Original subtitles

[faint indistinct chatter]

[zipper unzips]

[soft dramatic music]

* *

- Looking like a veritable movie star.

- Don't know how I got picked, Mr. Summers.

- Oh, you were our number one choice, Janet.

See you out there.

- Here, Ma. Excuse me, Jerry.

Where do you want this?

- Oh, exam room. Thanks.

- I feel bad asking,

but do you think I could talk with Dr. Duntsch?

- Oh, he's real busy. Can I do something?

- It's more of a doctor-patient thing.

- Definitely don't want me handling that stuff.

I'll talk to him.

- Thank you, Jerry.

- Will you make sure your mom's memorized on what she's saying?

I don't want her getting distracted

with lights, camera, action.

- Two reasons why patients normally present

to their doctors for pain related to the spine.

The first is related to the peripheral nervous system.

That's called radiculopathy.

Now, normally, that type of pain is associated

with depression or with... - Yo, Chris.

- Degenerative changes in-- - Cut.

- [sighs]

Okay, um, let's take a break.

Knock out the patient's portion.

Come back.

- Good idea.

Fuck me.

I am so sorry.

You're looking good. Feeling good?

- I thought it'd be more professional.

- Tell me what needs fixing, Chrissy, anything.

- Kim's all over it.

- I know you're in the zone, but Sarah wants to talk to you.

Janet's daughter. Our patient?

- Oh, yeah, that's fine.

- Hey. Dr. Duntsch, how can I help you?

- Hi, Dr. Duntsch.

I noticed something in my mom's scar.

Like, blue peeking out, like a piece of sponge.

So I got some tweezers and...

- Oh, wow. You should not have done that.

- Oh, my God. What did I do?

- No, it's just a stitch.

It's fine, but-- okay, you should call me

before you go digging around in there again, okay?

- I did call a few times. - Quiet on set.

- [shushes] - You ready, Jenny?

- Should I tell my own story? Because this isn't my story.

- Janet, you look great today.

Thank you so much for doing this.

[whispering]

[dramatic music]

* *

- You did good.

- [quietly] Yeah.

- Roll camera. And action.

- Dr. Duntsch is one great man.

He is the best doctor I think that you could ever go to,

and if you're having the problems that I had,

you know, give him a call because he'll fix you.

- No God damn way.

- Mr. Duntsch... - Doctor.

- I don't think you appreciate the position you're in.

- Doctor. - Dr. Duntsch,

I don't think you appreciate the position you're in.

- No, I don't.

I do not appreciate being locked up in a cage

like a dog for a year and a half.

And I certainly do not appreciate you telling me

that my best bet going forward

is not just to fire your asses and hire real lawyers,

but to ask for a continuance.

- I need to find someone to testify on your behalf.

- Put me on the stand.

If anybody else tries to describe what it is

that I do or how I do it,

they're just gonna end up looking like a bunch of jerks.

- See, that right there is why you can't take the stand.

You're emotionally driven.

And when you're emotional, you can't control what you say.

- [laughs]

[grunts]

[laughs softly]

Try me.

[soft tense music]

* *

- [sighs]

You are a drug- and alcohol- addicted surgeon

who was too impaired to perform surgeries.

- Allegedly. None of that was--

- Like a drunk driver, which, by the way,

you have on your record, Mr. Duntsch.

- Doctor.

- No, you're no longer a doctor.

You had your license stripped.

- Temporarily.

- Not if we have anything to do with it.

And how about that email? The one in which

you're prepared to become a cold-blooded killer.

- I never meant for that to be taken literally--

- You wrote it.

So it was just a coincidence

that you wrote that email to your lover,

who also happens to be your assistant,

just prior to killing or maiming over 33 patients?

- It's not my fault!

The anesthesiologists and the nurses

and the fat fucking patients...

[sighs]

- Fire me,

but know whoever slides into this seat

is gonna tell you a version of the same thing.

I am trying to keep you

from spending the rest of your life in prison.

- I don't want to.

You've got my deposition, and you've got my records.

I don't have anything more to give.

- The judge ruled you have to testify in front--

- How could the emails not be true?

He sent them to me.

- The defense has a right

to cross-examine you and confirm that.

[soft uneasy music]

* *

- You know, I thought the other side of the world

was far enough.

They don't want me there because of the emails.

They wanna know about us, about our relationship.

[sniffles]

[sighs] What are they gonna ask?

- If it were me,

I would remind them as often as I could

that you two were sleeping together

to establish a conflict of interest.

- You mean to call me a whore who can't be trusted?

- I know you're trying to leave this all behind, Ms. Morgan,

but there's only one way to do that.

