A surgeon who carries out radical bladder cancer surgery has told an inquest in Bradford he has changed his procedures following the death of a patient after an operation.

Bradford Royal Infirmary consultant Sanjai Addla said he requests CT scans earlier if he cannot explain why a patient is not improving.

And he also gives bladder cancer patients like 60-year-old Jean McGann, who died, the choice of surgery or drug treatment when first diagnosed with the superficial but aggressive kind of tumours that were found in her case.

The inquest yesterday heard how standard practice differs from hospital to hospital but in Bradford, the usual option at that first diagnosis stage was to treat the cancer with drugs.

In the case of Mrs McGann, of Broomfield, Clayton, the drugs seemed to have worked at first but then the cancer re-appeared and, after having had the risks explained to her, Mrs McGann chose to go ahead with radical pelvic clearance and have a stoma fitted which she hoped would give her a few more years of quality life.

At first she appeared to recover well but about a week later deteriorated.

Mr Addla said: “She just looked unwell, pale, we could not understand why. The operation was straight forward. We could not put our finger on what was happening. Her blood tests were normal, she just looked washed up.”

He said he checked on her about three times a day. She would respond to treatment and then get worse again. He finally requested a CT scan and as a result she was taken to theatre again to have the piece of bowel used to reconstruct her urinary tract removed.

Mr Addla, who has carried out more than 120 of the procedures, said Mrs McGann had so much cancer that her blood was clotting and he believed it was those clots that had stopped blood going from the piece of bowel they had made a stoma from, making it engorged. “We did what we could and hoped she had enough immunity to fight the infection she had,” said Mr Addla, who explained bacteria would have got into her bloodstream.

He said Mrs McGann’s death had affected him “immensely” but he was not sure if doing a CT scan any earlier would have changed anything.

About 15 to 20 per cent of patients have three to five years’ survival after such radical surgery. About one in three of patients having their bladder removed experience complications.

Recording a verdict that Mrs McGann died as a result of a recognised complication of a surgical procedure, Assistant Deputy Coroner Tim Ratcliffe said: “I’m satisfied the care given to Jean was appropriate and Mr Addla did the right things, not to say with benefit of hindsight he would not have done other things.”