A surgeon at a crisis-hit NHS trust used a Swiss Army penknife to open up the chest of a patient because he claimed he could not find a sterile scalpel.

University Hospitals Sussex has said the operation was an emergency, but the surgeon’s actions were “outside normal procedures and should not have been necessary”.

Prof Graeme Poston, an expert witness on clinical negligence and a former consultant surgeon, told the BBC: “It surprises me and appals me. Firstly, a penknife is not sterile. Secondly it is not an operating instrument. And thirdly all the kit [must have been] there."

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The surgeon in the penknife case, who the BBC is not naming, was operating on a patient at the Royal Sussex Hospital in Brighton when he struggled to find a scalpel.

Instead he used a Swiss Army knife which he normally used to cut fruit for his lunch.

The patient survived but internal documents show the surgeon’s colleagues felt his behaviour was “questionable” and were “very surprised” he was unable to find a scalpel.

The BBC has also discovered the same surgeon carried out three supposedly low-risk operations in two months where all three patients died soon after.