Dr. Death in Dallas: Trial, Appeals, and Reforms

Christopher Duntsch, the Dallas surgeon known as Dr. Death, was a neurosurgeon who injured 33 of 38 patients and killed two while operating at four hospitals in the Dallas and Collin County area between late 2010 and mid-2013. A Dallas County jury convicted him in February 2017 of intentionally causing serious bodily injury to an elderly patient and sentenced him to life in prison, making him the first doctor in the United States to receive a life sentence for conduct during the practice of medicine.¹

Who Christopher Duntsch Was

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

A neurosurgery resident is typically expected to perform about 1,000 surgeries during training. Records obtained by the Dallas County District Attorney’s office showed Duntsch had performed fewer than 100 by the end of his residency and fellowship.³ Even so, his residency program chairman, Dr. Jon Robertson, wrote a letter telling prospective employers that Duntsch’s “work ethic, character, and ability to get along with others” was “beyond reproach.”²

In 2011, Duntsch was recruited to Dallas with a $600,000 salary advance and granted 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. Of 38 patients, 33 were injured and 2 died.¹ Injuries ranged from chronic pain to permanent paralysis.

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. Floella Brown, 64, suffered a stroke and brain death after Duntsch pierced and blocked her vertebral artery during cervical spine surgery at Dallas Medical Center; her family withdrew life support.³

Jerry Summers, Duntsch’s childhood friend from Tennessee, came to Dallas to help him set up his practice. After a car accident left Summers with a neck injury, Duntsch performed spinal surgery that left Summers a quadriplegic.⁴ Summers died in February 2021 from an infection related to his condition.

Mary Efurd, 71, underwent elective back surgery at Dallas Medical Center in July 2012. Duntsch misplaced hardware in soft tissue, poked three holes in her spinal column, and amputated a nerve root. She woke in agony, could not move her legs, and has used a wheelchair ever since.⁵ Her case became the basis for the criminal prosecution.

Other patients included Barry Morguloff, who needed emergency surgery after Duntsch’s lumbar fusion left bone fragments in his spinal canal and who now walks with a cane;³ Lee Passmore, left with a screw lodged in his spinal canal that cannot be removed; and Jeff Glidewell, Duntsch’s final patient, who suffered a punctured artery, a hole in his esophagus, vocal cord damage, and a retained surgical sponge that caused a life-threatening infection.¹

How He Kept Operating

What allowed the harm to continue was not just Duntsch’s incompetence but the way hospitals handed him off. After catastrophic outcomes at Baylor Plano, the hospital required him 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 meant to warn future employers about problem practitioners. Baylor even 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 completing reference checks. After the surgeries on Floella Brown and Mary Efurd, Dallas Medical Center 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

Financial incentives shaped those decisions. Neurosurgeons were described as “cash cows” capable of generating an estimated $2.4 million in annual revenue for a hospital. Institutions feared lawsuits from doctors if they were fired and liability exposure if they reported colleagues. Dallas plaintiff’s attorney Kay Van Wey called the pattern “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, roughly six months after that denial.³

The Doctors Who Tried To Stop Him

Two Dallas-area physicians drove the effort to pull Duntsch out of operating rooms. Dr. Randall Kirby, a vascular surgeon, assisted during Barry Morguloff’s surgery, watched Duntsch use improper instruments, and argued with him in the operating room. Kirby then contacted the Texas Medical Board and told it, “He’s got to be stopped.” When he later discovered University General Hospital had granted Duntsch privileges, he called the hospital to intervene.³

Dr. Robert Henderson, a spine surgeon, was called in to repair the damage to Mary Efurd. What he found was so extreme that he initially suspected Duntsch was an impostor and sent a photograph of him to the University of Tennessee to confirm his identity.¹ Henderson recorded his corrective surgery on Efurd because he believed no one would otherwise accept the extent of the damage, and he contacted Duntsch’s former residency chief, hospital officials, and the medical board.³ Both physicians later spent hours with prosecutors explaining medical terminology and helping build the criminal case.

