Conflicting medical theories surround the death of a man who passed away after two operations on his foot, an inquest heard.
Lee Madgin, the brother of murder victim Samantha Madgin, went under the knife in 2017 to repair an agonising heel injury he had suffered after falling off a roof in 2014.
An inquest at Newcastle Civic Centre heard Lee, 31, had been left with severe pain and deformity in his left foot after the 25-foot drop.
Orthopaedic surgeon Malik Siddique said he met with Lee two years after his accident and was told he was "no way happy to live in the condition he was in".
He told the inquest: "He had worked offshore and he was very keen to get back to work."
Lee underwent surgery on his foot on March 30 2017, and had a further operation on May 4 after being re-admittted to the Freeman Hospital in Newcastle .
But the inquest heard that just as he was preparing to go home, Lee took a dramatic turn for the worse on May 11, and died a week later.
However the cause of his dramatic deterioration has remained a mystery, and the inquest heard conflicting theories from doctors as to what triggered it.
It was said a pathologist's report concluded Lee had an infection in his heel, but Mr Siddique disagreed, saying, "It's not osteomyelitis."
Mr Siddique said surgeons found no sign of infection in the bone during the first operation, when they reconstructed Lee's heel.
He told the inquest he had been "upset" to see Lee out of bed in hospital so soon after the surgery, but said he was still well enough to be discharged on April 5 2017.
Lee was admitted to hospital again a week later saying he had had "two falls at home and was in a lot of pain".
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Mr Siddique said he decided to keep Lee in hospital because he was a "non-compliant patient", and he wanted to keep an eye on him.
He told the hearing Lee's wound was healing and he was ready to go home when he became very unwell on May 20.
Mr Siddique said: "His hands were curling up, his knees were curling up, he was shaking, his face was very red - I’ve never seen him like that, he was a very healthy man.
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"I was completely shocked. I ran tests again but nothing was coming up.
"We didn’t have a clue what was happening. It was like his system had been hit by something."
Coroner Paul Dunn told the witness: "Your opinion was that it wasn’t to do with the bone or the wound, but you weren’t able to say what it actually was.
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"You don’t believe he had an infection in the area you were treating."
Mr Siddique replied: "I know he was ready to go home, his wound was healing, I can’t find a clinical reason his body reacted so badly to something."
He added: "If you see Lee Madgin once you will never forget him, we became quite close.
"To see him go downhill so quickly was very upsetting."
Mr Siddique said he believed Lee may have had immunosuppression - a reduction in the efficacy of the immune system - but the inquest heard this was "a general opinion rather than from any specific tests".
He also mentioned the fact that Lee had eaten a burger handmade by his dad the day before he got ill, but the family's representative said "if he didn’t have vomiting or diarrhoea he probably didn’t have gastrointestitis".
Dr Suzanne O'Neill, consultant in anaesthetics and intensive care, said she believed he had sepsis at the time of his death.
Lee's death was a second tragedy for the family after the tragic murder of his sister Samantha in 2007.
Samantha, 18, was stabbed Samantha to death in a Wallsend alleyway by teen killer Jordan Jobson.
Jobson had never met her 18-year-old victim before their paths crossed by chance. But after a disturbance broke out, Jobson armed herself with a knife and stabbed Samantha repeatedly.
Jobson was originally handed a minimum jail term of 15 years. But after two separate appeals that was reduced to 11.
Following the pre-inquest review last year, their mum Alison said: "Lee really missed Samantha and I have to think that they are back together now and they are smiling with each other. That is the way I have to think."
The inquest, scheduled to last two days, continues.
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