The Texas Observer May 1st, 2014 Review of the Press Article Review of the Morguloff Petition uploaded publically. Review of the Kirby TMB letter uploaded publically. Review of the Baylor contract uploaded publically, and Attorney Girard’s legal position. In January 2012, Barry Morguloff, a 45-year-old Dallas man, went to his doctor at Baylor Regional Medical Center of Plano, complaining of back pain. When steroid injections didn’t work, his doctor referred him to the hospital’s new surgeon: Christopher Duntsch. Morguloff’s surgery, a spinal fusion, didn’t go well. With the exception of anterior exposure challenges with a general surgeon assisting, the case went very well. The OR time was short, the decompression and instrumentation of the hardware well placed. The next day, he stated he had never felt better. Dr. Randall Kirby, a prominent Dallas surgeon who assisted Duntsch in the surgery … Dr. Randall Kirby only assisted me on one case, months earlier, not this case. He was fired that same day, banned from my OR, reported to Baylor for negligence. I never saw or heard from him again. So is he confusing dates and events and patients, is just negligent, or is this intentional. Or is he changing the facts for the article. Or does he even know whom he operated on. This is a matter of public record, and he is without excuse to negligently misrepresent his role, then use that role to further comment. He was not even in the Hospital. He compared Duntsch’s technique to that of a first-year medical student. Duntsch, he later wrote, didn’t seem to have any understanding of spinal anatomy. Kirby performed an anterior exposure that was through a three inch incision. He refused my request to further expose as per routine in the 2000 surgeries I have been trained with, or performed. In a spine center that claims the largest number of neurosurgeons in the world, privately and academically. In a spine center that claims the largest number of orthopedic surgeons in the world, privately and academically. 70 spine surgeons on staff, and likely 50 residents and fellows as well. 130 spine surgeons. The vasculature and large vessels were exposed yet not identifiable or protected due to the poor exposure and the depth of the surgical tract. When I insisted he complete the exposure, he refused, his response, “I am in a hurry, I have another case book at another hospital. Have you not done many ALIFS? You should be done in 20 minutes”. I immediately went back to the surgery, completed it, then when he closed, made it very clear my opinion of his exposure and behavior. But again, that was different patient. Morguloff says he woke up with agonizing pain in his left leg. Duntsch prescribed him painkillers and told him the pain would go away. He is on record saying he has never felt better in his life in recovery. He was given temporary narcotics at low doses, and for reasons that only he and his family and I know of, and discussed at his first visit. Six months later, a doctor at Presbyterian Hospital of Dallas found that Duntsch had installed the spinal hardware wrong and left bone fragments in the nerves of Morguloff’s back, requiring another round of surgery to remove them.

This patient had a 1 week, 4 week, 6 week, 3 month, 4 month, and five month follow up visit. He did complain of pain but it was not neuroanatomical, and began around 3 months after surgery. In month 4 and 5, we started a complete workup, and conservative care. The results of a dozen radiographs, several CTs, several MRIs, were normal, good surgical result, fusion, and hardware in good position. I explained that all was normal and there was no treatment to provide except more narcotics. Which I would not do. But would refer him to a chronic pain doctor. I also suggested a second opinion. He was very angry, and came to office on an off today and simply walked out with his records. Despite my review and readings on all neuro imaging, and that of 16 radiologists over 6 months, no pathology was found. All agreed on the result and outcome being as good, as expected. In March, Barry Morguloff—along with three other plaintiffs in related suits—sued the Baylor Health Care System in federal district court in Dallas. The lawyers representing Morguloff, Kenneth Fennell, Mary Efurd and Passmore are coordinating their cases, arguing that Duntsch was dangerous and Baylor should have stopped him from operating on them. Their stories have the trappings of farce: For example, when Duntsch operated on Passmore, a Collin County medical examiner, in December 2011, the surgery went so badly that the assisting surgeon grabbed Duntsch’s surgical instruments and tried to force him to stop, according to Passmore’s lawsuit. (He failed.) Once again Dr. Randall Kirby is confused. Because he is the surgeon who performed this case. And he was not the assisting surgeon. General surgeons expose, leave the OR, and close at the end. They do not assist in any part of a surgical spine procedure. And he did put his hands on the surgery, but to expedite my hardware placement so he could get to another hospital. And was fired for surgical manner, and medical conduct within 1 minute of closing. Morguloff’s complaint cites the case of another patient—one of Duntsch’s first at Baylor—who he left unattended in the recovery room while he went to Las Vegas. This is the best textbook example of the gross negligence that exists in this article. And who is responsible. Doug Won Mike Rimlawi Key Van Wey Kirby? The factual basis, is quite different. 1 I was invited to Las Vegas to a surgical spine and pain course, over the weekend. Invited by the Texas and US directors of neurostim and surgical pain at Medtronic. 2 I had a single level but emergent C67 ACDF with profound neurologic deficits and pain present on a Monday. 3 I performed her surgery on that Monday, discharged her on a Tuesday. That would be five days before the Vegas spine course, (not my leaving her in recovery on that Friday)? 4 On Wednesday I broke my contract with MISI and Doug Won et al and moved my clinic the same day. The reason was complete breach of contract, embezzlement, and something close to extortion under duress. 5 On Thursday I saw her in follow up. No pain. Compete neurologic recovery. She was told I would be out of town from Friday night until Sunday AM, and to call my PA for any issues or questions. 6 On Friday, she came to the office to ask a question, but went to the old office. Doug Won was there, told her I was fired, no longer practicing, and literally physically pushed her out into the hall. She panicked feeling abandoned, and went to the ER. I was called just as I landed in Vegas. The ER doctor told me a full workup, medical and neurologic were normal. That she was just anxious. I called my former partner Mike Rimlawi, and asked as a favor if he would see her. He agreed. He called me later, said she was upset, and talking about malpractice. I called the ER, spoke to her directly. She told me she was just frightened by Won, and because Rimlawi told her she should sue me, not the other way around. I

reviewed all results and events with her, and in 5 minutes she was calmed, apologized for the event, and went home 20 min later with no treatment ever given. She was discharged one year later without pain, normal neurologic function. No follow-up needed. I returned on Sunday am. Barry Morguloff’s care was standard and textbook. Clinically and surgically. Mary Effurd’s care was standard and textbook. Clinically and surgically. Her outcome was so good, that she agreed to be a representative for the XLIF procedure for patients like her with back pain. Kenneth Fennel’s surgery went well, but he had comorbidities of a medical nature after. He was very happy with his surgery. His back pain improved, spinal stenosis symptoms subsided, and “he could finally live his retirement as he dreamed of, with travel, and all that comes with retirement”. He did so well, he agreed to be a representative for Baylor and Baylor Spine. Note the complexity of spine in a private system at the highest level. Given all that has occurred it is no issue to relate the following which I was very concerned with. 1 At the time of Fennel’s surgery, I was told by business and marketing that my surgeries were averaging a net profit of 65K$. They are a nonprofit but were very excited. 2 Fennel was on Medicare. He surgery and care cost the hospital a loss of >100K$. 3 The CEO actually asked me to her office, to request that bring all Medicare to the Medical Center of Plano. I refused on moral grounds and told her that was not medically ethical. 4 Shortly after, I received an email from marketing that Santa Clause, could be in the Baylor spine program. They did not want elderly Medicare patients to start seeking care there. The irony is that he was referred to as Santa Clause to not link his name to the request in the email. And that he is Santa every year and proud of it, and the best I have ever seen. And that attorney Key Van Wey has this email and has tried to find out who Santa Clause is for 2 years. Key it is your client. Passmore, did require a second surgery, for a ruptured disc posteriorly after an ALIF surgery. But after that he did very well. He was able to stop all narcotics, gained weight and health, and was pain free. This is important for him in that he came to me after a TLIF done by a north Dallas neurosurgeon, that failed, and left the anatomy scarred and the compression intact. In our first visit, he was in tears for the pain, and the impact on his life. According to his attorneys, Morguloff will walk with a cane for the rest of his life. I hope that is not true but cannot understand the basis for this, even with bone fragments on a nerve root. Especially because I performed an ALIF, did not breach the posterior longitudinal ligament, thus the surgery was not causal. I have never been given any medical evidence or neuroimaging to support these claims. Further, the TMB reviewed the case in full and responded that the clinical care and surgical care were standard and well done. And that my care was not related to his spinal issues 8 months later. Passmore suffers from constant pain and, according to his suit, can’t “lift objects of any significant weight.” In my last visit with him, he was without pain, and completely normal neurologically. Had gained weight. Looked and felt so much better. That was 3mo after surgery. Efurd and Fennell allege in their lawsuits that they sustained severe nerve damage. At Baylor, Neither of these cases resulted in any morbidity of any kind. Both did well, recovered well, were happy with their surgery. Mary Effurd’s care was standard and textbook. Clinically and surgically. Her outcome was so good, that she agreed to be a representative for the XLIF procedure for patients like her with back pain. Kenneth Fennel did so well, he agreed to be a representative for Baylor and Baylor Spine.