[sighs deeply]

- This is hostile. She's being hostile.

- Do you need her to testify?

- I do if I wanna introduce that email.

- Can you prove your case without the email?

- Precedent-setting is precedent-setting,

Dr. Henderson. No one's ever done this before.

Gotta assume every little bit helps.

- She's been through enough.

- What the hell are you talking about, Bob?

She was in the O.R. She was in the consult.

She had to know what was going on.

You ask me, she hasn't been through enough.

- What about questioning his training and the investments?

And we have the hospitals moving him around.

What? What?

- We brought charges of elder abuse.

The only way to prove that

is to prove that he was trained well

and that he knew what he was doing,

the whole time, he knew he was going to harm her.

- Well, what about the drugs?

- That would be helpful, but--

- Fine, fantastic. Drag Kayla Gibson in here.

- Unless Ms. Gibson knew he was high and was with him

in surgery that day, it's inadmissible.

- This is ridiculous. - No, it's not.

You came to me to help you stop Duntsch.

We have to choose.

If he's our goal,

then we have to focus on him and only him.

[tense music]

- State, call your first witness.

- Drew Sweeney.

- Joe Padua. - Harold Brennan.

- Earl Burke. - Elaine Johnson.

- Henry Aldrich.

- Cindy Tremblay. - Stan Novak.

- Would you tell us a little about yourself?

- I'm 41.

I work for the Collin County Medical Examiner's Office.

- I worked for a pool company.

- My wife, Shelley, was an elementary education teacher.

- Dorothy and I were married 46 years.

Two kids, nine grandkids.

- Commercial construction project manager.

- Started driving trucks in '98.

- Two children--both had better be in school right now.

- I'm an air conditioner contractor.

- What were your symptoms prior to seeing Dr. Duntsch?

- Light back pain. - Lower back pain.

- We were decorating the Christmas tree,

and Shelley missed a rung.

- Neck pain.

- Pain in the neck and numb pinky.

- Numbness. Tingling in my finger.

- Back pain.

Hard to be a mom when you can't pick anything up.

- Broke my back. Motorcycle accident.

- How did you hear about Dr. Duntsch?

- My doctor. - Family doctor.

- Website called Best Docs.

- Baylor Medical website. Five stars.

- Seemed like he knew what he was talking about.

- He told us he was gonna fix her.

That's all we needed to know.

- Arrogant.

Told me he was the best in the metroplex.

- So it's the day of the surgery.

- I had second thoughts that day.

- My understanding was my surgery was supposed

to last a couple of hours. It took four.

- When you woke up from surgery,

what was that like?

- A nightmare.

I woke up in a nightmare, tubes coming out of everywhere.

Feeding tubes, drain tubes.

- I couldn't move, and the pain...

- They were pumping me full of blood,

and I didn't know why.

- I was sore. I hurt.

I was worse.

- Couldn't move, and my wife told me he'd found a tumor

and had to abort the surgery.

It turns out it was a piece of my neck muscle.

- Every bone hurt. I was crying.

I'm sober, so I can't take the meds.

- She never woke up.

- I went home. I laid around.

Wasn't eating or drinking anything

'cause of the sore throat.

- I remember being like I was a baby.

You know, like a baby who can't hold himself up.

First thing that went through my mind: what's he done to me?

- He looked at the incision and said everything was fine.

- He kept repeating himself.

He kept saying that what was wrong

wasn't related to the surgery.

- I knew there was something wrong with this guy.

Sorry, man. You looked high as a kite.

- Objection. - Sustained.

- Has this changed your life?

- I walk with a limp.

I have trouble with incontinence,

erectile dysfunction.

- I can't sing.

Not that I was ever a good singer,

but that's just an everyday reminder.

- She was the love of my life.

It's hard to get over a broken heart.

- Just living one day at a time,

just like recovery.

- I can't play with my children like I used to.

- I learned ways to control the pain,

mostly through prayer and meditation.

- I sit in a recliner, watch TV,

a lot of medicine, antidepressants.

- I miss her.

She was--

she was a very--

very good woman.

And that's all I can say.

- Can you tell us how old you are?

- 70.

- And what did you do for a living?

- I was a teacher's aide,

and then I worked in physical therapy for a bit.

Ironic.

- What took you to Christopher Duntsch?

- I had back pain for years,

and it radiated to the end of my foot.

And I tried all the treatments.

Steroid shots, PT.

Nothing worked.

- Before you met the defendant, had you had surgery?

- Mm-hmm. 2008.

A laminectomy.

It helped for a number of years,

but it didn't last and then my pain management team

referred me to Dr. Duntsch.

- How did you feel going into the surgery?

- Fine. Good.

