Surgeon Simon Bramhall has admitted assaulting two patients by marking his initials onto their livers during transplant operations.
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.
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, 53, who appeared in the dock wearing a pink shirt and dark suit, was granted unconditional bail and will be sentenced on 12 January.
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.”
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.
Adjourning the case for a pre-sentence report, Judge Farrer told Bramhall: “For reasons that you are aware of, I am not going to sentence you today.
“The prosecution need to do further work. Your legal team need to do further work in terms of completing the documents that you wish to place before me in due course.”