At DMC, MS. Efurd did suffer a damaged left L4L5 nerve root. While this was the first time I had this complication, and while this is common in spine, I am still very sad and frustrated that this happened and why. Ms. Martin, a very sad event. She died of anaphylactic shock and disseminated intravascular coagulation. She had several risk factors for narcotic allergy, but no history of allergy, especially to Fentanyl. She received in surgery three doses, and fourth after recovery. And entered a fulminant end stage multi organ failure. That is definitive and proven. Conversely, not a single doctor, surgeon, staff, or the pathologist of the autopsy, every stated that I surgically caused vascular injury. Note these comments. 1 Surgical retroperitoneal injury is rare, and seen as case reports. There are 17000 reported fentanyl deaths. 2 Note that all physicians, pathologists, peer review, found no evidence of any surgical event, nor even suggested it much less documented it. 3 Finally, more bizarre negligence and lack of diligence by Dr. Kirby. The surgery was posterior L5S1 METRx MIS. 15 mm incision, 50 ml blood loss, no breach of the disk, just removal of large fragment of disc that was free and in the epidural space. It is anatomically and surgically impossible that I would even get near these large lower iliac arteries. Thus this is an operation on the lower lumbar spine, upper buttocks, posterior. Worse, Dr. Kirby states that it was a vertebral artery. A cervical neck vessel. That would be a neck surgery, anterior, 3 feet away. This has been misreported to the board, to press, in petitions. How is that a first year medical student, would accurately document this 100% of the time, yet for 3 years Dr. Kirby has the anatomy and diagnosis wrong. 20 years ago, my former chairman might have fired me for such a idiocy. My chairman in residency, would just let 20 spine surgeons attack me harshly in MM until he was satisfied that I understood I needed to do a better job. Finally, I posted this case to 12000 spine surgeons in various media, confidentially, no information given. 120 / 120 spine surgeons agreed with my perspective, or looked elsewhere. Not one even suggested surgical vascular damage as a cause. According to Morguloff’s lawsuit, Summers woke up from surgery a quadriplegic; he told Baylor’s ICU staff that Duntsch had been up using drugs all night. The striking thing about Duntsch’s relationship with Baylor Plano is just how tolerant the hospital was of his behavior—according to the lawsuits, he literally had to kill someone to get fired. A month after Morguloff woke up in agony, Duntsch operated on Jerry Summers, his best friend and former roommate. According to Morguloff’s lawsuit, Baylor didn’t raise a stink about Summers’ paralysis or Martin’s death. Baylor suspended Duntsch for a month. In his first surgery after his suspension lifted, he nicked the vertebral artery of Kellie Martin, a 55-year-old Garland woman. She bled to death in the ICU. Jerry had an anterior spinal cord stroke, textbook and without a doubt. Present at recovery, and due to many different reasons, in particular my failure to walk him from the OR to recovery. Instead I left that to my PA and anesthesia with strict O2 and blood pressure parameters. On arrival his BP was 60/40, instead of 160/100 as ordered. Baylor did not suspend me. They did not take any actions, until 8 days later when a family member and Attorney Robert Crane became litigious. Against my judgment, I let his ICU care be managed other

doctors, and I was in full agreement that a peer review was indicated. I agreed to hold my cases until that was completed. I was not suspended but in good faith volunteered to hold in a suspension state of sorts, until peer review was done. Regarding drug allegations, what Jerry actual said on POD 5 in the ICU, while in Florid ICU psychosis, was that He and I and his fiancé and my PA, stayed out all night, used drugs, and had an orgy. That is a textbook verbatim quote from Jerry Garrison to me the next day. All I could do was laugh out of shock of such a statement. But because of what was implied from my patient to ICU nurses to the CNO to the CEO. The next day, orders for day night restrictions and Seroquel brought into normal neurologic cognition. To this day, he does not remember saying this. My staff and I were all drug tested immediately. The results negative. I tested him as well, and he was positive. Regarding our night before surgery, he was in his bed with his fiancé at 9pm. I was in bed at 10pm. My PA was home with her father and 4 children. But sadly, there is some truth to what he said, but not related to my surgical team or his fiancé. Or the night before. Jerry Summer’s case can only be discussed by addressing his spinal pathology in the context of 3 neurosurgeons, two orthopedic surgeons, three hospitals in two states, and a list of risk factors real and caused by the patient negligently, and by addressing 20 pages of his care at Baylor over 6 months, to present the real complexity of his spine surgery and spinal pathology, comorbidities at surgery, and care afterward. I have never done so publically out of respect for him, and because his own attorneys over years have missed the medical records of fact that I understood in full in 30 minutes. This is a case that is best left to seek its own way, or to address in full and in a manner that is harsh if not unpleasant, factually and as real events and issues. It didn’t report Duntsch to the National Practitioner Data Bank, a database managed by the U.S. l Department of Health and Human Services—even though hospitals are required, by law, to inform the NPPD when they suspend a doctor. Instead, according to the lawsuits, the hospital let him go quietly. Not true. Morguloff’s lawsuit includes a letter that Baylor gave Duntsch the day he resigned, asserting that Duntsch had no outstanding investigations or restrictions at Baylor. Baylor, found my care to be standard and well done. Found no fault. That is fact of record, and the results of dozens of Baylor staff and physicians. That is true. Interestingly, Baylor did act in an unprofessional manner with my credentialing at both MCMckinney and DMC when I resigned. MCMckinney actually denied my credentials after trying to get clear communication from Baylor for weeks, and also reported that to the NPDB. Ms. Effurd and Brown, are cases for a different venue as well. There is no way to communicate what happened there, without a 20 page document of disclosures and events and responsible parties. That venue is a civil or federal jury trial, and I would accept that if it gave the way forward to disclose, remedy, address what happened at DMC with these patients. And for the record, in Ms Efurd, I placed one pedicle screw 3mm off target medially, the first pedicle misplacement in my career. It did however damage her left L4L5 nerve root, which causes disability due to the inability to lift the foot while ambulating. Which is more of an issue than most might imagine. Regarding Ms. Brown, all medical doctors, radiologists, at DMC, were in full agreement with my neurosurgical diagnosis, plan, and serious concerns. She did not have a surgical injury; she had a stroke the next day. She had several comorbidities for brain stroke and required anticoagulation. And was a high

risk stroke. In addition to DMC, all neurosurgeons, staff, residents, ER, radiologists, at the University Hospital agreed with me on all counts in full. Same diagnosis. Same plan of care. Same concern for a poor outcome due to delay in treatment at DMC, that I could not control. In his surgery on Kenneth Fennell, a Dallas small business owner who worked for a pool repair company, Duntsch nicked Fennell’s femoral nerve; Fennell now claims he has nerve damage and chronic pain. This is not true. I was two feet from the peripheral nerve of concern. It was not cut, it was compressed by his weight in surgery. He had a peripheral neuropathy, that occurs in 5% of all patients given an XLIF. Most recover well and quickly. He did not. However, this was expected as a potential event, discussed, and written on his medical consent. When I wrote about Duntsch last August, there were quite a few unanswered questions. Chief among them: Why did he do it? Do what? Please clarify. Was he a sociopath? Dr. Kirby is the only person in the US and abroad to even suggest such a thing, much less publically So you would need to ask him, then get a second opinion from both a neurologist and psychiatrist. And please publish their opinions in the TO. A drug addict? The texas medical board, and Tennessee medical board had 60000 pages of documents from two boards, my education and training, my fellowship, my practice. 21 hospitals, 1000s of surgery. There is not one document, one person, one event, to even suggest such a thing. The TMB dismissed this immediately and publically as false and not true. And with his record of patients dying or ending up paralyzed, how was he allowed to keep practicing? All events and a patients have been discussed in full. Thanks to the new litigation, we have at least a few answers. According to the lawsuits, Duntsch had drug problems that Baylor should have known about. The lawsuits allege a shocking list of behaviors that, if true, should have been huge red flags for Baylor. I would love to hear the list of behaviors referenced here. There are none. So it will be a simple matter to address quickly and in full. They contend he was in treatment for drug abuse during his residency at the University of Tennessee. That is more negligence. It is common knowledge that is based on a passing comment by one my own scientists, it was agreed per protocol that I would to the Tennessee evaluation program, for 2 days. For medical and psychologic evaluation. And drug testing. I did so, and by third day a letter was written to the board that I had no issues, drug or mental, that I should return to neurosurgical practice the next day. All doctors that are senile, angry, alleged of issues, go to the 3 day program. No exception. In exchange, all doctors are cleared and returned quickly, and confidentially to prevent harm from statements as here. That he was abusing prescription drugs

