UK Edition
Surgeon admits marking his initials on patients' livers during transplant ops
A surgeon has admitted burning his initials into the livers of two transplant patients with a laser beam.
Consultant Simon Bramhall, 53, branded "SB" on the organs of a man and a woman undergoing transplant operations.
On Wednesday, he admitted two counts of assault by beating at Birmingham Crown Court but pleaded not guilty to alternative charges of assault occasioning actual bodily harm.
Liver surgeons use an argon beam to stop livers bleeding, but can also use the beam to burn the surface of the liver to sketch out the area of an operation.
It is usually not harmful and the marks would normally disappear.
But the female patient's liver did not heal itself in the normal way and the initials were found in a follow-up operation, it is alleged.
After Bramhall's pleas were entered, prosecutor Tony Badenoch QC said the Crown accepted the medic's not guilty pleas in a case which was "without legal precedent in criminal law".
Bramhall, who appeared in the dock wearing a pink shirt and dark suit, was granted unconditional bail and will be sentenced on January 12.
Judge Paul Farrer allowed Bramhall to stand in front of the dock, in the well of the court, as the surgeon pleaded guilty to assaulting a patient whose name is protected by a court order during an operation in August 2013.
He also entered a guilty plea relating to an operation performed on an unknown patient in February of the same year.
Addressing the court after the pleas, Mr Badenoch said: "This has been a highly unusual and complex case, both within the expert medical testimony served by both sides and in law.
"It is factually, so far as we have been able to establish, without legal precedent in criminal law."
The barrister added that Bramhall was employed as a consultant surgeon in Birmingham at the time of the transplant operations and that both patients had been under anaesthetic.
"The pleas of guilty now entered represent an acceptance that that which he did was not just ethically wrong but criminally wrong," Mr Badenoch told the court.
"They reflect the fact that Dr Bramhall's initialling on a patient's liver was not an isolated incident but rather a repeated act on two occasions, requiring some skill and concentration. It was done in the presence of colleagues."
Bramhall was a liver, spleen and pancreatic surgeon who worked at the liver unit within the Queen Elizabeth Hospital in Birmingham, West Midlands, for 12 years.
He was also involved in tutoring and examining medical students and supervising postgraduate students in higher degrees, management and research.
Describing the offences as an abuse of position, Mr Badenoch said they had been carried out with a disregard for the feelings of unconscious patients.
The prosecutor said of the assaults: "It was an intentional application of unlawful force to a patient whilst anaesthetised.
"His acts in marking the livers of those patients were deliberate and conscious acts. "Suffice to say, for current purposes, these pleas meet the broad public interest.
"It will be for others to decide whether and to what extent his fitness to practise is impaired."
The offence of assault by beating was brought against Bramhall to reflect the act of marking the liver and there is no suggestion that he was responsible for physically "beating" either patient.
Crown Prosecution Service specialist prosecutor Elizabeth Reid said: "Simon Bramhall was a respected surgeon who assaulted two of his patients while they were undergoing surgery.
"It was an intentional application of unlawful force to a patient whilst anaesthetised. His acts in marking the livers of those patients, in a wholly unnecessary way, were deliberate and conscious acts on his part.
"Those assaults were wrong not just ethically, but also criminally. It was an abuse of the trust placed in him by the patients."