We trust doctors with our lives and often remember some of them for as long as we draw breath. But how would any of us feel if branded with the initials of a physician who has saved our life, and branded on the inside at that? A renowned English surgeon literally left his mark on the livers of two patients he operated on in 2013 and is now awaiting his verdict on charges of assault by beating. Simon Bramhall, 53, has pleaded guilty to the charges in a case without precedent in the British criminal justice system.

Bramhall carved “SB” on livers he transplanted into one male and one female patient at the Queen Elizabeth hospital in Birmingham, where he worked for 12 years before handing in his resignation in 2014. He might have gotten away with the deed if a colleague hadn’t noticed the initials while performing a follow-up operation on the female patient. They were left by an argon beam, which surgeons use to stop bleeding during liver operations. The harmless marks left by the beam usually disappear after a while, but in this case the tell-tale signs were still in place at the time of the follow-up surgery, and Bramhall was exposed, becoming the subject of an internal disciplinary investigation.

While prosecutors have more work to do, the surgeon pleaded guilty this week to two counts of assault by beating. The phrasing merely reflects the fact that he marked the livers and does not suggest Bramhall actually beat the patients. He pleaded not guilty to accompanying charges of causing bodily harm. The names of the two patients have been kept confidential.

“The pleas of guilty now entered represent an acceptance that that which he did was not just ethically wrong but criminally wrong. 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,” prosecutor Tony Badenoch said in court.

Badenoch went on to add: “It was an intentional application of unlawful force to a patient whilst anesthetized. 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.”

 

However, a former patient of Bramhall’s has come out in his defense. The surgeon made headlines in 2010, when he successfully transplanted a liver into Tracy Scriven. The noteworthy thing was that the organ came from the victim of a plane crash. Speaking to the Birmingham Mail, Scriven had the following to say:

“Even if he did put his initials on a transplanted liver, is it really that bad? I wouldn’t have cared if he did it to me. The man saved my life.”

Bramhall is out on unconditional bail and will hear his verdict next month.