Surgeon Laser Etches His Initials into Liver in Transplant Patients

Medical Justice solves doctors' complex medico-legal problems.

Learn how we help doctors with...

Let’s start at the end. You kind of know how this ends.

Dr. Simon Bramhall, a liver transplant surgeon in the UK, pleaded guilty to two counts of assault by beating. He pleaded not guilty to the more serious charge of assault occasioning actual bodily harm. Prosecutors accepted his plea and he is scheduled for sentencing on January 12th.

In 2013, colleagues discovered Bramhill had been initialing his patient’s organs. Doctors first spotted the initials SB on the liver of one of his transplant patients during follow-up surgery. Then they found another patient with the same initials.

Bramhill was suspended in 2013 and resigned the following year from the hospital where he had privileges.

Earlier this year, the General Medical Council issued Bramhall a formal warning, saying at the time that Bramhall’s case “risks bringing the profession into disrepute, and it must not be repeated.”

Here’s how he did his handiwork. Not with a Montblanc. He used an argon beam laser (otherwise used to coagulate oozing during a transplant). Doctors who were part of the investigation did not believe any patient suffered any harm.

Still, prosecutor Elizabeth Reid said that the organ signing amounted to a criminal abuse of trust, “It was an intentional application of unlawful force to a patient whilst anesthetized,” she said. “His acts in marking the livers of those patients, in a wholly unnecessary way, were deliberate and conscious acts on his part.”

One person who thinks this is much ado about nothing. One of the doctor’s liver transplant patients, Tracy Scriven.

“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,” she added. “The man saved my life.”

I do understand the sentiment that many patients might feel violated. But, it’s hard for me to believe that this surgeon may be sentenced to prison time. There are not many liver transplant surgeons in the UK and if one is removed from the pool, some unfortunate patients may spend more time on the transplant waiting list. And that would truly be tragic.

What do you think? Share your comments below.

12 thoughts on “Surgeon Laser Etches His Initials into Liver in Transplant Patients”

  1. Willie White was a plastic surgeon in Pittsburgh for many years. Mostly he did hand surgery. But he used to say that he signed his initials in all his patients; WWWWWWW.

    Nobody minded. And you could actually see some of his–not much since his technique was quite excellent. But some.

  2. If something like this is discovered it should be brought to the attention of the attending physician and he should be asked to stop it so as to maintain the trust of our patients. However, I don’t see the need for punishment. Much like a child that acts out, sometimes a helpful question might bring other things to light. Perhaps this doc is stressed out, burnt out, or doesn’t get recognized adequately for the hard work he does.
    Just like we don’t like tagging on walls on the streets, it’s fair to assume that we should minimize organ graffiti. But not every single action requires a punishment that involves fines and jail time.

  3. This is NOT something to which patients consented and therefore IS violation. Beyond that though (and I speak from a theologically grounded medical ethics perspective)–the surgeon’s actions are dehumanizing, smacking of branding another human being’s living. breathing unique body part with the surgeon’s permanent signature. There is no benefit to the patient-only to the surgeon’s ego. Using another person’s body–without consent– solely to satisfy one’s own needs or desires is narcissistic and abusive–and to me, an assault. Count me in the “inexcusable” camp.

  4. Poor Simon. Whoever advised him to plead guilty to “assault by beating” should be disbarred. The surgeons who brought this to light are guilty of jealousy, and coveting their colleague’s art – two of the seven deadly sins.

  5. I find it disturbing that there is only one dissenting opinion above. This person has been using other people for his own gratification. Period. What can be forgivable, justifiable, or respectable about that?

  6. Yeah, I guess he should not go to jail or have his license pulled.

    It’s just that I expect MORE from people granted the special privilege of being a doctor.

    Michael M. Rosenblatt, DPM

  7. Marking a transplanted liver to make it appear specific to a surgeon and his technique for others during reexploration may be smart. There is nothing dehumanizing about this. I don’t think it’s an Inflated surgeon’s ego issue. At worst a small effort before closing the abdomen. This issue is to the detriment of Simon’s patients, and those in need of a liver in the UK.

  8. This certainly is detrimental to renal patients everywhere: his thuggery and sophomoric pranks remove the honor and prestige associated with the profession thus reducing the pool of acolytes. “Making his technique apparent” can be more completely accomplished with a records request, not a branding. There is no medical, legal or ethical reason to allow his actions to continue or to excuse his past behavior.

  9. Seem to me to be disrespectful to the patient to do this. This amounts to nothing more than arrogance on the surgeon’s part. This also damages tissue however small amount. What if bleeding or scarring and adhesions were to result. How does this benefit the patient? Physicians like this think to highly of themselves and should learn some humility. First role of the physician is to do no harm. This act harms the medical profession and portrays all of us as pompous and arrogant. What a shame the the surgeon wasn’t smart enough to realize this.

  10. Not knowing the surgeon, I cannot comment on the man’s personality, and whether or not he has ethical or moral shortcomings.
    However, the amount of dedication, training, discipline and talent that this surgeon posses definitely places him in a very elite class of surgeons of whom others appear to be somewhat jealous. Perhaps the only way that they can attempt to enter his orbit is through petty criticism of a unique trait that in no way jeopardizes his patients.
    Like a great artist signs his paintings, a great surgeon leaves his “signature” on his work, whether its on the surgical report or the unique manner in which he performed the surgery. Obtaining the patient’s written consent may be something he should strongly consider to protect himself from the rest of us!

  11. Bizaar..totally not med or surg indicated…give him a reprimand only…i think reprocussions will be enough…its public so that is its own punishment

Comments are closed.

Jeffrey Segal, MD, JD
Chief Executive Officer & Founder

Jeffrey Segal, MD, JD is a board-certified neurosurgeon and lawyer. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country's leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Subscribe to Dr. Segal's weekly newsletter »
Latest Posts from Our Blog