I walked into the hospital happy,

and I was thinking, "This is gonna fix it."

- And how did you feel when you woke up?

- I was in pain.

[disquieting music]

I was in pain,

and no one could tell me what was wrong with me

until Dr. Henderson.

He said that he thought that

the fusion was improperly placed,

and that something was pressing against a nerve.

He said he didn't want to wait

to operate on me, so they rushed me in.

- What happened after Dr. Henderson operated on you?

- The pain was much better, and I could--

I could move my right foot a bit,

but not my left.

- So prior to surgery with Christopher Duntsch,

you had pain, but you could still live life.

And now?

- I wish I could go back to the days

before I met Christopher Duntsch.

[unsettling music]

[faint indistinct chatter]

- Would you please introduce yourself to the jury?

- Randall Parker Kirby.

I went to Rice undergrad. Baylor for medical school.

Stayed at Baylor for

my five-year general surgery residency

as well as my two-year vascular surgery fellowship.

I have privileges at every major hospital in Dallas,

including Baylor, Medical City Dallas,

Medical City Children's,

Methodist, Dallas Medical, Presbyterian,

and approximately 40 other smaller hospitals

and outpatient surgery centers here in the metroplex.

My area of expertise is anterior spinal access.

I work with most of the neurosurgical

and orthopedic spine surgeons here in DFW.

I open up the chest and the abdomen so they can correct

whatever deformity they need to correct in the front.

I perform between two to four of these operations per day.

Five--call it six days a week.

I do hernias, gallbladders,

blockages of the legs and the neck arteries, anyone?

But my area of expertise and the chapters I've published

have all been on anterior spine access.

- And were you called in on a case

regarding a patient named Joe Padua?

- Yeah, he works with the company

that takes care of my pool.

I was asked to come in, lend a hand.

It seemed nobody else was available.

- Available?

- Nobody wanted to work with him.

- Objection.

The witness has no way of knowing that.

- [chuckles] Oh, I do.

- Sustained. - Eh.

- Did you know Dr. Duntsch prior to this surgery?

- I met him one time before we had a conversation.

I was scrubbing in on a case, and he tried to convince me

that he was the best spine surgeon in town.

I found the conversation disturbing.

I mean, sure, most surgeons are superior sons of guns,

some would even say yours truly,

but this guy was next level.

I mean, he tried to tell me

that all the surgeries in Dallas

were being performed incorrectly.

- And what did you observe during your operation with him?

- An anterior lumbar fusion at L5-S1

is about the easiest procedure a spine surgeon can perform,

and he just struggled.

I mean, he was functioning at the level

of a first- or second-year resident.

Instead of using a scalpel to remove the disc,

he just started grabbing at it with a double-action rongeur.

All right, imagine, instead of using a pizza slicer

to divide and conquer your extra-large pepperoni,

you went after it with a pair of lockjaw pliers.

Not appetizing, right?

- Did it appear to you

that there was more blood loss than there should be?

- When he was taking the disc out,

he took off a bit of bone

from the bottom of the L5 vertebral body.

In surgical parlance, he violated the endplate.

Very difficult to do in healthy bone.

He did the same thing to the sacrum.

When you start chewing into bone,

you get a lot of bleeding.

It's not easy to stop bleeding when it's coming from bone.

You're just really not supposed to do that.

- What are you supposed to do?

- Curet off the cartilage.

A curet is like a scraper.

You scrape off all the cartilage

so you can get a proper fusion, and then heal bone to bone.

- When did you leave the surgery?

- Midway, I was called into a previously scheduled operation.

Grudgingly.

- Grudgingly. Why grudgingly?

[soft tense music]

* *

- He was the neurosurgeon. He was in charge.

I did my job.

I did my best to guide him, and then I left.

In hindsight, I suppose I could have dragged him out of there.

If there's ever a next time, I will.

[faint indistinct chatter]

- State passes. - Defense.

- You stated that Dr. Duntsch was operating at the level

of a first- or second-year surgical resident.

How many years does a neurosurgical resident

typically study?

- Six.

- And would that include his training?

- [laughs softly] Or lack thereof.

- Or lack thereof.

Well said.

Defense passes the witness.

- We stand in recess until tomorrow.

[indistinct chatter]

[dramatic music]

* *

- We can shift the blame to your training.

- My training was some of the best in the world.

- No, it was some of the worst.

- What are you talking about?

- We'll say you slipped through the cracks.

You were told you were good enough to graduate,

but you didn't have enough training hours.

Your financial ties to Skadden

and the rest of the investors blinded them to your--

to your flaws. - Stop.

- The entire medical community

of Dallas should have recognized it.