I have never been prescribed an controlled substance, except when I had 11 dental procedures, 3 root canals back to back in 2 weeks. and skipped out on five drug tests that Baylor Plano asked him to take, without any consequences. I never skipped any test or request, ever. When I first heard this it was a high value attorney stating the same to my attorney but privately. He told me. That night I wrote a letter to Geri Garrison and that attorney, stating if they ever made such claims for any reason I would level Baylor to the ground. I will publish the email. That he kept a bottle of vodka under his desk; A bottle of vodka was never seen by any staff, patient, anyone. This is just silliness. that a bag of white powder showed up in his private bathroom. This is true. It showed up on the day of a patients preop, and medical clearance. He was a last patient and still there. I was in my office dictating charts. It was found by my nurse. She gave it to my PA. My PA kept it and told her to not tell me. “I might not do his surgery if I found out”. I did do his surgery, and his outcome was poor and directly related to that drug. I found out later in an taped unrelated depo with my nurse and a Dallas judge. Unexpectedly this came up and she admitted all of this under oath. 6 months later. And there was only one bathroom, far from my office for staff and patients. That he took off for Las Vegas immediately after a surgery, leaving his patient unattended. Again, this is the best textbook example of the gross negligence that exists in this article. And who is responsible. Doug Won Mike Rimlawi Key Van Wey Kirby? The factual basis, is quite different. 1 I was invited to Las Vegas to a surgical spine and pain course, over the weekend. Invited by the Texas and US directors of neurostim and surgical pain at Medtronic. 2 I had a single level but emergent C67 ACDF with profound neurologic deficits and pain present on a Monday. 3 I performed her surgery on that Monday, discharged her on a Tuesday. That would be five days before the Vegas spine course, (not my leaving her in recovery on that Friday)? 4 On Wednesday I broke my contract with MISI and Doug Won et al and moved my clinic the same day. The reason was complete breach of contract, embezzlement, and something close to extortion under duress. 5 On Thursday I saw her in follow up. No pain. Compete neurologic recovery. She was told I would be out of town from Friday night until Sunday AM, and to call my PA for any issues or questions. 6 On Friday, she came to the office to ask a question, but went to the old office. Doug Won was there, told her I was fired, no longer practicing, and literally physically pushed her out into the hall. She panicked feeling abandoned, and went to the ER. I was called just as I landed in Vegas. The ER doctor told me a full workup, medical and neurologic were normal. That she was just anxious. I called my former partner Mike Rimlawi, and asked as a favor if he was see her. He agreed. He called me later, said she was upset, and talking about malpractice. I called the ER, spoke to her directly. She told me she was just frightened by Won, and because Rimlawi told her she should sue me, not the other way around. I reviewed all results and events with her, and in 5 minutes she was calmed, apologized for the event, and went home 20 min later with no treatment ever given. She was discharged one year later without pain, normal

neurologic function. No follow-up needed. I returned Sunday. But despite this, and despite the numerous warnings about Duntsch from doctors and nurses who had worked with him, Baylor continued to allow Duntsch to operate, and even publicized his practice and encouraged doctors like Morguloff’s to refer their patients to him. What doctors? There were none. What nurses, there were none. Both of my Baylor nurses are under oath on all matters. According to the lawsuits, the reason for this was simple: The hospital had advanced Duntsch $600,000 to move from Tennessee to Dallas. “Baylor had spent a lot of money on Duntsch,” attorney Jim Girards wrote in Passmore’s complaint, “and they wanted it back.” If he didn’t work, they didn’t get paid. What person could spend 5 minutes on this matter, and not realize that Baylor and MISI broke their contracts. That MISI embezzled 250K of my salary before I quit. That I built my practice on work ethic and large business loans. That no revenue was given by Baylor or MISI. The four Duntsch patients want to change that. Their only recourse is to challenge the constitutionality of the laws shielding Baylor Plano. If they win, hospitals could once again be responsible for the actions of the doctors they allow to practice. But they’re confronting powerful opponents, not just a lucrative hospital. Texas Attorney General Greg Abbott, who’s made limiting lawsuits a feature of his political career, is facing off against them in court. Barring an upset in court, it’s likely that the hospitals who allowed Duntsch to kill and maim patients will never pay a cent in damages. I disagree, because I also see a huge need for revision and restructuring. Cap Reform and immunity work against the system, and actually harm patients and doctors through a fiscal path that was not predictable. Whether they care or not, I am making this effort to find a path to the board and its protocol function. I cannot comment on Abbot. It is right that he defend CAP reform in its true form. It is wrong to ignore the damages to the system that come with its architecture. But despite there lack of faith in success, I have different expertise that might make a difference. Tort reform—an effort to reform liability laws to make it harder for plaintiff to sue—had been a major aim of the Republican Party since the mid-1990s, when cases like Liebeck v. McDonald’s —the infamous “woman sued McDonald’s because her coffee was too hot” case—began to circulate in the media, part of a PR campaign by the tobacco and insurance industries to convince Americans that the country faced an onslaught of frivolous lawsuits. Never mind that Liebeck required skin grafts, or that McDonald’s had already received more than 700 complaints of injuries from scalding coffee. The frivolous lawsuit line fit into both American distrust of lawyers and the “other people are taking what’s yours” narrative so dear to American conservatism. After President Bill Clinton vetoed a 1996 tort reform bill that, he said, “tilted the playing field against consumers,” the tort reform campaign shifted to the states. The campaign wasn’t totally baseless—trial lawyers wielded an enormous amount of power in Texas back in the 1980s and 1990s. But the reformers went far beyond a small correction. In Texas, virtually the only defense people have against malpractice by doctors and hospitals is the civil courts. And in the late 1990s, the Texas Legislature and Texas Supreme Court began working in tandem to strip those defenses away. The first blows came from the courts. In 1996, in two separate cases, the Republican-dominated Texas Supreme Court held that hospital credentialing records were confidential. To practice medicine in a hospital, a doctor has to receive permission, or credentials, from the hospital. The credentialing process can generate documents that provide insights into the hospital’s due diligence and the doctor’s past. After Supreme Court ruling, plaintiffs trying to prove that a hospital had erred in giving a doctor credentials had to do so without having access

to the documents. Then in 1997, in St. Luke’s Episcopal Hospital v. Agbor, the court made a decision that led to a further deterioration in the rights of patients. The Agbors sued St. Luke’s after their baby’s arm was permanently crippled during birth. They argued that St. Luke’s never should have given their doctor credentials, given her lack of medical malpractice insurance and the numerous malpractice cases she’d racked up. During the trial, St. Luke’s lawyers made an innovative argument. Under Texas law, anyone suing a hospital for improper credentialing had to demonstrate that the hospital had acted with malice. Until Agbor, this had been understood to be a standard for doctors: A litigious doctor suing a hospital’s peer review board for denying him or her the right to practice had to prove that the board had done so to harm him deliberately. St. Luke’s lawyers stood this precedent on its head and argued that it should also apply to patients. The Agbors, they said, had to prove that the hospital had acted maliciously toward them by giving the doctor credentials. The Supreme Court agreed and the Agbors lost. The ruling hit malpractice lawyers like a thunderbolt. This new standard was “idiotic,” said Paula Sweeney, a Dallas attorney and authority on medical liability. “What the Legislature intended was for hospital staff to be able to get rid of a bad egg if they wanted to do that.” Together with the new secrecy around credentialing, it became very difficult to successfully sue hospitals for permitting a dangerous doctor. “It was a perfect Catch-22,” Sweeney wrote me in an email. “You have to prove malice but you can’t get any evidence to do it.” I am amazed to read this article and find it grossly, even criminally negligent. Then read the final text on tort reform and cap law and find it accurate, well written, and appropriate. I had shivers to read his report and overlay it with my perspective. The editor and his comments and implications are dead on. About immunity, the effect of cap reform, on plaintiffs and patients, and immunity making this even more difficult. It is a flawed system with genuine good intent misplaced. If anyone thinks I am here to gain something, or defend myself that is not true. I will defend myself, but my efforts are benevolent and serve something bigger than myself. And in the near future.

Click to read Barry Morguloff’s suit against the Baylor Health Care System.

But the ruling didn’t kill the ability to sue hospitals. You had to prove malice, but malice then was a broader category than it is now: It included the legal concept of “gross negligence,” which means knowing something is dangerous and doing it anyway. Mike Lyons, Morguloff’s attorney, defined gross negligence to me as akin to “knowingly allowing a child sex offender to take a job in a pre-school.” If someone could prove in court that, say, hospital administrators knew that a doctor was addicted to cocaine and that his patients had a tendency to wake up paralyzed, the attorney had a reasonable chance of winning the case even without credentialing documents. But then in 2003 the Legislature closed even that avenue. There is no basis or proof for events and statements not true, negligent and harmful. In the years leading up to the 2003 session, a coalition of Texas medical interests and insurance companies unveiled a new plan which would, they said, massively increase Texans’ access to medical care. The coalition, which included the Texas Medical Association, the Texas Hospital Association and groups like Texans for Lawsuit Reform, argued that doctors were fleeing the state. Texas, they claimed, had become “the lawsuit capital of the world. “Greedy patients were teaming up with cynical fat-cat trial lawyers to file frivolous big money lawsuits that were chasing away Texas doctors. While relatively few doctors were sued, the argument went, the judgments helped lead to expensive medical malpractice rates. Tort reformers argued that these high rates were chasing away doctors. If that sounds oversimplified, well, that really was about the level of debate at the time. Some of the reformers’ arguments were simply false: Texas was gaining doctors, not losing them. And while it was true that medical malpractice rates had spiked in the years before the session, the role of lawsuits in the spike is disputed. According to a 2003 Public Citizen report, rates were climbing because insurers had kept them artificially low throughout the 1990s in an industry-wide competition for market share. But tort reform had a seductive ring to it. I have on my computer a 2002 direct mailer in support of Proposition 12, the ballot measure that enacted sweeping changes to Texas’ civil liability laws. The front has the face of a concerned-looking guy in a lab coat juxtaposed with a fat-faced schmuck smoking a cigar. Below it, in bold text: “Whom would you trust … If your life was on the line?” Given that choice, the answer was obvious. Proposition 12 overwhelmingly barely passed, with 51 percent of the vote. The measure didn’t end up dropping medical costs or attracting more doctors to Texas. But it did make it dramatically more difficult—and in the case of hospital credentialing, impossible—to successfully sue a hospital. The best-known provision: the Legislature capped all non-economic damages—pain and suffering and the like—at $250,000. The idea was to keep juries from handing out big awards based on squishy emotional appeals. But because plaintiffs could still get compensated for hard costs, like lost wages, the effect was to kill medical malpractice lawsuits for all but the richest plaintiffs. “When you cap non-economic damages but not economic damages, your worth is what your paycheck is,” said Alex Winslow of Texas Watch, a nonprofit consumer watchdog. “If you’re a corporate CEO, or a lawyer, and you can calculate high economic damages, you might be able to get a case to court. For the rest of us, who don’t have huge economic damages, we won’t get to go to court. The effect of the law has been such as to close the courts for most victims of medical malpractice.” And as they made it difficult to get much money from doctors, lawmakers made it impossible to get anything from hospitals. With House Bill 4, the legislation that Prop 12 enacted, the Legislature took the legal tool of “malice” and rendered it useless. In House Bill 4, the Legislature rewrote the definition of malice to mean “specific intent to harm.” Under the new law, a plaintiff now had to prove that a hospital had given a bad doctor credential in

