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A doctor in the U.K. has been removed from the country’s medical register for branding patients’ livers with his initials. The incidents occurred in February and August 2013, when Simon Bramhall used a surgical device to write his initials on transplanted livers at the end of two surgeries.

The 1.6-inch initials were discovered by another doctor when an organ transplanted by Bramhall failed after about a week, according to BBC News.

In 2017, Bramhall pleaded guilty and was convicted of two counts common assault, according to documents from the U.K.’s Medical Practice Tribunal Service, known as MPTS, which hears complaints against doctors and determines if they are fit to practice. He was fined £10,000 ($13,619.90 U.S. dollars) and sentenced to community service.

Bramhall had resigned from his job at Birmingham’s Queen Elizabeth Hospital in 2014 and had been suspended from practicing for at least five months in December 2020, according to BBC News.

However, MPTS invited Bramhall to have his case reviewed in December 2020. The service reviewed evidence in the case, including statements from Bramhall, in which he stated he “foolishly made a mark on the adjacent liver” and admitted his actions in 2013 “were stupid and entirely wrong,” according to the MPTS documents. 

Bramhall’s legal counsel argued that the former doctor’s “fitness to practice was no longer impaired,” and “that this case had never been about his surgical skills; rather it was about Mr. Bramhall’s lack of respect for the dignity of the patients.”

MPTS “was satisfied that there is no discernible risk of repetition” of the incident and said Bramhall’s fitness to practice is “no longer impaired by reason of conviction.” The order that suspended him from practice was revoked.

However, the case was re-submitted to MPTS, and during a hearing on Monday, the service said it “accepted that no lasting physical damage was caused to either patient,” but that Bramhall’s actions had caused one of them “significant emotional harm,” according to BBC.

While they said Bramhall was of “previous good character,” removing him from the medical register was the appropriate punishment and even though he provided life-saving care, he was still in “gross violation of his patients’ dignity and autonomy.” 

After the hearing, an immediate suspension was put in place, but Bramhall has a 28-day appeals period. CBS News has reached out to MPTS and Bramhall for comment and is awaiting response.

yearlong CBS News investigation found that the system responsible for licensing and disciplining doctors in the U.S. — state medical boards — often fails to police doctors who repeatedly hurt their patients. For patients in the U.S., the CBS News investigative unit put together this state-by-state guide that shows how to check your doctor’s license and disciplinary history along with information on how to file a complaint against a healthcare provider in your state.