Instead, they simply moved you from hospital to hospital.

- You are erasing my legacy.

- Legacy?

Christopher, you're done.

- Fuck you.

- You'll never practice medicine again.

- Fuck you.

And why aren't you pushing back on any of their witnesses?

- How exactly would I do that, Chris?

- I don't know. That's your job, isn't it?

You break them down. You tell them they're wrong.

You get them to admit-- admit whatever it was

that they lied to me about that messed up their surgery.

- Chris--

- You do something to defend me.

- The only witness,

the only defense that I have right now

is gonna speak to your narcissism.

Our best bet is to prove

that you never should have practiced medicine.

Give me this. Please give me this,

and we might be able to save you.

- [sighs]

- Thanks for being here today, Mr. Summers.

Can you tell us how you know Mr. Duntsch?

- We were classmates. Went to high school together.

Lost touch.

Reconnected when he returned to medical school in Memphis.

- What led you to have surgery with Mr. Duntsch?

- Sharp, stabbing-like sticking pain in my neck.

Numbness.

- Did he explain the risks?

- He advised it was dangerous.

He promised to take care of me.

- What did you do the night before the surgery?

- Watched a game. Basketball.

Then I went to bed around 10:00.

May--maybe more like 11:30.

- What's the first thing you remember after the surgery?

- I could barely move.

I just kind of started freaking out, hollering.

Wanting to know what was going on.

- And did Chris come and talk to you?

- Not at first, but eventually.

And then they took me in for a second surgery,

and when I got out, I couldn't move at all.

- Do you remember making a statement in the ICU

that you and Chris were doing cocaine together

the night prior to surgery?

- I wanted to see him.

He wasn't coming around, and I--I was mad.

I made it up.

He was my doctor.

I wanted to know why I couldn't move.

He was in charge.

He wouldn't come see me.

- And he was your friend?

Let the record show the witness nodded.

He was your best friend?

Let the record show the witness nodded.

And he abandoned you?

[pensive music]

* *

The State passes the witness.

- I'm terribly sorry for what happened to you.

You and Chris played football together, yes?

- That's right.

- And did you have some victories

and some not-so-great games?

- Yeah.

- And how did Chris deal with those games?

Did he always go in and always try to do his best?

- Yeah.

- Were you aware that he was in a fellowship program

studying under Dr. Geoffrey Skadden?

- Yes.

- And from your understanding, was it very important,

what he was doing for Dr. Skadden?

- Yeah.

- And things like doing surgeries

while he was there under Skadden's supervision,

that was important to becoming a successful surgeon?

- Yeah.

- Did you ever see Chris get out of obligations

that he had at school?

- I felt that way sometimes.

- Can you give us an example of that?

Like, something that you saw or that made you think that?

- I can just remember maybe making a phone call

to a doctor,

maybe Dr. Skadden or another doctor,

to say that he had stuff to do for DiscGenics.

And I can remember them

let him out whatever he had to do.

- When you would find out that Dr. Skadden

and/or some other doctor would just excuse him

from doing things at school in lieu of staying in the lab,

I mean, did you think that was a problem?

- I never knew that, you know, what was happening,

and so I--I--I don't know what he was missing

or where he was going. So I--I don't know.

- Okay.

Well, did you ever meet

any one of his classmates, or anyone

who went to the University of Tennessee Med School,

and talk to them about the rigors

of completing medical school and completing that fellowship?

- I don't remember.

- You don't remember anyone saying

that he only got through medical school

because Skadden liked him?

- I heard that after--you know,

something similar to that since my surgery.

- Do you remember who that was that told you that or is that--

- I heard it from a friend

who heard it from another friend,

and he made a comment

that Chris was able to circumvent the program.

- Did they attribute that circumventing to Dr. Skadden

or some other doctor or both? - I don't know.

I don't--I don't know.

- Okay. - I don't know.

- Okay, you said you understood--

- I think what they attributed to is the fact

that they had companies with them.

- Well, that was the next thing

I was gonna ask you about.

You said they had companies with him.

They gave all the funds to those companies.

- Right.

- For him to do the research, right?

- Right.

- Okay, and it was very important

that research be successful to those companies.

Is that correct?

- Yeah.

- Now, when Chris moved here,

did he cut off all work

with Dr. Skadden and DiscGenics?

- Not that I know of.

- So Chris came to Dallas,

and he worked at the Minimally Invasive Spine Institute.

Is that correct?

- Yeah.

- And while he was working there,

he was being pursued by Amy Piel at Baylor-Plano.

Is that correct?

- Well, she was interested in having

a successful clinic on the property.

- Mm-hmm. All to herself.