an effort to hurt them, the patient. This is basically a horror movie scenario. And like a horror movie, it’s hard to imagine it actually happening. “The standard is impossibly high,” Alex Winslow of Texas Watch told me. “Other than the hospital administration turning to the doc and saying, ‘Here’s your next victim, go get them,’ I don’t even know how anyone can meet that standard.” And, he said, it misses the point: Patients have little way of knowing first-hand about the quality of a hospital’s doctors. They rely on hospitals for that. “The hospital should have some legal responsibility for making sure doctors seeing patients have a safe track record,” he said, “that they have no history of abuse, they’re not on drugs, they’re meeting basic standards of safety. And law doesn’t require that.” In 2005, all the pieces came together, as the Texas Supreme Court showed just how high the bar now was for suing a hospital. In a case that gruesomely foreshadowed Duntsch’s, the court completed the work of shielding hospitals entirely from liability. On July 15, 1998, Ricardo Romero went in for elective back surgery to Columbia Kingwood Medical Center, in northeast Houston. His doctor was Merrimon Baker, a South Carolina resident who had been sued 10 times for malpractice. Baker also had a serious hydrocodone addiction, according to the Supreme Court decision. No one at the hospital told the Romeros any of this. The Romeros also weren’t told that Baker had been suspended a month before Romero’s surgery by Cleveland Regional Medical Center, another Houston hospital, for operating on a patient’s wrong leg. Baker had secured a temporary restraining order to keep Cleveland from telling Columbia’s administrators what had caused his suspension, even though one doctor served on both hospitals’ peer review committees. That restraining order expired the day after Romero’s surgery. That was a day too late. During surgery, Baker perforated Romero’s spine. Over the next 45 minutes Romero lost, according to the Supreme Court decision, “almost all of the blood in his body.” Romero’s heart stopped, and though the doctors resuscitated him he was left brain damaged to the point that he was unable to care for himself. Dolores Romero, Ricardo’s wife, sued Columbia Regional for letting Baker operate. At trial, a jury awarded the Romeros $28.6 million and punitive damages of $12 million. Columbia appealed. The Romeros had to prove “malice,” but because Romero’s surgery had happened before the Legislature weakened the statute, the family could still argue that malice included gross negligence. But the appellate court’s decision demonstrated how much patients’ rights had been eroded even since the late 1990s. The appellate court ruled that Baker did represent an “extreme risk” to his patients. But because Columbia had the right of keeping its credentialing files confidential, there was no way to know that it hadn’t taken actions to protect patients, such as requiring him to take drug tests. “But one thing we do know,” the judge ruled, “we cannot infer anything from this lack of information.” In other words, the Romeros couldn’t prove Columbia hadn’t done anything to rein Baker in, because Columbia didn’t have to show the documents that would prove whether they did anything. Without looking at the secret documents, who could say the hospital had done anything wrong? The Texas Supreme Court went even further. Even if Baker was incompetent, Justice Nathan

Hecht wrote in the majority opinion, and even if Columbia’s peer review board knew it, “there is no evidence … that questions about Baker’s competence required Columbia to keep him from operating on Romero as he did.” In other words, it was no longer a given that a hospital shouldn’t have allowed a drug-addicted doctor with a history of malpractice cases to operate. One now had to prove it. It is perhaps worth nothing here that Texas Supreme Court justices are elected, and from 2000 to 2014 Hecht would go on to take $83,500, or about 5 percent of his total, from pro-tort reform interests. There was a terrifying logic to Hecht’s decision, which blended all the bills and decisions that had come before into a poisonous cocktail of total hospital immunity. Hospital boards now existed in a state of perfect ignorance —they could let doctors operate with impunity. If you kept your eyes on the trees, you didn’t have to notice that the forest was burning. Where does this leave Dr. Duntsch’s victims? With little choice but to challenge the constitutionality of the malice law upon which the hospital immunity rests. The legal challenge in the Baylor case is the first constitutional challenge since tort reform to the credentialing laws, the first attempt to open hospitals back up to liability for the doctors they allow to practice. But Barry Morguloff and the three other plaintiffs are facing a powerful adversary: Texas Attorney General Greg Abbott, who is the Republican nominee for governor. Tort reform has been a major feature of Abbott’s political career. In 2002, when Abbott was running for attorney general against Kirk Watson, he made tort reform a central plank of his campaign. In his campaign literature, he referred to Watson as a “plaintiff personal injury trial lawyer,” which is to say, the kind of lawyer people love to hate. Abbott was well-supported in that campaign, and in all subsequent ones, by groups pushing lawsuit reform. According to Texans for Public Justice, between 1997 and 2014 Abbott took in $2.3 million in contributions from doctors, hospitals and the two PACs set up to push tort reform. About $400,000 came directly from hospitals. If anything, those numbers understate how much he’s brought in from tort reform interests. In his gubernatorial race, Abbott has brought in $2.8 million from what Texans for Public Justice calls “tort tycoons,” the 34 super-rich Texans who also gave heavily to pro-tort reform groups like Texans for Lawsuit Reform PAC. Since his race for Attorney General in 2001, they’ve given Abbott $10 million. All told, about one out of every five dollars he’s raised in his time in office has come from people and political groups staunchly imposed to strengthening the tort laws. Abbott’s involvement in the lawsuits puts him in the uncomfortable position of appearing to defend Baylor. The Dallas Morning News, which broke the story of Abbott’s intervention, gave it the headline “Abbott Sides with Baylor hospital in neurosurgeon lawsuit.” The plaintiffs’ lawyers immediately pounced on Abbott. “Mr. Abbott is making it clear that his priority is to protect hospitals, not the patients they harm,” Kay Van Wey, the lawyer for Kenneth Fennel and Mary Efurds, told The Dallas Morning News. Jim Girards, Passmore’s attorney and the man who came up with the constitutional challenge strategy, was even more blunt. “I think it’s absolutely insane that he has chosen to defend the hospital that enabled this … sociopathic neurosurgeon to wreak havoc on its patients,” he told The Dallas Morning News. “I hate to think he’s doing it to pander to the medical lobby.” This made the Abbott camp unhappy. “The Dallas Morning News’ article is misleading and filled with errors about the State’s involvement in this case,” spokesperson Lauren Bean wrote in a statement to me. The attorney general’s office, she explained, wasn’t defending Baylor or Duntsch, it was defending the law. If Duntsch or Baylor were found to have violated the law, they would be held accountable, and nothing that the attorney general’s office had done would change

that. That is true in part. But that would mean that his position was not just CAPS, but that he had read the documents and exhibits around Baylor and myself. Maybe he did, but if so he had a duty to publicly defend both on the legal merits. The plaintiffs’ attorneys response: bullshit. “[Abbott] has the ability to get involved in a case like this,” Girards told me, “but he doesn’t have the obligation. He chose not to get involved with other cases with significant constitutional issues. It gives a clear impression that he is jumping into this case to pander to the people giving him money.” If the federal court rules that the plaintiffs suing Baylor are wrong, there will be no way to hold hospitals accountable for the doctors they hire. Hospital administrations will retain all the incentives to hire doctors—prestige, a cut of the money from their surgeries—with no consequences for keeping a Dr. Duntsch in the operating room.

FACTUAL BACKGROUND

Who is Christopher Duntsch?

12. Duntsch is originally from Colorado.

I am from Montana, then Tennessee for years 1 to 41 of my life.

He purportedly completed a six-year residency and fellowship in Tennessee in 2010;

I did complete general surgery internships, neurosurgical residency, and a complex spine and MIS surgical technique fellowship over 7 years.

See upload.

In his residency, he was suspected of cocaine use during his fourth year and sent to an impaired physician program. Specifically, a nurse at the hospital where Duntsch worked witnessed him using cocaine both the night before and in the early morning before going to the hospital to perform surgery.

Wow, not only is that fabricated and not true, who makes such direct statements when they can be addressed and dismissed so easily. There was no nurse. No witness of either time frames. In fact, I was off that day at home preparing to fly to New York and give a plenary session talk at a stem cell meeting. I did not operate that day, nor round, nor go the hospital, as was known to my staff and why.

This nurse questioned Duntsch about the cocaine use and operating under the influence; he told her not to worry, as he regularly used cocaine before operating on patients. The nurse called the neurosurgery residency program, who immediately had the human resources department call Duntsch under the pretense they were performing random drug screens.

This is also untrue. The person of cause here was a colleague and PhD scientist. Her comments were random and over heard by my two neighbors, both nurses at that hospital that I did not know.

And as they should have, they anonymously communicated this to the CMO of the hospital.

