A surgeon used a Swiss army knife to open up the chest of a patient in cardiac arrest because he claimed he could not find a sterile scalpel.

The patient, treated at Royal Sussex County Hospital in Brighton in December 2023, survived, but the BBC has reported that internal documents show how colleagues felt the surgeon’s behaviour was “questionable” and were “very surprised” he was unable to find a scalpel.

The NHS trust that runs the hospital, University Hospitals Sussex NHS Foundation Trust, said the patient was due to have an emergency operation but went into cardiac arrest before going into theatre which meant life-saving care was needed.

The trust’s chief medical officer, Professor Catherine Urch, said: “In December 2023, a patient due to have an emergency operation went into cardiac arrest before going into theatre, and as a result needed immediate, life-saving care.

The surgeon involved reported the incident, and together with the wider team they have reviewed what happened, to learn lessons

“The patient’s life was thankfully saved as a result of the actions of the surgical team, but everyone involved has accepted that those actions taken in the moment were outside normal procedures, and should not have been necessary.

“The surgeon involved reported the incident, and together with the wider team they have reviewed what happened, to learn lessons.

“The patient was fully informed as part of our commitment to duty of candour, and the team rapidly made changes as a result, as well as sharing their learning with colleagues at patient safety meetings.”

The BBC also reported that the same surgeon who used a Swiss army knife, who the broadcaster did not name, carried out three operations where the patients died soon afterwards.

The Care Quality Commission found there was no breach in regulations over the deaths, the BBC added, but investigations carried out by the trust raised “themes for improvement”.

Prof Urch said: “Our investigations did not raise concerns about the surgeries themselves but did identify common themes for improvement, which we acted on immediately to ensure our services are as safe as possible.

“These included better communication with patients before and after surgery, improved training for end-of-life care, and strengthened processes, especially when care is transferred from one site to another.”

It comes as Sussex Police are investigating allegations of medical negligence at the trust between 2015 to 2021, relating to neurosurgery and general surgery at the Brighton hospital.

Claims of medical negligence were made by two consultant surgeons who lost their jobs after blowing the whistle about patient safety, The Guardian previously reported.

A Sussex Police spokeswoman said: “A number of cases from within the specified NHS departments and during the specified time period have been assessed and are forming part of the ongoing investigation.

“A dedicated team of specially trained officers are in contact with those patients or families of patients whose cases are included in the investigation and providing information to support them while the investigation is ongoing.

“We are working closely with partner agencies and the University Hospitals Sussex NHS Foundation Trust is co-operating fully with our investigation.”

This case involving the surgeon using his own penknife is absolutely appalling

Nisha Sharma, principal lawyer at Slater and Gordon, who is acting for patients and families in cases of poor standards of care at the Royal Sussex, said: “For months, we have been shocked by ongoing details emerging from the Royal Sussex, but this case involving the surgeon using his own penknife is absolutely appalling.

“The facts that are being uncovered about practices at this hospital are genuinely shocking to the community – people living in Brighton rely on the Royal Sussex for their own care and that of their families, and this is yet another reason for them to be deeply concerned.”

Trust chief executive Dr George Findlay said he wanted to reassure patients and staff that thorough investigations took place and action was taken when necessary to make sure lessons were learnt.

“If we ever fall short of the standards people have a right to expect, then we are open, honest, and move swiftly to make improvements,” he said.

“Our trust faces a number of long-standing challenges, and our teams are working hard to address them.

“I am proud of the progress they have made and they will be supported to make the further improvements we know are necessary.”