Because if he was with Missy,

she wasn't getting all the fees that he would generate.

- Yeah.

- So both the chair of his fellowship,

the person responsible for his training,

and one of the largest hospitals

in the Dallas-Fort Worth area had financial reasons

for ensuring that Christopher Duntsch was successful.

- I'd say so.

- Defense passes the witness.

- Redirect.

Did Christopher ever visit you after the surgery?

After you returned home to Memphis?

- Once. He came to visit.

- What did you talk about?

- His baby, his practice.

Nothing in depth.

- Did he ask about you?

About what was happening in your life?

- No.

- Ms. McClung said that she was sorry

for what happened to you,

even though she has no connection to your surgery.

Has Christopher ever said he was sorry?

[dramatic music]

* *

- No.

- Final question, Mr. Summers.

He's here now.

Is there anything you want to say to him?

- Objection. - Sustained.

- I love you.

- The jury will disregard that last statement.

- The State has no further questions.

- Would you please introduce yourself to the jury?

- Major Kimberly Morgan.

United States Air Force.

- And are you currently out on deployment

in a location you cannot disclose?

- Yes, ma'am, due to security.

- Are you familiar with a person

named Christopher Duntsch?

- Yes, ma'am.

I ran the office at his clinic

and assisted in surgery.

- Can you tell us what the defendant was like?

His demeanor?

- Caring, kind,

always very nice to the patients.

He took time to listen to them.

- And did that change over the course

of the time you were with him?

- Yes,

after the event in February 2012.

- The event?

- Jerry Summers' surgery.

[tender music]

Mr. Summers wasn't able to use his limbs,

was having difficulty breathing,

and then he talked about how he and Dr. Duntsch

were doing cocaine the night before the surgery.

- You were ordered to take a drug test?

- Myself and Dr. Duntsch. I took it right away that day.

- Did the defendant?

- Eventually.

It came back clean,

and Baylor reinstated his privileges.

- Shelley Brennan would be

the last patient you assisted on?

- Yes.

- What do you remember about her surgery?

[ominous music]

* *

- It's a simple surgery.

In one day, home the next.

- This is an email from Duntsch@TNIclinic.net

to Kimberly Morgan.

The subject is "Occam's Razor."

"Kim, unfortunately, you cannot understand that

"I really am building an empire,

"and I am so far outside the box

"that the Earth is small and the Sun is bright.

"Anyone close to me thinks that I'm likely

"something between God, Einstein,

and the Antichrist...

- Because how can I do anything that I want

across any discipline boundary

like it's a playground and never ever lose?

Unfortunately, despite the fact

that I am winning, it is not happening fast enough.

What is the problem, Kim?

It is simply that everyone else is human,

and there's nothing I can do about it.

So I pick and choose my humans

and try to help them.

You, my child,

are the only one standing between me and the other side.

I am ready to leave the love and kindness and goodness

and patience that I mixed with everything else that I am

and become a cold-blooded killer.

The sad fact is, I could go faster, do better,

catch more honor and respect

by fucking everybody in the brain,

emotionally and mentally controlling them

in a manner that borders on abuse,

taking no prisoners, sending everyone in my way,

especially that fucks with me, to hell

for the simple fact that they thought they could.

What I am being as what I am,

one of a kind,

a motherfucker stone-cold killer.

- I'll pass my witness, Your Honor.

- I don't think it's morning

where you are, but good morning.

Now, the State is making a big deal out of this email

they just read.

Did you know Christopher liked poetry?

- I found out later.

- But you're not surprised by his--his flowery language.

I mean, he sent emails

like that one quite often, didn't he?

- Yes.

- Do you think Dr. Duntsch was a cold-blooded killer?

- No.

- Now, it's no secret that you and Dr. Duntsch

had an intimate relationship.

We know that involves sex,

but was there an emotional element?

- Meaning?

- Well, among the people in his life,

based on everything you saw

working with him day in and day out,

sleeping with him,

you thought you were pretty close?

- I thought so.

- Close enough that perhaps

you didn't allow yourself to see the truth?

- The truth?

- About his abilities.

- I don't understand.

- Was he a good surgeon?

- That's outside my area of expertise.

- You were in his office. You were in the O.R.

You don't have a professional opinion?

- No.

- Okay, well, after Shelley Brennan,

did you ever work with Dr. Duntsch again?

- No. - Why not?

- I didn't wanna be in that environment anymore.

- That environment? What environment?

[uneasy music]

* *

- Unhealthy, you know?

- You mean the environment in which patients

were being maimed and killed?

- Objection. - Sustained.

- Just one more question.

If you believed that Dr. Duntsch

wanted to hurt patients,

you certainly would go and tell somebody about that,

wouldn't you?