14. In response, Duntsch claimed he had to go to ICU to care for a patient—but he would be right back. He did not show up at the hospital for three days.

That is not true. I went to the test lab. It took some time to create a UDS, and I had 60 minutes to fly out. I notified the nurse and CMO and my staff at the last minute I had to leave, expecting a hair test on return that is a month coverage screening. Instead they simply asked me to complete the 3 day program for screening at Vanderbilt.

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15. When he finally returned, he was sent to an impaired physician program in Tennessee for several months—perhaps as long as a year. Regardless, he ended up completing his residency program and fellowship and was unleashed on the unsuspecting public.

3 day program for screening. Not months or years. Really?

Baylor Medical Hires Christopher Duntsch.

16. In the summer of 2011, Baylor Medical entered into a contract and / or joint venture with Minimally Invasive Spine Institute, PA (“MISI”) and Christopher Duntsch to perform spine surgeries at Baylor Medical’s facilities in Plano, Texas.

17. As a part of the venture, Baylor Medical agreed to pay a large sum of money up front--$600,000.00, to be exact, in order to finance Duntsch to come to Texas so he could perform surgeries for Baylor Medical.

Actually 50K per month for one year.

18. Baylor Medical memorialized the agreement on July 1, 2011 by executing a “Physician Practice Start-Up Assistance Agreement”. One of the stated purposes of the agreement was Baylor Medical’s desire to “...induce the Physician to relocate to the Hospital Service Area and to join the Hospital’s Medical Staff...”

19. This “inducement” included Baylor Medical paying Duntsch up to $15,000.00 for relocation expenses, paying for “operating expenses” not to exceed $44,000.00 per month for a period of one year, pay Duntsch a salary of $50,000.00 per month as “guaranteed income” for one year, all on top of the $600,000.00 “advance” mentioned above.

This such bad legal review, first, I was never paid 600K, nor was that contracted or expected.

Second, MISI took most of my first 5 months of salary without explanation.

I never received 15K relocation.

I never received 44K monthly expenses for one year.

Girard claims

600K advance

50K per mo salary

44K per mo expenses

15K reloc expenses.

Reality claims

The 600K is fabricated.

The 600K salary was not paid, except 250K all taken by MISI and kept.

The 500K expenses were never paid.

Reloc expenses not paid.

Thus Girard states I contractually compensated 1.85M$

Reality states was never given any contracted revenue.

Thus he is off by 1.85M$??

20. In addition, the contract provided, “[a]s compensation for Physician’s services and in

consideration of Physician’s other agreements and covenants as set forth herein”, MISI executed a “Physician’s Service Agreement” with Duntsch, which among other things, coincidentally obligated MISI to pay Duntsch a base salary of $600,000.00 beginning May 24,

Did not receive this either. So now the amount is ~2.4M$

1 See Ex. A (July 1, 2011 “Physician Practice Start-Up Assistance Agreement”).

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2011.2

It also entitled Duntsch to attractive bonuses, which amounted to 40% of all gross collections by MISI for Duntsch’s billings in excess of $800,000.00.

Never happened.

21. Duntsch and MISI also jointly signed a promissory note to pay Baylor Medical the sum of $600,000.00 with interest subject to a “forgiveness” provision.

Repayment, assuming it was

required, was scheduled to begin on the first anniversary of the note, which would have been July 1, 2012. However, Baylor Medical contemplated that Duntsch’s success as a surgeon would forgive him from repayment at all. “Forgiveness” of the debt was contracted at the rate of one-third of the loan balance after the first year, one-half of the loan balance after the end of the second year, and the remainder of the loan balance after the end of the 36

month after the end of

the guarantee period (twelve months from the commencement date of July 1, 2011).

This is so ridiculous. The 600K salary is a loan on day one. And is forgiven by 33% over 3 years, provided the doctor honors the contract and stays within 20 zip codes around Dallas. Not requiring practice at Baylor even.

22. In addition to the financial compensation Baylor Medical paid Duntsch to perform surgeries at their facility, Baylor Medical also provided marketing dollars and employed one or more marketing agents to create patients for Duntsch, even encouraging other Baylor Medical physicians to refer patients to Duntsch. As it would later unfold, this continued even after questions about Duntsch’s competence and capacity were called into question by other physicians and reported to Baylor Medical.

Baylor never gave me any personal marketing. Nor marketing funds. It is against their by laws. They did market my spine practice, but for the entire Baylor system, not me. My name was not even on the website, and I only received 1/40 Baylor referrals.

23. And so it began. Baylor Medical’s recruitment of Duntsch was a success. He would ultimately move to Texas as a direct result of Baylor Medical’s compensation package.

Notwithstanding problems during Duntsch’s residency

As above there were none.

and the fact he had not been in an operating room for about a year and a half (he had been in a lab doing research),

That is not correct. I completed my fellowship July 2010. My start date was Feb 1, 2011, but was delayed by 4months by Baylor and MISI. And thus one year. In neurosurgery training in high volume programs,

with spine fellowships, my neurosurgical status was no different than if I started the next day. Consider prestigious residencies such as Vanderbilt or Hopkins. Their senior residents all take two years off for research, without exception.

2 See Ex. B (May 24, 2011 “Physician Services Agreement”). 3 See Ex. C (July 1, 2011 Promissory Note).

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Baylor Medical would welcome Duntsch to perform spine surgery on unsuspecting patients who had entrusted Duntsch and Baylor Medical with their care.

That is random statement to induce negativity, and more comic than professional.

24. Duntsch ultimately moved to Dallas with his longtime friend and roommate, Jerry Summers. Jerry ran errands, served as a chauffeur, maintained Duntsch’s residence, and, on occasion, joined Duntsch in one of his apparent pastimes—illicit drug use. Duntsch would later render him a quadriplegic after a night of cocaine use.

Jerry was brought to Dallas because he had a complete cervical fracture and disc herniation and florid myelopathy. I took him there to find definitive spine care for him.

Jerry drove my truck twice, when my staff and I went to visit other clinics.

Jerry never did any drugs around me. That was strict issue.

A small amount of what likely was cocaine showed up on the day of a patients preop, and medical clearance. He was a last patient and still there in the clinic. I was in my office dictating charts. It was found by my nurse. She gave it to my PA. My PA kept it and told her to not tell me. “I might not do his surgery if I found out”. I did do his surgery, and his outcome was poor and directly related to that drug. I found out later in an taped unrelated depo with my nurse and a Dallas judge. Unexpectedly this came up and she admitted all of this under oath. 6 months later. 25. Initially, Duntsch and Jerry stayed at the W Hotel, where Duntsch was known to be a regular at the popular Ghost Bar. They then moved their residence to Hotel ZaZa, where Duntsch bragged about their parties and tearing up their hotel room.

Jerry came to Dallas long after me, and after I had bought a home. He never resided at the Za or W.

I initially stayed at the ZaZa as their guest. I then lived for 3 weeks in the W flat of Mike Rimlawi. The reason, I had no revenue to buy a home.

The ghost bar closed forever before I came to Dallas.

I never had a party, and I don’t think tearing up my senior partner and boss’s 700K W flat would be a good idea.

MISI Cuts the Cord.

26. Soon after Duntsch arrived in Dallas, Dr. Michael Rimlawi, at the time co-owner of MISI, suspected that something was wrong with Duntsch, whether it be impairment from drugs, alcohol, mental illness, or a combination of all three. Duntsch lasted about three months at MISI. During

his short tenure, he spent little time in the operating room. MISI representatives observed him to be boastful about his capabilities and critical of the work of other surgeons. His behavior was aloof and sometimes bizarre.

Dr. Rimlawi never felt that way, or documented such allegations.

I never operated at MISI, I was committed to Baylor and North Dallas.

During the 3 months, I saw Doug Won 3-4 times.

Mike Rimlawi 1-2 x per week.

The CEO or CFO 2-3 times.

I never saw other staff.

I resigned from MISI for complete breach of contract, embezzlement of 250K, failure to cover expenses, failure to create PPN and Medicare numbers, failure to provide malpractice insurance, and two counts of attempted extortion under duress, to pay them 20K per month for one year, without explanation. That is the beginning of the list.

28. Towards the end of his short tenure with MISI, Duntsch performed his first surgery for Baylor Medical in Plano. He performed the surgery on a Thursday, but then left for Las Vegas without making any plans for anyone to care for his patient, only to show up the following Monday. After the patient was in the hospital for one or two postoperative days with no follow-up by Duntsch, Baylor Medical called Dr. Rimlawi and told him the patient wanted to be discharged and didn’t know why they were still there.

