Dr. Death in Dallas: Trial, Appeals, and Tort Reform

Christopher Duntsch, the Dallas surgeon known as “Dr. Death,” was a neurosurgeon who injured 33 of the 38 patients he operated on between 2011 and 2013, killing two, before a Dallas County jury convicted him in 2017 and sentenced him to life in prison — the first U.S. doctor ever to receive a life sentence for conduct in the practice of medicine.¹ The case exposed how hospitals, a state licensing board, and federal reporting systems all failed to stop him.

Who Christopher Duntsch Was

Duntsch earned an M.D. and a Ph.D. from the University of Tennessee at Memphis College of Medicine and completed a six-year neurosurgery residency there, followed by a one-year minimally invasive spine surgery fellowship at the Semmes-Murphey Clinic under Dr. Kevin Foley.² During training he was referred to an impaired-physician program after an anonymous report of cocaine use and a missed drug test, and was restricted from operating independently during his final year.³

A neurosurgery resident is typically expected to perform about 1,000 surgeries in training. Records obtained by the Dallas County District Attorney’s office showed Duntsch had performed fewer than 100 by the time he finished.³ His residency program chairman, Dr. Jon Robertson, nevertheless wrote to prospective employers that Duntsch’s “work ethic, character, and ability to get along with others” were “beyond reproach.”²

In 2011, he was recruited to Dallas with a $600,000 salary advance and given surgical privileges at Baylor Regional Medical Center at Plano.³

The Patients He Harmed

Over roughly two years, Duntsch operated at Baylor Plano, Dallas Medical Center, Legacy Surgery Center of Frisco, and University General Hospital.⁴ Injuries ranged from chronic pain to paralysis and death.

Kellie Martin, a 55-year-old schoolteacher, bled to death at Baylor Plano after Duntsch cut a major blood vessel in her spinal cord during a laminectomy.³
Floella Brown, 64, suffered a stroke and brain death at Dallas Medical Center after Duntsch pierced and blocked her vertebral artery during cervical spine surgery. Her family withdrew life support.³
Jerry Summers, Duntsch’s childhood friend, was left a quadriplegic after Duntsch operated on his neck. Summers died in February 2021 from an infection related to his condition.⁵
Mary Efurd, 71, underwent elective back surgery in July 2012. Duntsch misplaced hardware in soft tissue, punched three holes in her spinal column, and amputated a nerve root. She has used a wheelchair ever since. Her case became the basis for the criminal prosecution.⁶
Barry Morguloff needed emergency surgery after an anterior lumbar fusion left bone fragments in his spinal canal. He walks with a cane.³
Lee Passmore lives with a screw lodged in his spinal canal that cannot be removed.⁴
Jeff Glidewell, Duntsch’s final patient, at University General Hospital, suffered a punctured artery, a hole in his esophagus, vocal cord damage, and a retained surgical sponge that caused a life-threatening infection.⁴

How He Kept Getting Hired

After the disasters at Baylor Plano, the hospital required Duntsch to resign on April 20, 2012, rather than firing him. Because the departure was technically voluntary, Baylor was under no obligation to report him to the National Practitioner Data Bank, the federal clearinghouse designed to warn future employers about problem practitioners. Baylor also provided a letter stating he had no administrative restrictions on his clinical privileges.²

Dallas Medical Center then hired him and granted temporary privileges before finishing reference checks. After the Brown and Efurd surgeries, that hospital also told him to stop operating. He moved on to Legacy Surgery Center of Frisco and then to University General Hospital, which hired him in May 2013.³

Neurosurgeons were described as “cash cows” capable of generating an estimated $2.4 million in annual hospital revenue. Institutions feared lawsuits from doctors if they were fired and feared liability exposure if they reported colleagues. Dallas plaintiff’s attorney Kay Van Wey called it a culture of “kick the can down the road and protect yourself first.” Methodist McKinney Hospital eventually denied Duntsch privileges, generating the first National Practitioner Data Bank report in January 2013, about six months after the denial.³

The Doctors and Board That Finally Stopped Him

Two Dallas-area physicians drove the effort to shut Duntsch down. Dr. Randall Kirby, a vascular surgeon, assisted during Barry Morguloff’s operation, observed Duntsch using improper instruments, and later contacted the Texas Medical Board. “He’s got to be stopped,” Kirby told the board. When he learned University General had granted Duntsch privileges, he called the hospital to intervene.³

Dr. Robert Henderson, a spine surgeon, was called in to repair Mary Efurd. What he found was so extreme that he initially suspected Duntsch was an impostor and sent a photograph to the University of Tennessee to confirm his identity.⁴ Henderson recorded his corrective surgery because he believed no one would otherwise credit the extent of the damage, then contacted Duntsch’s former residency chief, hospital officials, and the Texas Medical Board.³

The board’s own handling became a case study in regulatory failure. Its investigations are confidential until finalized, so other hospitals and patients had no way to know Duntsch was under review. The board received 6,000 to 8,000 complaints per year, relied on volunteer specialists, and averaged nine months to resolve a case. Emergency suspension existed but carried a high evidentiary burden. The board received complaints throughout 2012 and 2013 from hospitals and at least a half-dozen doctors.⁷ It finally held an emergency meeting and suspended Duntsch’s license on June 26, 2013, calling him an “imminent peril to the public health, safety or welfare.”⁸ His license was permanently revoked in December 2013. By then, according to prosecutors, complaints had sat with the board for ten months while roughly twenty additional patients were injured.⁴

