Mary Efurd: Botched Surgery, Duntsch Conviction, and Baylor Suit

Mary Efurd was the 74-year-old Texas woman whose spinal surgery by Christopher Duntsch on July 25, 2012 went so catastrophically wrong that it became the basis for his life sentence. Duntsch operated on the wrong vertebrae, drove a screw into her spinal canal, amputated a nerve root, and left her permanently disabled. A Dallas County jury convicted him of injury to an elderly individual for what he did to her, and in February 2017 sentenced him to life in prison, believed to be the first time a U.S. doctor received a life sentence for harm caused through medical practice.

Who Mary Efurd Was

Efurd had chronic lower back pain and had already undergone a laminectomy in 2008.¹ She sought out Duntsch because he struck her as a smart, charismatic surgeon who promised he could relieve her pain.² She had undergone a prior procedure with him at Baylor Medical Center at Plano before the second surgery at Dallas Medical Center. She was 74 years old, independent, and living on her own.

What Happened During the Surgery

On July 25, 2012, Duntsch performed a spinal fusion on Efurd at Dallas Medical Center in Farmers Branch, Texas.³ He fused the wrong vertebrae, operating on L3–L4 instead of the consented L4–L5.¹ He placed spinal fusion hardware into muscle and soft tissue rather than bone. He amputated a nerve root for no identifiable medical reason and drove a screw directly into her spinal canal, skewering the nerves that control her bladder and one of her legs.⁴ He left multiple failed screw holes in her bone and cut through a nerve bundle sac, causing spinal fluid to leak. She lost more than a half-gallon of blood on the table.

Operating room staff warned Duntsch mid-procedure that his hardware placement was wrong. He refused to listen.² At one point he reportedly threw a tantrum, leaving Efurd on the operating table for fifteen minutes.⁵

When Efurd woke from anesthesia, she was in excruciating pain and could not move her legs or feet.³ She later described the pain as comparable to childbirth, rating it “10-plus on a scale of one to 10.” When hospital staff suggested Duntsch perform a follow-up procedure, she refused. “No! He will never touch me again. Something is wrong. Dead wrong.”¹

The Revision Surgery That Documented the Damage

Dallas Medical Center called in Dr. Robert Henderson, a pioneer of modern spinal surgery, to try to salvage her back. Two days later, on July 28, 2012, Henderson performed a corrective procedure.³ What he found was so appalling that he recorded the revision on video, believing no one would take his word for it otherwise.²

Henderson found three holes in her spinal column where Duntsch had failed to properly insert screws, a screw jabbed directly into her spinal canal, a completely amputated nerve root, and hardware buried uselessly in soft tissue. He called the surgical work “an atrocity” and said it was “as if he knew everything to do, and then he’d done virtually everything wrong.”⁴ Henderson was so stunned he initially suspected Duntsch was an imposter and sent a photograph to the University of Tennessee, where Duntsch had trained, to verify his identity. The university confirmed it was the same man.²

Her Injuries Afterward

The damage was permanent. Efurd developed “drop foot,” which prevents her from raising her left foot and requires a brace. She lives with incontinence and partial leg paralysis, though extensive rehabilitation restored some limited muscle function.³ She uses a wheelchair and a walker and cannot stand for more than about ten minutes at a time.¹ The independent life she had before the operation was gone; afterward she relied on others for transportation, meals, and basic daily activities.⁶

Why Her Case Was the One That Convicted Duntsch

Duntsch operated on 38 patients over roughly two years at Dallas-area hospitals. Prosecutors later determined that 33 were injured and two died. The day before Efurd’s surgery, on July 24, 2012, Duntsch had operated on Floella Brown at the same hospital, piercing and blocking her vertebral artery; Brown suffered a massive stroke and was eventually pronounced brain dead. Duntsch operated on Efurd the next morning while Brown was still dying in the ICU.⁴

In July 2015, a Dallas County grand jury indicted Duntsch on five counts of aggravated assault causing serious bodily injury and one count of injury to an elderly individual.⁵ The elderly-individual charge named Efurd. The indictment identified Duntsch’s “hands and surgical tools and a pedicle screw” as deadly weapons.³ Prosecutors chose her case as the primary charge because her age qualified the offense as injury to an elderly individual, which carried an enhanced sentencing range up to a first-degree felony, and because the facts were considered the strongest from an evidentiary standpoint.²

Her Testimony and the Verdict

Efurd was the first witness when the trial opened in February 2017. Seated in a wheelchair, she told the jury about waking from surgery unable to move, about the searing pain, and about her trust in the man who had promised to help her. “I trusted him,” she said. “I trusted that he would do what was right.”¹ Over a two-week trial, prosecutors presented 39 witnesses covering six of Duntsch’s cases.² Expert witnesses, including Drs. Henderson, Martin Lazar, and Randall Kirby, testified that the surgical errors were so egregious they could not have been the result of mere incompetence; a trained neurosurgeon would know that performing these actions would cause serious bodily injury.³

The jury deliberated about four hours before finding Duntsch guilty of injury to an elderly individual. He was sentenced to life in prison on February 20, 2017. Efurd told reporters afterward: “I had so much anger because my life changed so much. I was very independent and suddenly became dependent on other people for transportation, meals and a lot of things.”⁶

The Appeal

Duntsch appealed, arguing that the trial court improperly admitted evidence of surgeries on other patients, that the evidence was insufficient to convict, and that prosecutors failed to prove he acted intentionally or knowingly rather than negligently. On December 10, 2018, the Court of Appeals of Texas in Dallas rejected all three arguments and affirmed the conviction and life sentence, holding that evidence of the other surgeries was properly admitted to show intent, knowledge, and absence of mistake.³

Efurd’s Civil Suit Against Baylor

Efurd was one of four plaintiffs, alongside Barry Morguloff, Kenneth Fennell, and Leroy Passmore, who filed a federal lawsuit against Baylor Health Care System in March 2014. The suit alleged that Baylor knew about red flags regarding Duntsch’s competence and drug use but continued to credential him, in part because the hospital had given him a $600,000 advance to relocate to Dallas.⁷ The case, Morguloff v. Baylor Health Care System in the U.S. District Court for the Northern District of Texas, was terminated in September 2015.⁸

The suits challenged Texas laws that shield hospitals from malpractice liability. Under Texas law, suing a hospital for negligent credentialing requires proving “malice,” defined as specific intent to harm, and hospital credentialing records are kept confidential, making it extremely difficult for plaintiffs to build their cases.⁷ Dallas attorney Kay Van Wey represented 14 of Duntsch’s patients in civil proceedings; settlements allowed clients to cover lost income, medical expenses, and related costs, though specific amounts were not publicly disclosed.⁴

1
D Magazine. Testimony Begins in Neurosurgeon Christopher Duntsch’s Assault Trial
2
Texas District and County Attorneys Association. Taking Down Dr. Death
3
Court of Appeals of Texas, Dallas. Duntsch v. State, No. 05-17-00235-CR
4
ProPublica. Dr. Death: A Surgeon So Bad It Was Criminal
5
Rolling Stone. Dr. Death Follow-Up Podcast
6
Courthouse News Service. Texas Doctor Criminally Convicted for Poor Care
7
The Guardian. Texas Legal Doctor Lawsuit: Christopher Duntsch
8
CourtListener. Morguloff v. Baylor Health Care System, 3:14-cv-01065