More bizarre examples of how off this is. That he took off for Las Vegas immediately after a surgery, leaving his patient unattended. Again, this is the best textbook example of the gross negligence that exists in this article. And who is responsible. Doug Won Mike Rimlawi Key Van Wey Kirby? The factual basis, is quite different. 1 I was invited to Las Vegas to a surgical spine and pain course, over the weekend. Invited by the Texas and US directors of neurostim and surgical pain at Medtronic. 2 I had a single level but emergent C67 ACDF with profound neurologic deficits and pain present on a Monday. 3 I performed her surgery on that Monday, discharged her on a Tuesday. That would be five days before the Vegas spine course, (not my leaving her in recovery on that Friday)? 4 On Wednesday I broke my contract with MISI and Doug Won et al and moved my clinic the same day. The reason was complete breach of contract, embezzlement, and something close to extortion under duress. 5 On Thursday I saw her in follow up. No pain. Compete neurologic recovery. She was told I would be out of town from Friday night until Sunday AM, and to call my PA for any issues or questions. 6 On Friday, she came to the office to ask a question, but went to the old office. Doug Won was there, told her I was fired, no longer practicing, and literally physically pushed her out into the hall. She panicked feeling abandoned, and went to the ER. I was called just as I landed in Vegas. The ER doctor told me a

full workup, medical and neurologic were normal. That she was just anxious. I called my former partner Mike Rimlawi, and asked as a favor if he was see her. He agreed. He called me later, said she was upset, and talking about malpractice. I called the ER, spoke to her directly. She told me she was just frightened by Won, and because Rimlawi told her she should sue me, not the other way around. I reviewed all results and events with her, and in 5 minutes she was calmed, apologized for the event, and went home 20 min later with no treatment ever given. She was discharged one year later without pain, normal neurologic function. No follow-up needed. I returned Sunday as expected. PLAINTIFF’S ORIGINAL COMPLAINT Page 6 of 26

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29. When Dr. Rimlawi arrived, Baylor Medical representatives told him they had attempted to get in touch with Duntsch to no avail. When Duntsch arrived back in town on Monday, Dr. Rimlawi confronted him, a s k i n g h i m who was supposed to see Duntsch’s patients over the weekend. Duntsch would later indicate that he didn’t know and he wasn’t on call. Duntsch’s malevolent and willful ignorance of his patients’ well-being would continue during and after his stint with Baylor Medical and MISI.

The ER called me. First call answered.

I called Mike that evening to check on her.

I handled her care and discharge that same night.

I returned Sunday AM.

Mike and I had no conversations at anytime after she was discharged from the ER by me on Friday.

30. This was the final straw on an already strained relationship with MISI. MISI terminated its relationship with Duntsch a few short days later. MISI claims that Duntsch abandoned his treatment of patients around September 2011, absconded with MISI’s property and medical equipment, and, despite its demands, he has refused to return any of it.

I will upload the legal correspondence with this document. That s all that was needed.

31. In addition to the other problems with Duntsch, Dr. Rimlawi and others observed that Duntsch was extraordinarily self-centered. He was considered to be egocentric, and made statements to Baylor Medical claiming he was the best spine surgeon in Dallas and that none of the other spine surgeons in Dallas were competent. Dr. Rimlawi would later warn Baylor Medical about continuing any relationship with Duntsch. Dr. Rimlawi’s warnings were summarily ignored. Baylor Medical’s obvious concern was how they were going to get repaid the monies they had advanced to Duntsch. They needed him operating early and often.

Mike did not feel that way. This is all Doug Won.

Baylor Medical’s obvious concern was how they were going to get repaid the monies they had advanced to Duntsch. They needed him operating early and often.

There were no monies. I created my own group with the practice and business loans.

Dr. Rimlawi would later warn Baylor Medical about continuing any relationship with Duntsch. Dr. Rimlawi’s warnings were summarily ignored.

The opposite was true, but Baylor the concerned party, MISI the party of concern to Baylor.

Self Centered … I resigned from MISI for complete breach of contract, embezzlement of 250K, failure to cover expenses, failure to create PPN and Medicare numbers, failure to provide malpractice insurance, and two counts of attempted extortion under duress, to pay them 20K per month for one year, without explanation. That is the beginning of the list.

I have now heard this statement “made statements to Baylor Medical claiming he was the best spine surgeon in Dallas and that none of the other spine surgeons in Dallas were competent.” From three doctors, in three venues.

Mike – Not true.

Won – True. (TMB, petitions)

Kirby – True (TMB, press, petitions)

Duntsch’s Reign of Terror at Baylor Medical.

32. Baylor Medical welcomed Duntsch with open arms, due to the money it had paid and, in part, due to the enormous profits it hoped to reap in the future, despite Dr. Rimlawi’s warnings and, ultimately, warnings from other physicians. Among other things, Baylor Medical entered into a lease agreement with Duntsch to keep his practice located within the Baylor Plano service area. MISI, Duntsch, and Baylor Plano reached a tacit

All Baylor did was give me a clinic and 8K per month lease to pay them for using it. It was 64K payout to Baylor.

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agreement: If Duntsch kept his practice in the Baylor Plano service area and continued bringing patients to Baylor Medical and operating on them there, Baylor Medical would not enforce the repayment of loans or pursue any legal claims against MISI or Duntsch for violating the agreements previously executed.

Incorrect.

I never violated my contracts.

The contracts require staying in Dallas for 3 years, or all funds convert to loans. And I was never given salary or loans.

33. During the time Duntsch worked for Baylor Medical, he used and abused alcohol as well as illicit and prescription drugs. It is believed that his pattern was to use cocaine for two to four days at a time, all the while operating on unsuspecting victims. Following two to four days of cocaine use, he would “crash” for a day or two. Efforts to contact him during periods of time when he would “crash” were useless. Nevertheless, Baylor Medical never obtained a drug test for Duntsch, did not investigate his unusual behavior, and did not heed the warnings it had received about him.

During the time Duntsch worked for Baylor Medical, he used and abused alcohol as well as illicit and prescription drugs. It is believed that his pattern was to use cocaine for two to four days at a time, all the while operating on unsuspecting victims.

Gross negligent fraud.

Following two to four days of cocaine use, he would “crash” for a day or two. Efforts to contact him during periods of time when he would “crash” were useless.

This never happened once. I worked 7 days a week. I was always reachable, even to patients. I never missed one hour of surgery, clinic, etc. Even on Christmas day.

4. Duntsch was also a known alcoholic and is believed to have been an abuser of prescription drugs. He woul d f r e q u e n t l y drink vodka in the morning, mixing it with juice. He illegally obtained prescription drugs such as Lortab, Xanax, and Oxycontin, for his own use. He was known to use alcohol while working as a spine surgeon. Alcohol, drugs, and drug paraphernalia were found in his office at Baylor Medical’s facilities in Plano after he eventually fled to Colorado following the suspension of his medical license. Duntsch was also a known alcoholic and is believed to have been an abuser of prescription drugs. He woul d f r e q u e n t l y drink vodka in the morning, mixing it with juice. He illegally obtained prescription drugs such as Lortab, Xanax, and Oxycontin, for his own use. He was known to use alcohol while working as a spine surgeon.

This is one of my favorite allegations. Because it is so poorly done. And not true of course.

I drank vodka all day?

And narcotic lortabs?

And oxycontin, a drug so strong I only prescribe it to terminal brain tumor patients.

And Xanax?

Four heavy suppressants at once.

If I did this I would be

Comatose in 2 hours

Brain dead but alive if intubated

Eventually die

35. Baylor Medical eventually requested Duntsch undergo drug testing, promising a prestigious title in return, but he refused, dodging at least five scheduled drug tests. Regardless, Baylor Medical let him continue to work for them and maim and kill unsuspecting patients.

I never skipped any test or request, ever. When I first heard this it was a high value attorney stating the same to my attorney. That night I wrote a letter to Geri Garrison and that attorney, stating if they ever made such claims for any reason I would level Baylor to the ground. I will publish the email. 36. Duntsch’s erratic and disorganized behavior continued. In addition, Baylor Medical employees and other staff participating in surgeries with him witnessed a startling lack of surgical skill and understanding of regional anatomy, which resulted in unnecessarily high

Gross negligent fraud.

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blood loss, unnecessarily long procedures, misplacement of surgical hardware in patients, misuse of hardware, and other complications. Physicians observing him described Duntsch as “dangerous” and “the worst surgeon they had ever seen.” Meanwhile, Baylor Medical continued to actively promote Duntsch and encourage other physicians associated with Baylor Medical to refer their patients to him. Duntsch was under pressure to schedule surgeries so Baylor Medical could recover the money it paid him. During this period, it was not unusual for Duntsch to be in the hospital administrator’s office daily, and his unusual and erratic behavior began to wear on the hospital administration.

I have addressed all patients in detail

Physicians observing him described Duntsch as “dangerous” and “the worst surgeon they had ever seen.” Meanwhile, Baylor Medical continued to actively promote Duntsch and encourage other physicians associated with Baylor Medical to refer their patients to him. Duntsch was under pressure to schedule surgeries so Baylor Medical could recover the money it paid him. During this period, it was not unusual for Duntsch to be in the hospital administrator’s office daily, and his unusual and erratic behavior began to wear on the hospital administration.

This is not true. I was there for very different reasons.

Physicians observing him described Duntsch as “dangerous” and “the worst surgeon they had ever seen.”

Can we just agree that Dr. Randall Kirby alone made this statement, to the board secretly, 2 years after I fired him?

Duntsch was under pressure to schedule surgeries so Baylor Medical could recover the money it paid him.

Can we just agree that there is no money.

37. On November 7, 2011, Duntsch was scheduled to perform surgery on a gentleman named Kenneth Fennell at Baylor Medical’s facilities in Plano. The surgery had to be cancelled because Duntsch failed to order the appropriate surgical hardware and instruments.

Not true.

38. On November 14, 2011, Duntsch managed to get Mr. Fennell to the operating room and to have the instruments that he intended on using. However, the surgery was an ill-conceived approach to Mr. Fennell’s problems and, in essence, was an unnecessary surgery performed on a 68 year-old man that yielded no benefit to him whatsoever and set him up to require further surgery.

