All language subtitles for Dr.Death 08

[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]

* *

* *

* *

* *

* *