A surgeon who admitted burning his initials on to the livers of two unconscious transplant patients has been sentenced to a 12-month community order, 120 hours’ unpaid work and a £10,000 fine.
Simon Bramhall used an argon beam machine to “write” on the organs of two anaesthetised victims in February and August 2013 while working at Birmingham’s Queen Elizabeth Hospital.
A judge at the city’s Crown Court said Bramhall, who resigned from the hospital in 2014, had carried out an “an abuse of power and a betrayal of trust”.
The 53-year-old admitted two counts of assault by beating at Birmingham Crown Court last month after prosecutors accepted his not guilty pleas to charges of assault occasioning actual bodily harm. He was given a formal warning by the General Medical Council (GMC) last February.
The Crown Prosecution Service (CPS) said Bramhall marked his initials on the patients’ livers without their consent “for no clinical reason” using a medical instrument designed to seal bleeding blood vessels.
Judge Paul Farrer QC 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.”
Opening the facts of the case against Bramhall, prosecutor Tony Badenoch QC said one of the two victims initialled by the world-renowned surgeon had been left feeling “violated” and suffering ongoing psychological harm.
Acknowledging that Bramhall’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.”
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. But 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 Patient A’s liver.
A nurse who saw the initialling queried what had happened and Bramhall was said to have replied: “I do this.”
The court heard that Bramhall later told police he had “flicked his wrist” and made the mark within a few seconds.
“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,” Mr Badenoch said
The offence of assault by beating was brought against the consultant surgeon to reflect the act of marking the liver and there is no suggestion he was responsible for physically “beating” either patient.
The charges were brought more than three years after Bramhall was suspended by the University Hospitals Birmingham NHS Foundation Trust.
Medical experts have previously said that the “burning” of organs using the argon beam process would not have caused damage to health or affected clinical outcomes for patients.
Additional reporting by PA