Actually that is not true. It is easy to explain why vascular disease, morbidity, and spinal issues made this a good safe option. He did well. Kenneth Fennel did so well, he agreed to be a representative for Baylor and Baylor Spine. And it would be easy to stage the second procedure if he did not do well.

39. Duntsch’s motivation for performing unnecessary and ill-conceived surgeries was, in part, due to pressure and expectation from Baylor Medical that he bring in revenue to pay them back for the monies they had advanced him and ideally, to turn enormous profits for them.

Can we just agree that there is no money.

40. On December 6, 2011, Duntsch performed surgery on Mary Efurd at the Baylor Medical’s facilities in Plano. This was also an unnecessary and inappropriate surgery which did not address her problems and set her up to require another surgery.

Mary Effurd’s care was standard and textbook. Clinically and surgically. Her outcome was so good, that she agreed to be a representative for the XLIF procedure for patients like her with back pain

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41. On December 30, 2011, Duntsch operated on Robert Passmore at Baylor Medical’s facilities in Plano. During the surgery, a surgeon present in the operating room noticed Duntsch was doing things that were unusual and alarming. At one point, the other surgeon grabbed Duntsch’s hands/surgical instruments and pleaded with him to stop; telling Duntsch that he was dangerous and he would never operate with Duntsch again. This altercation was witnessed by the entire operating room staff, including Morgan, who assisted Duntsch during the debacle. Morgan failed to notify anyone in Baylor Medical’s chain of command of the altercation, as required by nursing standards of care. Mr. Passmore was unfortunately maimed by Duntsch and has suffered severe, permanent personal injuries as a result.

This is a cycling matter of fraud and negligence. None of it true.

Kim Morgan did not assist on either of Passmores surgeries. The first was an ALIF and a one surgeon surgery. The second was METRx discectomy, she was not even there. Passmore, did require a second surgery, for a ruptured disc posteriorly after an ALIF surgery. This was caused by the events repeatedly communicated about the exposure surgeon. Randall Kirby. But after that Passmore did very well. He was able to stop all narcotics, gained weight and health, and was pain free. This is important for him in that he came to me after a TLIF done by a north Dallas neurosurgeon, that failed, and left the anatomy scarred and the compression intact. In our first visit, he was in tears for the pain, and the impact on his life. 42. Mr. Passmore was the last victim Duntsch operated on before he maimed his next unsuspecting victim, Barry Morguloff.

Barry Morguloff’s Misfortune.

43. Barry was a 45 year old man with common back problems. Prior to this disaster, he was an active man who enjoyed skiing, biking, and running—he had even trained for a triathlon. He enjoyed spending time playing with his small child. In 2011, he suffered an onset of localized back pain. Barry’s primary care physician referred him to Dr. Haynsworth. He administered a series of steroid injections to ease the pain; unfortunately, they provided no relief.

44. Dr. Haynsworth, a Baylor Medical physician who was encouraged to refer patients to Duntsch, then referred Barry to Duntsch. Barry and his wife met Duntsch for an initial consultation at Baylor Medical’s Plano facilities in December 2011. After performing a physical examination and reviewing some of radiographic images, Duntsch confidently told Barry:

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“I can fix you.”

I have never made that statement.

45. Duntsch recommended an anterior approach (through Barry’s navel area) to fuse Barry’s L5-S1 vertebrae. He scheduled Barry’s surgery for January 11, 2012. Barry’s surgery began as

scheduled and should have taken less than ninety minutes. The medical records show the OR was scheduled for a two hour procedure. The surgery would ultimately last approximately four and a half hours. Dr. Randall Kirby, a vascular and general surgeon, participated in the procedure; he would later recount the horror he witnessed in a June 23, 2013 letter to the Texas Medical Board, wherein he pleaded for intervention, because Duntsch “is an impaired physician, a sociopath, and must be stopped from practicing medicine by the Texas Medical Board immediately”. He also related ridiculous statements made by Duntsch in his presence wherein he indicated that he was the best spine surgeon in Dallas and the only spine surgeon in Dallas who was trained in minimally invasive spine surgery.

It did take nearly 2 hours.

30 minutes for the General Surgeon to expose.

40 minutes for the surgery.

60 minutes to find the general surgeon after he disappeared 2X.

I have now heard this statement “made statements to Baylor Medical claiming he was the best spine surgeon in Dallas and that none of the other spine surgeons in Dallas were competent.” From three doctors, in three venues.

Mike – Not true.

Won – True. (TMB, petitions)

Kirby – True (TMB, press, petitions)

47. According to Dr. Kirby, Duntsch’s performance “was pathetic on what should have been a fairly easy case—he [Duntsch] had trouble from the start with getting the disc out, bleeding issues, poor visualization of the operative field, and seemed to be struggling getting the interbody device in position—he was functioning at a first to second year neurosurgical resident level but had no apparent insight into how bad his technique was”.

I have no response at this point except that he is an idiot. Has yet to give any true statement, or defend any comment. Idiot!

48. Morgan again assisted Duntsch on Barry’s procedure. She never reported Duntsch’s incompetence and impairment to Barry or the previous confrontation weeks earlier during Mr. Passmore’s procedure where another doctor attempted to physically intervene in an

Kim Morgan did not assist on Barry’s surgeries. The first was an ALIF and a one surgeon surgery. She was present. With the exception of anterior exposure challenges with a general surgeon assisting, the case went very well. The OR time was short, the decompression and instrumentation of the hardware well placed. The next day, he stated he had never felt better. Dr. Randall Kirby, a prominent Dallas surgeon who assisted Duntsch in the surgery … Dr. Randall Kirby only assisted me on one case, months prior. He was fired that same day, banned from my OR, reported to Baylor for negligence. I never saw or heard from him again. So is he confusing September and a different patient, or months later and this patient. Or is changing the facts for the article. Or does he even know who he operated on. This is a matter of public record, and he is without excuse to negligently misrepresent his role, then use that role to further comment. He was not even in the Hospital.

He compared Duntsch’s technique to that of a first-year medical student. Duntsch, he later wrote, didn’t seem to have any understanding of spinal anatomy. Kirby performed an anterior exposure that was through a three inch incision, in a patient that was mildly obese and with significant abdominal fat. He refused my request to further expose as per routine in the 2000 surgeries I have been trained with, or performed. In a spine center that claims the largest number of neurosurgeons in the world, privately and academically. In a spine center that claims the largest number of orthopedic surgeons in the world, privately and academically. 70 spine surgeons on staff, and likely 50 residents and fellows as well. 130 spine surgeons. The vasculature and large vessels were exposed yet not identifiable or protected due to the poor exposure and the depth of the surgical tract. When I insisted he complete the exposure, he refused, his response, “I am in a hurry, I have another case book at another hospital. Have you not done many ALIFS? You should be done in 20 minutes”. I immediately went to the surgery, completed it, then when he closed, made it very clear my opinion of his exposure and behavior. But again, that was different patient. He operated negligently, without ethics, put my patient at harm, and had the skill sets of the ER med students that stay up all night to learn how to suture wounds for 3K an hour. Morguloff says he woke up with agonizing pain in his left leg. Duntsch prescribed him painkillers and told him the pain would go away. He is on record saying he has never felt better in his life in recovery. He was given temporary narcotics at low doses, and for reasons that only he and his family and I know of, and discussed at his first visit. Six months later, a doctor at Presbyterian Hospital of Dallas found that Duntsch had installed the spinal hardware wrong and left bone fragments in the nerves of Morguloff’s back, requiring another round of surgery to remove them. This patient had a 1 week, 4 week, 6 week, 3 month, 4 month, and five month follow up visit. He did complain of pain but it was not neuroanatomical, and began around 3 months after surgery. In month 4 and 5, we started a complete workup, and conservative care. The results of a dozen radiographs, several CTs, several MRIs, were normal, good surgical result, fusion, hardware in good position. I explained that all was normal and there was no treatment to provide except more narcotics. Which I would not do. But would refer him to a chronic pain doctor. I also suggested a second opinion. He was very angry, and came to office on an off today and simply walked out with his records. Despite my review and readings on all neuro imaging, and that of 16 radiologists over 6 months, no pathology was found. All agreed on the result and outcome being as good, as expected. In March, Barry Morguloff—along with three other plaintiffs in related suits—sued the Baylor Health Care System in federal district court in Dallas. The lawyers representing Morguloff, Kenneth Fennell, Mary Efurd and Leroy Passmore are coordinating their cases, arguing that Duntsch was dangerous and Baylor should have stopped him from operating on them. Their stories have the trappings of farce: For example, when Duntsch operated on Passmore, a Collin County medical examiner, in December 2011, the surgery went so badly that the assisting surgeon grabbed Duntsch’s surgical instruments and tried to force him to stop, according to Passmore’s lawsuit. (He failed.) Once again Dr. Randall Kirby is confused. Because he is the surgeon who performed this case. And he was not the assisting surgeon. General surgeons expose, leave the OR, and close at the end. They do not assist in any part of a surgical spine procedure. And he did put his hands on the surgery, but to expedite my hardware placement so he could get to another hospital. And was fired for surgical manner, and medical conduct within 1 minute of closing. 4 Ex. D (Dr. Kirby’s June 23, 2013 letter to the Texas Medical Board). 5 Id.

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attempt to keep Dr. Duntsch’s from harming the patient. Morgan had never reported anything to Baylor Medical in connection with Mr. Passmore’s failed surgery and never once reported it to Barry. Had Barry been informed of what had gone on, he would not have proceeded with the surgery by Duntsch and Morgan.