The Texas Medical Board’s Delayed Response

It took more than six months of catastrophic surgeries before the Texas Medical Board received its first report on Duntsch, and nearly another year for an investigation to advance, during which he kept operating.³ Throughout 2012 and 2013, complaints came in from hospitals and at least a half-dozen doctors.⁶

Several structural factors contributed to the delay. The board’s investigations are confidential until finalized, so other hospitals and patients could not know Duntsch was under review. The board receives 6,000 to 8,000 complaints a year and relies on volunteer specialists to review cases. Average resolution time is nine months, and many complaints take years. Emergency suspension authority exists but requires evidence of a clear, ongoing pattern and carries a high evidentiary burden.⁶

The board 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.” His license was permanently revoked in December 2013.⁷ According to prosecutors, the board had received complaints ten months before Duntsch’s final surgery but failed to act, during which time twenty additional patients were injured.¹

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 built the lead charge around Mary Efurd because she was over 65, which elevated the offense to a first-degree felony with a broader punishment range.¹

The Dallas County prosecution team included Assistant Criminal District Attorneys Michelle Shughart, Stephanie Martin, and Jaclyn Lambert.¹ Duntsch was represented by Kristen Jernigan and Allan Fishburn.⁵

Prosecutors relied on the “Doctrine of Chances” to argue that Duntsch’s extraordinary frequency of disastrous outcomes was not accidental but intentional.¹ A critical piece of evidence was an email Duntsch sent to an assistant before Lee Passmore’s surgery in December 2011, in which he wrote: “I am 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 described himself as “a [expletive] stone cold killer.”⁸ Kimberly Morgan, Duntsch’s girlfriend and physician assistant, testified about the email via Skype from the Middle East.

The trial court admitted evidence of surgeries on other patients, including Lee Passmore, Barry Morguloff, Jerry Summers, and Kellie Martin, to prove intent and absence of mistake.⁵ Dr. Henderson testified that Duntsch’s actions were “as egregious as you can imagine” and that any neurosurgeon would know such conduct would cause serious bodily injury. Dr. Martin Lazar, another neurosurgeon, testified that Duntsch had “no conscience.”¹ The defense’s expert, Dr. Carlos Bagley, countered that Duntsch’s errors were “known complications” of neurosurgery.

On February 20, 2017, the jury deliberated for four hours before returning a guilty verdict, then deliberated for one hour on punishment before imposing the maximum sentence: life in prison.⁹¹

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 patients’ surgeries. On December 10, 2018, the court affirmed the conviction 2-1.¹⁰⁵ The Texas Court of Criminal Appeals refused his petition for discretionary review on May 8, 2019, ending his direct appeals.¹¹

Civil Suits and the Tort Reform Wall

Holding anyone other than Duntsch financially accountable proved extraordinarily difficult. Texas tort reform enacted in 2003 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 of Duntsch’s victims found it nearly impossible to 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 in the U.S. District Court for the Northern District of Texas against the Baylor Health Care System, arguing Baylor was grossly negligent in allowing Duntsch to operate and challenging the constitutionality of Texas statutes that shield hospitals from liability for credentialing decisions unless a plaintiff proves “malice,” defined as specific intent to harm. Then-Texas 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.

Reforms After the Case

The Duntsch case, together with KXAN News reporting that found at least 49 physicians listed by the Texas Medical Board as having clean records despite disciplinary actions in other states, prompted the Legislature to act. In June 2023, Governor Abbott signed HB 1998 into law, effective September 1, 2023.¹⁴ The law requires the Texas Medical Board to continuously query the National Practitioner Data Bank and update physician records for public view within 10 business days of any disciplinary action, and shortens the window for hospitals to report peer review actions affecting a physician’s privileges from 30 days to 14 days. It also mandates fingerprint-based background checks for applicants, bars doctors whose licenses have been revoked, restricted, or suspended in another state from practicing in Texas, and makes falsifying a license application a Class A misdemeanor, elevated to a state jail felony if done with intent to defraud or harm.¹⁵

Full implementation of the Continuous Query system for all of Texas’s roughly 122,000 physicians was expected to take until the fall of 2025, funded by an $11 fee collected from physicians at licensure and renewal.¹⁶

Where He Is Now

Duntsch is incarcerated at the Ellis Unit of the Texas Department of Criminal Justice, serving a life sentence. His TDCJ number is 02139003. He is not in the parole review process and will not be eligible for parole review until July 20, 2045.¹⁷

1
Texas District and County Attorneys Association. Taking Down Dr. Death
2
D Magazine. Christopher Duntsch Dr. Death
3
ProPublica. Dr. Death: A Surgeon So Bad It Was Criminal
4
Oxygen. Dr. Death’s Best Friend Jerry Summers in His Own Words
5
FindLaw. Duntsch v. State, No. 05-17-00235-CR
6
Texas Observer. Anatomy of a Tragedy
7
HealthLeaders Media. Allegations Swirl as Baylor Plano Rejects Baldrige Award
8
Dallas Morning News. What You Need to Know About Dr. Death
9
CBS News. Former Neurosurgeon Sentenced for Purposely Maiming Patients
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