A FAMILY'S four-year wait for an inquest into the death of their 33-year-old daughter after a routine tonsil operation ended yesterday.

The surgery on Elaine Basham, who suffered from Down's syndrome, involved the use of disposable surgical instruments, introduced amid fears the conventional, re-usable steel types could spread the human form of mad cow disease.

It is expected the inquest, which is being held before a jury because of the concerns over public safety, will shed light on whether Government medical advisors were right to tell surgeons to use the disposable instruments.

Yesterday, Miss Basham's mother, Julie, and her three sisters listened as the Government official responsible for that advice gave evidence on the first day of the inquest in Middlesbrough.

Professor Pat Troop, who was deputy chief medical officer at the time, advised surgeons in England and Wales to switch to the single-use instruments to minimise the risk of patients catching variant Creutzfeld-Jakob Disease (vCJD).

That was withdrawn a month after Miss Basham's death, after Department of Health officials concluded there was a greater risk of increased haemorrhaging.

Miss Basham, of Loftus, east Cleveland, died in November 2001 at the former North Riding Infirmary, in Middlesbrough.

Earlier, Home Office pathologist Dr James Sunter said that a post-mortem examination on Miss Basham revealed that the cause of death had been multiple organ failure following haemorrhage, complicated by cardiac arrest.

Reading from a statement, Prof Troop, now chief executive of the Health Protection Agency, said she first became involved in discussions about the risk of CJD transmission through tonsil surgery in 1999.

She said after meeting vCJD experts she advised ministers to tell surgeons not to switch to single-use instruments.

At the same time, she ordered a £300m drive to improve decontamination facilities in NHS hospitals.

Asked by the coroner, Michael Sheffield, whether the decision to introduce disposable surgical instruments was political, she said: "No, I would not be party to a public health decision which I didn't think was in the interests of public health."

Under examination from Mr Richard Follis, representing the Basham family, Prof Troop agreed that no case of vCJD transmission through surgical instruments had ever been proved.

But Prof Troop pointed out that when her policy was being formulated, there was talk of an epidemic claiming up to 250,000 lives.

The inquest continues.