DEC 18, 2017 2:52 PM PST

Surgeon Branded Patients' Livers with His Initials


Image credit: FA Video/PA Wire/AP

Simon Bramhall, a previously successful British surgeon, must have felt God-like when he etched his initials “SB” onto the livers of two of his patients. This despicable act could be the last time Bramhall will be allowed near patients.

In 2013, Bramhall was involved in operations for two liver transplant patients. Using a device called an argon beam coagulator, normally intended to stop bleeding and resect organs, Bramhall marked his initials on the patients’ transplanted livers.

The argon beam works by creating a stream of argon gas through which an electrical current flows. This combination creates a superficial “char” on the organ surface, explained Dr. Dmitri Alden, a surgical oncologist at Lenox Hill Hospital in New York City, who was not involved with the case. The scarring effects of the argon beam usually disappear as the organ heals.

But, unlucky for Bramhall, one of his patients developed complications and required a follow-up operation. It was during this second procedure that Bramhall’s colleagues discovered his dirty secret, still fresh on the patient’s organ.

After admitting his “handiwork” on both patients, Bramhall was suspended in 2013, and later resigned from his position at Queen Elizabeth Hospital in Birmingham in 2014.

He was charged, and plead guilty, to two counts of assault by beating, a term which relates to his use of the argon beam to initial the organs. He plead not guilty to charges of assault by actual bodily harm.

"This has been a highly unusual and complex case, both within the expert medical testimony served by both sides and in law,” said Tony Badenoch, a prosecutor on the case. "It is factually, so far as we have been able to establish, without legal precedent in criminal law."

"The pleas of guilty now entered represent an acceptance that that which he did was not just ethically wrong but criminally wrong," said Mr. Badenoch to the court. "They reflect the fact that Dr. Bramhall's initialing 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."

Crown Prosecution Service  specialist prosecutor Elizabeth Reid added: "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."

Currently free on bail, Bramhall will be sentenced on January 12.

About the Author
  • I am a human geneticist, passionate about telling stories to make science more engaging and approachable. Find more of my writing at the Hopkins BioMedical Odyssey blog and at
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