Tuesday, December 24, 2013

Has a surgeon really "branded his initials on a patient's liver"?

Has a surgeon really "branded his initials on a patient's liver"? 

The media have reported that a Birmingham liver surgeon has been suspended for allegedly branding his initials on a patient's liver transplant. Of course they have all reported this as an allegation, not fact, but already people are expressing their disgust in a way that assumes that this allegation is fact, or at least credible. Is it?

If a surgeon were to do such a thing, he would have to secure the silence of his assisting surgeon(s) and scrub nurse. That seems extremely unlikely. What is the basis of this allegation? There may be professional rivalries behind this. And what's certain is that if (or more probably when) the investigation shows the allegation to be groundless, the media will not be reporting that. The story will live on however, and be used as proof of how arrogant surgeons are. 

The surgeon involved is well liked and respected for his surgical skills. It seems the reporting of this allegation owes more to the media's delight in sensational bad news about the NHS. The resemblance of this allegation to an incident in the crime novel "Remains Silent" seems remarkable.

In the two cases that might be considered similar, one surgeon puts his initials on the abdomen of his patient. The surgeon involved was argued to have Pick's disease, a type of dementia which often causes bizarre disinhibited behaviour. In another, a surgeon apparently branded his initials on an internal organ - but this was the organ he was removing, so although eccentric not harmful to the patient as such.

If this marking (not really branding, most likely argon beam cauterization) has occurred, then this could be viewed as a criminal assault - what specific offence is arguable, given that such an episode has not been prosecuted in the British courts hitherto. If the mark was inflicted prior to implantation, then arguably the patient has not been assaulted at all. It might be criminal damage. A more appropriate way to deal with the situation would be via the professional regulator, the General Medical Council. The mark would have a trivial effect on the liver, the main concern would be about the attitude of the surgeon concerned. 

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