An “arrogant” rogue surgeon boasted to a colleague: “This is what I do” as he burned his initials on to an unconscious patient’s newly-transplanted liver , prosecutors said.
The Crown Prosecution Service said Simon Bramhall used a medical instrument called an argon beam coagulator – which seals bleeding blood vessels by directing a beam of electricity on to the area – to inscribe two patients’ livers as they were under general anaesthetic.
The 53-year-old’s actions were only discovered when one of his patients had to have more surgery a week later, leading a different surgeon to spot the liver specialist’s calling card.
Bramhall resigned from his job at Birmingham’s Queen Elizabeth Hospital in 2014 when the act came to light, the city’s Crown Court was told.
He admitted two counts of assault by beating in December after denying the more serious charge of assault occasioning actual bodily harm.
Bramhall was ordered to carry out 120 hours of unpaid work and fined £10,000 at a sentencing hearing on Friday.
Frank Ferguson, head of special crime at the CPS, said Bramhall was a “very respected” surgeon to whom many patients owed their lives.
But, asked about the doctor’s motive, he said: “I can’t speak in terms of why he did that.
“Clearly he did not anticipate that it would be seen, I would suggest, but there was further surgery and he may not have understood how long it was likely to last.
“There was medical evidence that it may have lasted up to a couple of months in the way a minor burn might do on external skin.
“He accepted what he was doing was arrogant.
“He said ‘this is what I do’ to one of his colleagues in one of the operations but beyond that I could not say.”
Mr Ferguson said in the case of one of the victims, they had not been identified but Bramhall’s actions had been witnessed in the operating theatre.
He said the victim who had been identified in the “unique” case had suffered minor physical injury and psychological harm.
“There was a very profound impact on that person in terms of distress caused by what happened, the psychological impact,” Mr Ferguson said.
“There was physical damage, some physical harm to the liver, although that’s minor in terms of cell damage but it would be akin to a minor external burn.
“The first point is it’s a crime and the second point is the aggravating features are that it was very vulnerable victims, in the sense there is no greater trust than the trust which a patient places in a surgeon when they are having an operation.
“And no greater vulnerability than that of a patient who’s under general anaesthetic and the breach of that trust and the abuse of that power were aggravating features that led us to conclude it was the right thing to do to take this case forward.”
Mr Ferguson refused to be drawn on whether Bramhall had carried out the practice on other patients, saying: “He will be dealt with on the basis of two offences so it would not be appropriate for me to go into detail about anything else.”
He added he did not anticipate any further charges and there was no evidence Bramhall’s colleagues covered up his actions.
He said: “As far as we know it’s a unique case in terms of the facts and demonstrates really the vulnerability of patients and the degree of trust they place in their surgeons when they are having an operation and the importance that that trust is protected and respected by doctors.
“I’ve never heard of anything like this before.
“It’s applying the current law to a unique set of circumstances, so in that sense it’s a precedent because we’ve never come across a situation where a battery has taken place in these circumstances but the criminal law applies to everyone including doctors in situations like this.”
Passing sentence, Judge Paul Farrer QC told Bramhall: “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.”
The Queen Elizabeth Hospital said in a statement: “The Trust is clear that Mr Bramhall made a mistake in the context of a complex clinical situation and this has been dealt with via the appropriate authorities, including the Trust as his then employer.
“We can reassure his patients that there was no impact whatsoever on the quality of his clinical outcomes.”