A breast cancer surgeon accused of carrying out “unnecessary” operations on patients has told court his patients’ notes went “missing” and denied claims he had not made records.

Ian Paterson, 59, also told Nottingham Crown Court that he had ripped up or shredded second opinions provided for his cancer patients.

Mr Paterson, who was employed by Heart of England NHS Trust and also practised at Spire Healthcare, denies 20 counts of wounding with intent, linked to procedures he carried out on nine women and one man between 1997 and 2011.

The jury has previously heard claims he carried out “unnecessary” procedures on patients for “obscure motives”, such as boosting his reputation or income – claims he denies.

Addressing court this week, Mr Paterson described how copies of notes taken during clinical meetings with other medical experts for his patients would be shredded.

He claimed a breast cancer nurse would also take notes in “a series of diaries” but added it was “interesting that those seem to have gone missing”. When asked what would be found in those missing diary notes, he reportedly said: “Find the diaries and I’ll show you”.

Mr Paterson denied suggestions he “put a spin” or “gloss” on patients’ diagnoses and when the prosecution suggested notes could not be found because none had been made, the surgeon
replied: “That’s not true”.

The jury has also heard prosecution expert evidence from two consultants who suggested a different approach could have been taken for Paterson’s alleged victims.

The surgeon, who is now based in Altrincham, responded by saying: “To be honest, I don’t disagree with most of what they’ve said, but it’s important to remember that these experts in this case conducted a paper exercise.

“They did not interview these patients, they did not examine these patients, there’s no way for them to reproduce the conditions in which I saw each of those patients in a consulting room.”

He also said practices and understanding of breast cancer causes had changed.

The trial continues.

Thompsons Solicitors is representing many of Paterson’s patients in civil cases.