- Yes, ma'am.

- Pass the witness.

Stay safe, Ms. Morgan, wherever you've gone.

* *

- How are you feeling?

- If they ask me questions about Duntsch's training,

I can't promise you what I'm going to say.

- Yeah.

If we can't present our entire case,

the good, bad, everything,

if we can't lay it all out and still win,

then we shouldn't win.

[cell phone buzzes]

- You take that call.

- Hey, Ma. Hang on a sec.

Dr. Henderson.

If they ask, answer how you want.

- Thank you.

- Yeah, I'm here.

We asked you here to give your opinion

on four different cases the defendant performed.

What surgery did the defendant recommend for Jerry Summers?

- An anterior cervical fusion at C3-4 and C4-5.

- What was the outcome of Mr. Summer's surgery?

- He was rendered a quadriplegic.

- Would you walk us through it?

- There was a lot of bleeding.

- Suction. - Suction.

- Sponge. Give me a sponge.

- How many CCs were lost?

- A typical loss is somewhere between 25 and 200 CCs.

Mr. Summers lost 1,900 CCs.

- What accounts for that amount of blood loss?

- Injuring a major structure.

- Pituitary.

- He removed the disc from C3-4 and C4-5,

as he was supposed to do,

and then he removed a tremendous amount of bone

on the left side.

Over a third of the vertebral body.

And in doing so, he lacerated the vertebral artery.

- The defendant chose to go back in for a second surgery.

What procedure did he perform?

- Double action.

- A laminectomy in order to relieve pressure on the spine.

But by removing excessive bone

from both the front and the back,

you're compromising the entire structure.

- In layman's terms?

- His head was barely attached to his spine.

[soft gasps, exhales]

- Let's move on to Shelley Brennan.

The surgery Duntsch recommended,

was that a surgery that would fix her issue?

- Yes.

- What was the outcome of Mrs. Brennan's operation?

- She died.

- Is that normal for this type of procedure?

- Mortalities are less than 1 in 10,000.

The pituitary rongeur went through

the ligament in the front and lacerated the iliac vessels

that lie directly on the side.

- So Mrs. Brennan was bleeding?

- Heavily.

- Would there have been blood

visible in the operative site?

- Sometimes, yes.

It doesn't appear to have been the case here,

but they should have noticed a drop in her blood pressure.

- Should a neurosurgeon know that a drop in blood pressure

means there's a bleed somewhere?

- It's a fundamental rule, but the likelihood of them

being able to address the issue is small.

They'd call in a vascular surgeon for assistance.

- But he didn't do that.

- No.

- Dorothy Burke.

- Mrs. Burke had a previous anterior cervical fusion

at C5-6 and C6-7 that resolved her symptoms for a time,

but she began experiencing neck and shoulder pain

that had nothing to do with her prior surgery.

Dr. Duntsch diagnosed a disc protrusion at C4-5

and a disc extrusion at the C7 T1 level.

He sliced through the vertebral artery again.

[monitor beeping]

- We've been talking a lot about the vertebral artery.

Is it common for it to be hit during surgery?

- Exceptionally rare.

- How many times have you hit it?

- Never.

- And what happened to Mrs. Burke after her surgery?

- Her heart rate elevated. She couldn't open her eyes.

No verbal response to questioning or commands.

- And what does that indicate to anyone in the medical field?

- An impending disaster.

- What should Mr. Duntsch have done

as soon as he was informed of that information?

- Physically examine the patient.

Order appropriate studies. Scans.

They were ordered by the ICU physician,

which showed she was brain dead.

- Where was Dr. Duntsch?

- He was operating on Madeline Beyer.

- Had the defendant focused on Dorothy Burke

rather than Madeline Beyer, would she still be alive today?

- Based on what I know

of Dr. Duntsch's approach to surgery,

Mrs. Burke was dead the moment she agreed for him to operate.

- Objection.

- Sustained.

- Madeline Beyer?

- Mrs. Beyer is the reason I'm sitting here today.

I--I tried to fix her.

One of the screws was violating the spinal canal,

damaging dura and nerve roots.

- How do you know when you've hit the dura?

- Cerebral spinal fluid leaks out.

I found evidence of three attempted screw placements

on the left side where he put no screws.

The most disturbing part was,

the entire reason he was operating

was to remove the disc, and he didn't touch it.

- What did he take out?

- A large piece of the psoas muscle.

He made a portal through that muscle

and stuffed an implant in there.

- Cage.

- Is a trained neurosurgeon

going to know the difference between bone and muscle?

- Yes. - Mallet.

