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What price to sign a liver?

15th January 2018

A liver surgeon who branded his initials on the livers of two patients has been recently received a £10,000 fine and been sentenced to 12 months community order, following his sentencing at Birmingham Crown Court on two counts of assault by beating. More significant charges of assault occasioning actual bodily harm were dropped.

Mr Bramhall was once considered a well-respected surgeon, known for his meticulous work in the operating theatre. However, he decided to sign his initial onto the livers of two donor livers, using an argon beam machine, before they were transplanted into their patients. The actions only came to light when the transplants failed for unconnected reasons and the explanting surgeon noticed the markings.

The Court appears to have accepted that Mr Bramhall did not intend any significant consequences from his actions but was critical of his childish arrogance in marking the livers in the first place. It recognised that his victims had been traumatized by the knowledge and felt that their trust had been violated.

It is likely that civil proceedings will now follow for at least the two patients involved in the criminal case.  However, it will be a concern for his other patients, that Mr Bramhall stated “this is what I do” when the signature was noted for the first time by one of the nurses.

Could this mean that every patient of Mr Bramhall will have a claim against the Trust for the psychological harm caused by now being forced to suspect that they too have an organ branded by Mr Bramhall inside them? Potentially, yes. The value of the compensation for such harm is likely to be modest, and it is unlikely that surgeons would ever perform a laparoscopy solely to examine the internal organs to be sure. However, it is not a huge leap to envisage a particular patient feeling desperate enough to want to know and for there be a psychological justification for such an investigation.  In the alternative, would an MRI or Ultrasound scan be sensitive enough to see any branding?

It would be expected for the hospital to have rigorously examined Mr Bramhall’s patient records and to be considering making unilateral without prejudice offers to his transplant patients. If this is what he does, the list could be very long indeed…



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