A breast surgeon who carried out unapproved mastectomies was a “nightmare” to work with, an inquest heard.

Consultant surgeon Ian Paterson was jailed for 20 years in 2017 after being convicted of 20 counts of wounding.

More than 60 inquests have already been opened into the deaths of his former patients since July 2020.

Giving evidence on Wednesday, one of Paterson’s former colleagues and a consultant radiologist at Solihull Hospital, Dr Chris Fletcher, said the pair had a “frosty” relationship at times.

Speaking at the inquest of 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.

Ms Turbill was subjected to a so-called cleavage-sparing mastectomy by Paterson, where part of the breast is left in place but the risk of cancer returning was increased.

She later died of metastatic cancer.

Dr Fletcher told Birmingham and Solihull Coroners Court that reviewing mammograms from Paterson’s patients made up at least “90%” of his workload at both the NHS and also privately at Spire hospitals.

He said their relationship was “complex” and “difficult” because of the way Paterson worked and he ended up making a complaint about him.

“He was a nightmare,” he said.

“He was quite aggressive and quite demanding in a way I had never come across before.”

He said multidisciplinary meetings between NHS colleagues to discuss the treatment of their patients were “always difficult”.

“[Paterson] always tried to run the show,” Dr Fletcher said.

“We had a period where he was flooding me with work and I was struggling to cope.”

Their relationship deteriorated further after Dr Fletcher signed a letter, alongside other colleagues, raising concerns about Paterson.

The medical professional said he initially believed the jailed surgeon was just an “efficient and competent surgeon”.

But he started to become concerned with the way he was carrying out mastectomies when he discovered a tumour on a patient’s mammogram that Paterson had missed when operating on them.

“He had been arrogant and just done what he wanted to do and hadn’t looked at the mammogram,” he told the inquest.

“We were all a bit shell-shocked and embarrassed by that.

“Nobody ever flagged it as perhaps it should have been flagged.”

On 21 October, Judge Richard Foster ordered Paterson to give evidence at all 62 inquests after his legal team applied to have a witness summons instructing him to give evidence revoked.

Paterson agreed to give evidence remotely from prison at Mrs Turbill’s inquest on Thursday.

The first inquest, considering the death of Chloe Nikitas, 43, was adjourned on 24 October to a date yet to be set.

Mrs Turbill’s inquest continues.