- Would a trained neurosurgeon know

that by malpositioning the interbody device,

he was reasonably certain to cause her injury?

- Yes.

- Would a trained neurosurgeon have been aware

that if he malpositioned the pedicle screws,

he was reasonably certain

to cause her serious bodily injury?

- Yes.

- Would a trained neurosurgeon have been aware

that if he amputated the nerve root,

he was reasonably certain

to cause her serious bodily injury?

- Yes.

- The way the surgical tools were used

in Madeline Beyer's case,

do you think they were used in a manner

that was capable of causing death or serious bodily injury?

- Yes.

- We pass the witness.

- Dr. Henderson, Ms. Shughart made

quite the point that a trained neurosurgeon

should have done this or done that.

You're aware Christopher has both an MD and a PhD

from the University of Tennessee.

- I am.

- UT isn't some fly-by-night medical school.

It's not like one of those in--

in Guadalajara or Granada, is it?

- No, it's in Memphis.

- Do you know Dr. Geoffrey Skadden?

Does he have a good reputation?

- I do, and he does.

- And what was he responsible for

in Christopher Duntsch's training?

- After Dr. Duntsch finished his residency at UT,

he came under the tutelage of Dr. Skadden

for a fellowship training

in minimally invasive spine surgery.

- Were you familiar with the fact that Dr. Duntsch

was doing medical cancer research on the side

and that Dr. Skadden was involved in that research?

- I wasn't at the time, no.

- Should any doctor under any circumstances

have their surgical training hours disrupted by research?

- Absolutely not.

- So a neurosurgical resident or fellow

can't just skip those hours.

The supervisor has to sign off, no matter the excuse.

- Correct.

- Do the doctors in charge of the program have to sign off

that they're qualified to go and operate?

- Yes.

- Did Dr. Skadden write letters

of recommendation for Dr. Duntsch?

- Yes, he stated Dr. Duntsch

was a satisfactory surgeon in his fellowship.

- Well, had Dr. Skadden heard what was happening in Texas?

- Yes, because he had mentioned

poor outcomes at Baylor when filling out

a credentialing form at Forest Park.

- Do you have any idea why he wouldn't have explicitly told

these hospitals not to hire Dr. Duntsch?

- Dr. Skadden said that he had to write recommendations

based on what he'd witnessed in his program.

He couldn't speak to whatever was happening in Texas.

He didn't write any more recommendations for Mr. Duntsch

after we spoke.

- Has there ever been an instance

in which a doctor was sued for not writing a recommendation?

- Yes.

- Well, that's frightening, is it not?

- It is to me.

- So Skadden had to sign off on him,

or he wouldn't have been able to get their credentials?

- Correct.

- I mean, Baylor wouldn't let

somebody just walk in off the street,

start doing neurosurgery.

- I also assumed they would have reported

the outcomes of his surgeries to the authorities.

- As a matter of fact,

they didn't say anything negative to anybody.

Neurosurgery is a big moneymaker.

Do you think the corporate level of the hospital

was more interested in making money

than in protecting their patients?

[soft dramatic music]

* *

- [sighs] Yes, I do.

I think everyone was more interested in making money

and protecting themselves

rather than protecting their patients.

- Thank you for the truth, Dr. Henderson.

No more questions.

- I'd like to add something.

- Redirect.

Anything you'd like to add?

- Everyone knows the first tenet

of the Hippocratic Oath, "First, do no harm".

But there are others.

"I will respect the hard-won scientific gains

of the physicians in whose steps I've walked."

He did not.

"I will apply, for the benefit of the sick,

"all majors which are required,

"avoiding those twin traps of overtreatment

and therapeutic nihilism."

He did not.

"I will not be ashamed to say I know not,

"nor will I fail to call them my colleagues

"when the skills of another are needed

for a patient's recovery."

He did not.

Had I performed any of the 33 surgeries

in the manner that he performed them,

I never would have allowed myself

into an operating room again.

Any one of them.

Not ever again.

* *

- The State flooded you

with every possible patient they could,

but Madeline Beyer's case is the case the State chose

to go to trial on, so let's focus there.

Now, according to the state, Dr. Duntsch didn't head

into Madeline Beyer's surgery to fix her--

he wanted to hurt her--

but that's not what the evidence shows.

The evidence shows he was a suboptimal surgeon.

Now, are we trying to blame the hospitals?

No.

Are we trying to blame Dr. Skadden?

No, but the State asked time and time again,

what would a well-trained surgeon do?

I mean, what did Dr. Henderson tell you?

He got on the phone, called Skadden, and said,

"Hey, we got this guy here.

"It says he graduated from your medical school,

"went to your fellowship,

and I need you to stop recommending him."

