A SURGEON removed a knife from a patient's heart, possibly causing his death, without warning the anaesthetist, an inquest has heard.

Consultant John Gordon Stephen, 63, was heard to say, "I think we should remove the knife and see what happens," before doing just that.

Anaesthetist Ryan Hynd said that within 20 seconds Alan Dunn's pulse dropped severely and he arrested within a minute.

"I thought he was asking a question, but by the time I stood up he had taken the knife out," Dr Hynd told the inquest at Chester-le-Street Magistrates' Court, yesterday.

It was Dr Hynd's responsibility to monitor Mr Dunn's blood pressure, pulse and breathing, on the morning of December 10, 2005, at Darlington Memorial Hospital.

Mr Dunn, a 60-year-old hospital porter and former miner, had stabbed himself in the chest in an apparent suicide attempt at his home in Barrington Terrace, County Durham.

Mr Stephen, of The Willows, Bishop Auckland, was the surgical consultant on call for the County Durham and Darlington Acute Hospital NHS Trust.

"If he said he wanted to remove the knife, I would have said we needed to take him to theatre to do that, which would have taken 20 to 30 minutes to prepare," said Dr Hynd.

"Even if nothing had happened when the knife was removed, we still need to know because the patient would have to go to intensive care and we would need to prepare for that."

Dr Hynd was one of five doctors who observed the knife moving in time with Mr Dunn's heartbeat - evidence it was still embedded in the heart.

Established practice in such an event is to stabilise the patient and transfer them to the closest cardiothoracic unit, which is The James Cook University Hospital, Middlesbrough.

Consultant anaesthetist Roger Drummond also observed the knife moving, but said the injury was "unsurvivable" despite Mr Dunn having survived and hour-and-a-half already.

Dr Drummond agreed Mr Dunn was relatively stable at the time but said he could have arrested at any moment without intervention.

"It was an extremely difficult situation for Mr Stephen to deal with," said Dr Drummond. "I felt that the patient was in a very precarious situation with the knife in his heart. He could have bled to death or his heart could have been suffering further trauma as it beat against the knife.

"I felt it was extremely risky to subject Mr Dunn to a transfer to James Cook," he said.

The inquest continues today.