The death of an elderly cancer patient may have been hastened by a fall from her hospital bed in which she broke her leg, the Coroner's Court heard yesterday. The fall and an operation to set the bones could have speeded up the spread of cancer cells into the blood vessels of Chan Wun-sik, 74, the inquest into her death was told. Chan died in Princess Margaret Hospital on July 21 last year, the day after the operation. The court heard she fell out of bed while using a bedpan in the early hours of July 19, breaking her right leg. The operation on July 20 went smoothly but her condition suddenly deteriorated the following morning with acute breathing difficulties, abdominal pain and low blood pressure. Pathologist Ng Wai-fu said the autopsy report showed the direct cause of Chan's death was the spread of medullary thyroid cancer and disseminated intravascular coagulation - formation of clots in the blood vessels throughout her body. The cancer was found to have already spread to other parts of the body including both sides of the liver, adrenal glands, right thigh bone, lung and uterus. Mr Ng said the cancerous cells might have already spread to Chan's blood vessels by the time she was admitted to hospital on July 3, due to her low blood platelets. But he said the fall and the operation might have helped the cancer cells proliferate in her blood vessels, hastening her death. Orthopaedic specialist Wong Hing-cheong, who performed the operation, said the hospital's geriatric department had assessed Chan and found her suitable for the surgery. Chan's son told the inquest his mother was left on the floor for some time after she fell at 3am. Chan Kwok-man said his mother told him she was left on the floor until a hospital cleaner found her, but he could not say how long she had been left there. Chan's attending doctor, Victor Hung Hin-fai, said that in the clinical record, Chan was marked as having fallen from her bed at 5.45am on July 19. The inquest continues today before the coroner, Michael Chan Pik-kiu.