And Skadden replied, "Yes, he did train at my fellowship.

But I don't know what to do."

Because Skadden has figured out,

"I screwed up. I let him out."

I mean, Jerry Summers told you,

he let him out of surgeries in order to do research.

Now, you don't get to punish Dr. Skadden.

You don't get to punish Baylor.

You don't get to punish Dallas Medical,

but you have the right to know what they didn't do.

They didn't report him.

They didn't challenge him.

They didn't tell him that he was

a suboptimal surgeon who needs to find other work.

If you're a teacher and the children don't do well,

your principal tells you you're a suboptimal teacher.

If you're a mechanic

and the cars you're working on keep breaking down,

you're told you're a suboptimal mechanic.

If you're a pilot and you can't land,

well, you're told you can't do this anymore.

Well, Baylor does the opposite.

They allow him to resign.

And then they send a clearing letter

to Dallas Medical,

who hires him and then watches

as three surgeries in as many days go bad.

And what do they do?

Nothing.

They don't report him

to the National Practitioner's Data Bank

or the Texas Medical Board.

They allow this poorly-trained suboptimal surgeon to move on.

The system broke down from the very beginning.

Now, I don't envy your jobs.

Both sides have their own perceptions

of--of what happened,

but you're the sole judges of the facts.

Render your verdict according to the law,

not according to emotions

or sympathies or sending a message.

It's about whether or not the State has proven to you

that a crime was committed.

It was a failure.

It was a human failure,

a systemic failure,

but it wasn't a crime.

- On July 25th, 2012,

Christopher Duntsch went into surgery with Madeline Beyer,

an elderly individual.

He crippled her.

Pedicle screws, drilled and redrilled.

Nerves shredded. Leaking dural sacs.

Muscles hacked into.

These things happened.

But was it intentional?

How do you know what he intended?

You look at what he does before, during, and after.

He lied, about "this is normal pain."

"This is something new.

"I didn't do this to you.

"It's simply swelling, Jerry.

"Surgery went fine, Madeline.

"It's the surgical team's fault.

Your wives are dead, Earl, Harold."

Look at them.

Look at the faces of the lives that were ruined.

We didn't bring them to you to have you convict him

based on sympathy.

We bring them to you so that you can know

everything the defendant knew.

How many patients should it take

before you know that what you're doing is hurting people?

One, two, three?

You make your best friend a quadriplegic?

Four, you kill? Five, you kill?

Should I list all 33?

I want to call them tragedies,

but that implies no one could have seen them coming.

These were assaults.

We're here talking about Madeline Beyer.

I know you don't have a doubt that when Christopher Duntsch

went into Madeline Beyer's surgery,

he was reasonably certain he was going to hurt her.

That's the standard of knowing.

Not that you know 100%,

but that you're reasonably certain.

The defense is implying it was his training.

He was trained for 17 years

prior to operating on Mrs. Beyer.

Trained at the University of Tennessee.

Trained at Semmes-Murphey.

Institutions with doctors

who would not put their reputations on the line

by recommending a poorly trained surgeon.

[soft dramatic music]

Don't blame his training. Blame him.

Don't blame the system. Blame him.

He went into all those operations.

He put the scalpels to those patients' backs.

He kept going.

All these people.

If you're a human who values life,

who understands suffering...

You heard Dr. Henderson.

One botched surgery, just one,

and he never would have entered the operating room ever again.

If you don't stop him,

Christopher Duntsch will leave this courthouse,

leave this city, this state,

maybe even this country,

and he will find a corner of the world

that allows him to continue hurting people.

Only you can tell him no more.

* *

- They don't understand.

All I wanna do is go back to my research.

You gotta tell 'em, Dad.

I will never practice surgery again.

If they let me, I can still do good.

I can still help.

- Just stop, okay?

It's time to stop.

[sighs]

We had these hardwood floors when you were little.

Active, always active.

So energetic.

You were so strong.

You would push the furniture around across these floors.

You never played with toys. It was always the furniture.

And how many times did I ask you

to stop it with the furniture?

But you wouldn't stop.

You wouldn't stop.

Maybe jail's the best thing for you, my boy.

- You were less dull than I thought you'd be.

- You're too kind, Randy.

- Probably blown the whole case, but nice job.

- We could have done more. We should have done it more.

This is gonna happen again, you know.

- Suppose we could do something.

- I suppose we should.

- Jury's back.

- All right, well, we got time for some hoops.

- I wish. - [chuckles]

- We gonna win?

[dramatic music]

- I don't know.

- [sighs]

- I'm sorry.

- You did great.

* *

- [exhales]

* *

* *

* *

* *

* *