Surgeon who carved his own initials into patients' livers is spared jail

A surgeon who carved his initials on to two patients’ livers during transplant operations has been spared jail but fined £10,000.

Consultant surgeon Simon Bramhall was also sentenced to a 12-month community order at Birmingham Crown Court for assaulting the two patients by burning his initials on to their livers.

The 53-year-old used an argon beam machine to “write” his initials on the organs of two anaesthetised victims in February and August 2013 while working at Birmingham’s Queen Elizabeth Hospital

The consultant, who was given a formal warning by the General Medical Council (GMC) last February, admitted two counts of assault by beating last month after prosecutors accepted his not guilty pleas to charges of assault occasioning actual bodily harm.

Judge Paul Farrer QC, who also sentenced Bramhall to 120 hours of unpaid work, accused the surgeon of “an abuse of power and a betrayal of trust”.

Abuse of power – the judge said Bramhall had betrayed his patients’ trust (Pictures: PA)

He said: “Both of the (transplant) operations were long and difficult. I accept that on both occasions you were tired and stressed and I accept that this may have affected your judgment. This was conduct born of professional arrogance of such magnitude that it strayed into criminal behaviour.

“What you did was an abuse of power and a betrayal of trust that these patients had invested in you. I accept that you didn’t intend or foresee anything but the most trivial of harm would be caused.”


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Outlining the facts of the case, prosecutor Tony Badenoch QC said one of Bramhall’s two victims had been left feeling “violated” and suffering ongoing psychological harm.

Acknowledging that the world-renowned surgeon’s  actions had not caused either patients’ new liver to fail, Mr Badenoch said: “This case is about his practice on two occasions, without the consent of the patient and for no clinical reason whatever, to burn his initials on to the surface of a newly-transplanted liver.”

Fine – Bramhall was fined £10,000 at Birmingham Crown Court but was spared jail

One of the victims, referred to in court as Patient A, received a donor organ in 2013 in a life-saving operation carried out by Bramhall. The donor liver failed around a week later – for reasons unconnected to its implantation – and another surgeon spotted Bramhall’s initials on the organ.

A photograph of the 4cm-high branding was taken on a mobile phone and Bramhall, who now works for the NHS in Herefordshire, later admitted using the argon beam coagulator to mark the liver.

Mr Badenoch said Bramhall had to “work exceptionally hard and use all of his skill” in the initial transplant operation and when he performed a liver biopsy using the argon beam coagulator at the end of the surgery, he also used it to burn his initials onto the organ.

A nurse who saw the initialling queried what had happened and Bramhall was said to have replied: “I do this.”

Mr Badenoch said: “He knew that the action could cause no harm to the patient. He also said that in hindsight this was naive and foolhardy – a misjudged attempt to relieve the tension in theatre.”

Birmingham’s Queen Elizabeth Hospital said in a statement: “The Trust is clear that Mr Bramhall made a mistake in the context of a complex clinical situation and this has been dealt with via the appropriate authorities, including the Trust as his then employer.

“We can reassure his patients that there was no impact whatsoever on the quality of his clinical outcomes.”