The Criminal Case

In July 2015, Duntsch was arrested and charged with one count of injury to an elderly person and five counts of assault.³ Prosecutors from the Dallas County District Attorney’s office built the lead charge around Mary Efurd because she was over 65, elevating the offense to a first-degree felony with a wider punishment range.⁴

The state relied on the “Doctrine of Chances” to argue that so many disastrous outcomes could not be accidental.⁴ A critical piece of evidence was an email Duntsch sent to an assistant before Lee Passmore’s December 2011 surgery, in which he wrote that he was “ready to leave the love and kindness and goodness and patience that I mix with everything else that I am and become a cold blooded killer” and called himself “a [expletive] stone cold killer.”⁹ The trial court admitted evidence from other patients’ surgeries, including Passmore, Morguloff, Summers, and Martin, to prove intent and the absence of mistake. Henderson testified that Duntsch’s conduct was “as egregious as you can imagine.” A defense expert, Dr. Carlos Bagley, countered that the errors were “known complications” of neurosurgery.⁶

On February 20, 2017, the jury deliberated four hours before convicting Duntsch, then one hour on punishment before imposing the maximum: life in prison.¹⁴

Appeals

Duntsch appealed to the Texas Fifth District Court of Appeals, challenging the sufficiency of the evidence on his mental state and the admission of evidence from other surgeries. On December 10, 2018, the court affirmed his conviction in a 2-1 decision.¹⁰⁶ The Texas Court of Criminal Appeals refused his petition for discretionary review on May 8, 2019, ending his direct appeals.¹¹

Civil Suits Ran Into Texas Tort Reform

Holding anyone besides Duntsch financially accountable proved extraordinarily difficult. A 2003 Texas tort reform law capped non-economic damages in medical malpractice cases at $250,000 and caused the number of malpractice payouts in the state to drop by more than half. Many victims could not find attorneys willing to take their cases.³

Kay Van Wey ultimately represented 14 of Duntsch’s patients and settled multiple malpractice cases, though specific settlement amounts have not been publicly disclosed.¹² In March 2014, four patients filed a federal lawsuit against the Baylor Health Care System in the U.S. District Court for the Northern District of Texas, arguing gross negligence in credentialing and challenging the constitutionality of Texas laws that shield hospitals from liability for credentialing decisions absent proof of “malice,” meaning specific intent to harm. Then-Attorney General Greg Abbott intervened to defend the statute.¹³ The available record does not indicate a final ruling or published settlement in that case.

The 2023 Texas Reform Law

The Duntsch case, combined with KXAN News reporting that found at least 49 physicians were listed by the Texas Medical Board as having clean records despite discipline in other states, pushed the Legislature to act. Governor Greg Abbott signed HB 1998 in June 2023, effective September 1, 2023.¹⁴ Its main provisions:

The Texas Medical Board must continuously query the National Practitioner Data Bank and update a physician’s public record within 10 business days of any disciplinary action.¹⁵
Hospitals must report any peer review action affecting a physician’s privileges for more than 14 days, down from 30.
All physician applicants must submit fingerprints for criminal background checks through the Texas Department of Public Safety.
Doctors whose licenses have been revoked, restricted, or suspended in another state cannot practice in Texas.
Falsifying a medical license application is a Class A misdemeanor, elevated to a state jail felony when done with intent to defraud or harm.¹⁵

Full rollout of continuous data-bank monitoring for Texas’s roughly 122,000 physicians was expected to take until fall 2025, funded by an $11 fee added to licensure and renewal.¹⁶

Where Duntsch Is Now

Duntsch is incarcerated at the Ellis Unit of the Texas Department of Criminal Justice under TDCJ number 02139003. He will not be eligible for parole review until July 20, 2045.¹⁷

1
CBS News. Former Neurosurgeon Sentenced for Purposely Maiming Patients
2
D Magazine. Christopher Duntsch Dr. Death
3
ProPublica. Dr. Death: A Surgeon So Bad It Was Criminal
4
Texas District and County Attorneys Association. Taking Down Dr. Death
5
Oxygen. Dr. Death’s Best Friend Jerry Summers in His Own Words
6
FindLaw. Duntsch v. State, No. 05-17-00235-CR
7
Texas Observer. Anatomy of a Tragedy
8
HealthLeaders Media. Allegations Swirl as Baylor Plano Rejects Baldrige Award
9
Dallas Morning News. What You Need to Know About Dr. Death
10
D Magazine. Life Sentence Upheld on Appeal for Christopher Duntsch
11
Van Wey Law. Dr. Death
12
PR Newswire. Attorney Kay Van Wey: Dr. Death Settlements Lead to Criminal Case
13
The Guardian. Texas Legal Doctor Lawsuit Christopher Duntsch
14
Health Journalism. Dr. Death Reform Law Shows the Importance of Investigating State Licensing Boards
15
MedPage Today. Dr. Death Reform Law Features
16
Fox 44 News. Texas New Patient Safety Law Takes Effect Sort Of
17
Texas Department of Criminal Justice. Inmate Detail: Christopher Daniel Duntsch