apprise the patient of potential surgical outcomes as a procedural technicality.

He stated that consent had been granted to excise the tumour if achievable during the operation.

Mr Craig’s daughter, Professor Cathy Craig, who attended the inquest, described her father’s declining condition following the surgical intervention.

She reported that he sought clarification about what had occurred and expressed a desire to return to Northern Ireland, where he had previously worked in agriculture.

Mr Craig wished to be interred in Armoy alongside his parents and requested a significant memorial gathering.

Medical records indicated that Mr Craig had previously received treatment for a cardiac arrhythmia while holidaying in France in 2013.

He had also been admitted to the same Brighton medical facility in 2016 following a cerebrovascular event.

Following his admission to the Royal Sussex County Hospital in May 2024, investigations led to a diagnosis of gastric ulceration.

Following assessment and clearance for discharge, Professor Craig advocated for additional diagnostic testing.

Hospital personnel agreed to perform a computed tomography scan, which revealed a substantial unidentifiable mass within the abdomen.

Despite Mr Craig’s initial reluctance and preference to return home to Northern Ireland, he subsequently met with a stoma specialist nurse.

He subsequently executed a consent document for surgical intervention in the absence of his daughter.

Professor Craig informed the court that she remained uninformed regarding the specific nature of the procedure her father had sanctioned.

She was not present when the consent documentation was signed, despite holding power of attorney and hospital records specifically noting that she was to be afforded the opportunity to consult with her father.

During the operation, Mr Lamah determined it necessary to transition from laparoscopic surgery to an open procedure involving removal of the tumour and colon.

Evidence indicated that Mr Lamah had practised surgery for 25 years and performed in excess of 1,000 procedures.

He explained that obtaining a second opinion proved impossible because the weekly surgical meeting had already taken place and colleagues would not have been reachable on a Friday evening.

Mr Lamah conceded that he had not reviewed all documentation pertaining to Mr Craig prior to operating.

He characterised his failure to warn the patient that colon removal might become necessary as a technical matter.

Emma Corkill, appearing on behalf of the family, questioned the surgeon regarding his failure to document any discussion of surgical risks with Mr Craig in preliminary statements.

Mr Lamah responded that he could not recall precise particulars but maintained he would have provided a comprehensive explanation.

He recalled presenting two surgical alternatives but acknowledged uncertainty about specific details.

Ms Corkill observed that neither option appeared in his written account and that the addendum completed a year later similarly omitted any reference to presenting multiple surgical choices.

She noted this marked the inaugural occasion such options had been mentioned.

Mr Lamah confirmed this assessment.

Mr Lamah stated that the hazard associated with surgical intervention was considerably lower than the certainty of mortality from the malignancy.

He maintained he acted in his patient’s best interests and with appropriate consent, despite family members not being informed of operative hazards prior to the laparoscopy.

Following tumour examination, he determined removal was appropriate.

In his assessment, the tumour could be safely excised, offering Mr Craig a reasonable prospect of survival and potential cure.

He asserted that abstaining from intervention would have resulted in death.

Ms Corkill countered that the decision properly belonged to Mr Craig.

Mr Lamah disagreed, questioning what purpose would be served by rousing the patient to seek approval.

He stated his clinical assessment led him to conclude cure was unlikely yet possible.

He emphasised that surgical decision-making is nuanced and involves professional judgement regarding patient welfare.

He believed Mr Craig understood the alternatives, accepting either death from the tumour or from the operation itself.

Mr Craig did not receive intensive care monitoring or fluid replacement following the operation before transfer to a general ward.

Mr Lamah stated his view that the surgical procedure bore no relation to Mr Craig’s death, suggesting a coincidental perforated ulcer proved responsible.

No post mortem examination was conducted.

Mr Lamah’s practising privileges were suspended in 2023 when Nuffield Health identified concerns regarding his complication rates.

Figures indicated that during a twelve-month period, one third of his patients experienced moderate harm events.

The expected benchmark for such incidents falls below five percent.

Professor Craig delivered a tribute to her father at the commencement of the two-day hearing.

She depicted him as an independent individual who instilled values of mutual respect.

The grandfather, who had twelve grandchildren and six daughters, was described as unconventional and possessed of considerable wit.

He delighted in sharing anecdotes and reading weekend newspapers.

She reported he counselled his family to perceive the best in others and treat all individuals with dignity.

She expressed gratitude for the lessons he imparted and stated the family’s profound sense of loss.

The inquest remains ongoing.