The trial of two surgeons accused of manslaughter after a patient had the wrong kidney removed in a west Wales hospital, has been told that "the buck stops" with the consultant in charge.

Consultant surgeon Professor John Monson, told Cardiff Crown Court that, in his view, it would be foolish for a consultant not to check which side of the patient should be operated on.

Any sensible consultant knows the buck stops with him

Consultant surgeon Professor John Monson

Korean war veteran Graham Reeves died five weeks after the botched operation at Prince Philip Hospital in Llanelli in January 2000,

During surgery, Mr Reeves's healthy left kidney was removed, instead of the right one which was diseased.

Consultant urologist John Gethin Roberts, 60, and registrar Mahesh Goel, 40, from Burnley, Lancashire both deny the manslaughter charge.

Professor Monson, a general surgeon at East Yorkshire Hospital in Hull, told the court that any sensible consultant knows that the final responsibility for such a matter lies with him or her.

"It is reasonable to assume a registrar would have done the checks on the basis that he should have done them, although that assumption may be a rash one," he said.

"Any sensible consultant knows the buck stops with him."

Graham Reeves: victim of a "fateful chain of events."

The professor denied a question by Kieran Coonan QC, barrister for consultant eurologist John Roberts, that this was an unreal expectation.

He added that, as a consultant himself, he would not accept the word of even the most trusted registrar.

On Wednesday, the jury heard that Mr Roberts put his head on a desk and said "oh God" after learning that the wrong kidney had been removed from Mr Reeves.

The court heard that Mr Roberts, of Ty Coch in Swansea - responsible for overseeing the kidney removal - later performed a second operation on the patient despite being told not to by Carmarthenshire NHS Trust's director.

Second operation

The nurse then explained that during a subsequent conversation with Dr Peter Thomas - the NHS Trust Director - Mr Roberts was told not to perform any more surgery on Mr Reeves.

But, the jury was told that later that afternoon, Mr Roberts did perform another procedure on Mr Reeves, inserting a tube into the remaining kidney.

Prosecuting, Leighton Davies QC claimed that second operation must have subjected the patient to "substantial stress" and he later developed cardiac and breathing problems.

The jury had already been told that Mr Goel did not check the patient's notes properly before the operation and so began a "fateful chain of events".

Mahesh Goel denies the manslaughter charge

Retired pipe lagger and bachelor Mr Reeves underwent the operation because he was suffering a stone in his right kidney.

Two hours after that operation, the blunder came to light when the patient was unable to pass urine.

He was transferred to Morriston Hospital the following day where he underwent specialist dialysis.

But Mr Reeves went on to develop septicaemia - blood poisoning - and his condition deteriorated and his diseased kidney then had to be removed.

The trial continues.