A pathologist has told a south Wales court that there were three separate factors behind the death of a patient who had the wrong kidney removed in a botched operation.

A heart attack, a respiratory failure and a series of three operations were the reasons, according to Home Office expert Andrew Davison.

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

Dr Davison was giving evidence at Cardiff Crown Court in the trial of two surgeons accused of manslaughter.

Korean War veteran Graham Reeves, 70, died five weeks after the bungled operation at Llanelli's Prince Philip Hospital, during which his healthy left kidney was removed during removal of a stone and his disease.

Consultant urologist John Gethin Roberts, 60, and registrar Mr Goel, 40, from Burnley in Lancashire, are on trial for manslaughter, but both deny the charge.

According to Dr Davison, the first of three factors was the fact that Mr Reeves had suffered a heart attack 12 hours or more before his death.

Secondly, he had developed Adult Respiratory Distress Syndrome (Ards) which meant his lungs were filled with fluid.

Mahesh Goel denies the manslaughter charge

After the operation, the jury has heard how Mr Reeves then went through two further operations in a bid to improve his condition.

According to the pathologist it was not possible to say that one of the factors had caused the others - they were all interlinked.

"The operations were relevant to lowering Mr Reeves' blood pressure," said Dr Davison.

"They also provided a possible site of entry for infection.

"Being in hospital and intensive care increase the risk of infection - there are germs present in the atmosphere," he added.

The incident has previously been called a "fateful chain of events."

'The buck stops'

The court had previously heard earlier that junior surgeon Mahesh Goel was incompetent in removing the wrong kidney.

Earlier Thursday, the trial heard from another surgeon, Professor John Monson of East Yorkshire Hospital.

He told the court the system of safety checks at Prince Philip Hospital had failed "all the way along the line," though every system had the "potential for failure."

He said it was reasonable to assume a registrar, such as Mr Goel, would have carried out required checks.

But, he said, "the buck stops" with the consultant in charge.

The trial continues at Cardiff Crown Court.