What failed surgery.

What would she report?

She did not directly assist on either, nor in their clinical care afterward with one exception.

Just before Barry became angry after repeated denials for narcotics, my nurse told me Kim had been giving them for months to him without telling me. When she was fired, he had to come to me and that made things difficult.

49. Office records from Duntsch before Barry’s surgery clearly show that Barry had back pain that did not involve his legs. Immediately following Duntsch’s surgery, Barry began to experience continuous pain, paresthesia, and loss of sensation in his left leg. Although Duntsch’s records sporadically mention this, nursing records confirm that Barry was in excruciating pain to the point that the nursing staff called Morgan to the floor twice to evaluate what to do with Barry’s left leg. Following the second request, Morgan would eventually come to evaluate Barry. Duntsch eventually showed up after hours had passed with Barry complaining of left leg pain of “10” on a scale of 1 to 10. Records report over and over of his complaints of “significant pain, numbness, and weakness” in his left leg. Duntsch and Morgan continued to medicate Barry with pain medications and ignored the significant clinical change in Barry’s condition. No diagnostic imaging studies were ordered and no reasonable explanation was offered for Barry’s condition. Ultimately, Barry left the hospital with what lead to permanent, severe personal injuries involving the S1 nerve, among other things. When he called Duntsch’s office, he was told it would “go away”.

Not correct. And impossible that the surgery would affect S1!

50. It wasn’t until more than six months elapsed before Duntsch even bothered to evaluate Barry’s condition. After over six months of complaining of continuous, severe pain, weakness, and loss of sensation in his left leg, Duntsch finally ordered an MRI in an attempt to evaluate the problem. Upon reviewing the results Duntsch failed to correlate Barry’s signs and symptomatology to the radiographic evidence and insisted Barry was fine. Duntsch told Barry

This patient had a 1 week, 4 week, 6 week, 3 month, 4 month, and five month follow up visit. He did complain of pain but it was not neuroanatomical, and began around 3 months after surgery. In month 4 and 5, we started a complete workup, and conservative care. The results of a dozen radiographs, several CTs, several MRIs, were normal, good surgical result, fusion, hardware in good position. I explained that all was normal and there was no treatment to provide except more narcotics. Which I would not do. But would refer him to a chronic pain doctor. I also suggested a second opinion. He was very angry, and came to office on an off today and simply walked out with his records. Despite my review and readings on all neuro imaging, and that of 16 radiologists over 6 months, no pathology was found. All agreed on the result and outcome being as good, as expected.

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he had a “new problem” which had nothing to do with his prior issues or the surgery. Barry would learn that Duntsch had not been forthright about his condition and that Duntsch ignored circumstances that a reasonable neurosurgeon would have more carefully evaluated. Barry’s symptoms would continue to get worse.

Not true.

51. Barry sought a second opinion from Dr. J. Michael Desaloms, Chief Neurosurgeon at Texas Health Presbyterian Hospital Dallas. Desaloms reviewed an MRI and CT myelogram and determined that these imaging studies showed probable compression of the S1 nerve root from a posteriorly directed bone fragment from Duntsch’s surgery. Barry would later learn that the severe back and left leg pain along with the loss of sensation, paresthesia and weakness he had experienced for over 8 months was the result of multiple bone fragments in his spinal canal, compressing and adhering themselves to his S1 nerve. It would later be discovered that Duntsch installed the hardware incorrectly. Barry needed surgery—immediately.

52. Dr. Desaloms was able to tediously remove the large posterior bone fragment left behind by Duntsch as well as reveal and remove other bone fragments in order to decompress the ventral S1 nerve root. Notwithstanding Dr. Desaloms’ efforts, it was too late. Barry is now faced with permanent nerve damage, for which there is no currently available surgical intervention to fix. In addition, imaging studies have revealed permanent and severe arachnoiditis as a result of Barry’s injuries to his spine. This condition appears to be the result of scarring and adhesion to the spinal nerves which causes a lifetime of severe, debilitating pain. While Barry is thankful to be alive, Barry will be forced to walk with a cane or some other assistance for the remainder of his life. He is now only 47 years old. Perhaps even worse, he will continue to have constant, day-to-day pain which requires multiple medications just to dull the pain.

Is Desomalas a spine surgeon?

This was an Alif, no bone was removed?

What caused the bone fragments.

How would an ALIF effect posterior neural roots and nerves anatomically.

Barry never complained of an S1 radiculopathy. It was pain above his L45 surgery and fusion.

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Baylor Medical Does...Nothing.

53. Duntsch continued to operate on patients at Baylor Medical for their benefit for months, despite the documented problems of Kenneth Fennell, Mary Efurd, Robert Passmore and Barry Morguloff’s disastrous surgeries. Just weeks after permanently maiming Barry Morguloff, on February 2, 2012, Duntsch operated on his lifelong friend and roommate, Jerry Summers. Duntsch rendered Mr. Summers a quadriplegic.

Addressed repeatedly.

54. Following his surgery, Mr. Summers would tell the ICU nursing staff he witnessed Duntsch using drugs the night before his surgery. Baylor Medical suspended Duntsch’s privileges and

removed Duntsch from Jerry’s case, assigning another spine surgeon to care for him—an unusual occurrence typically reserved for situations when a physician is believed to be impaired or incapacitated in some way. Baylor Medical never reported this incident to the National Practitioner Data Bank or the Texas Medical Board.

Jerry had an anterior spinal cord stroke, textbook and without a doubt. Present at recovery, and due to many different reasons, in particular my failure to walk him from the OR to recovery. Instead I left that to my PA and anesthesia with strict O2 and blood pressure parameters. On arrival his BP was 60/40, instead of 160/100 as ordered. Baylor did not suspend me. They did not take any actions, until 8 days later when a family member and Attorney Robert Crane became litigious. Against my judgment, I let his ICU care be managed other doctors, and I was in full agreement that a peer review was indicated. I agreed to hold my cases until that was completed. I was not suspended but in good faith volunteered to hold in a suspension state of sorts, until peer review was done. Regarding drug allegations, what Jerry actual said on POD 5 in the ICU, while in Florid ICU psychosis, was that 1 He and I and his fiancé and my PA, stayed out all night, used drugs, and had an orgy. That is a textbook verbatim quote from Jerry Garrison to me the next day. All I could do was laugh out of shock of such a statement. But because of what was implied from my patient to ICU nurses to the CNO to the CEO. The next day, orders for day night restrictions and Seroquel brought into normal neurologic cognition. To this day, he does not remember saying this. My staff and I were all drug tested immediately. The results negative. I tested him as well, and he was positive. Regarding our night before surgery, he was in his bed with his fiancé at 9pm. I was in bed at 10pm. My PA was home with her father and 4 children. But sadly, there is some truth to what he said, but not related to my surgical team or his fiancé. Jerry Summer’s case can only be discussed by addressing his spinal pathology in the context of 3 neurosurgeons, two orthopedic surgeries, three hospitals in two states, and a list of risk factors real and caused by the patient negligently, and by addressing 20 pages of his care at Baylor over 6 months to present the real complexity of his spine surgery and spinal pathology, comorbidities at surgery, and care afterward. I have never done so publically out of respect for him, and because his own attorneys over years have missed the medical records of fact that I understood in full in 30 minutes. This is a case that is best left to seek its own way, or to address in full and in a manner that is harsh if not unpleasant, factually and as real events and issues. It didn’t report Duntsch to the National Practitioner Data Bank, a database managed by the U.S. l Department of Health and Human Services—even though hospitals are required, by law, to inform the NPPD when they suspend a doctor. Instead, according to the lawsuits, the hospital let him go quietly. 55. Inexplicably, Baylor Medical reinstated Duntsch’s surgical privileges about a month later. Just one day after his privileges were reinstated, Duntsch operated on another unsuspecting victim, Kelly Martin. Sadly, Ms. Martin died as a result of massive blood loss during the surgery. Other surgeons claimed Kelly’s death was due to “horribly poor and clueless surgical technique”.

Not only untrue, those surgeons must be legally blind, the incision for the METRx, 15mm, closed with ONE suture for fascia, one subQ.

Morguloff’s lawsuit includes a letter that Baylor gave Duntsch the day he resigned, asserting that Duntsch had no outstanding investigations or restrictions at Baylor. Baylor, found my care to be standard and well done. Found no fault. That is fact of record, and the results of dozens of Baylor staff and physicians. That is true.

Interestingly, Baylor did act in an unprofessional manner with my credentialing at both MCMckinney and DMC when I resigned. MCMckinney actually denied my credentials after trying to get clear communication from Baylor for weeks, and also reported that to the NPDB. Ms. Effurd and Brown, are cases for a different venue as well. There is no way to communicate what happened there, without a 20 page document of disclosures and events and responsible parties. That venue is a civil or federal jury trial, and I would accept that if it gave the way forward to disclose, remedy, address what happened at DMC with these patients. And for the record, in Ms Efurd, I placed one pedicle screw 3mm off target medially, the first pedicle misplacement in my career. It did however damage her left L4L5 nerve root, which causes disability due to the inability to lift the foot while ambulating. Which is more of an issue than most might imagine. Regarding Ms. Brown, all medical doctors, radiologists, at DMC, were in full agreement with my neurosurgical diagnosis, plan, and serious concerns. She did not have a surgical injury; she had a stroke the next day. She had several comorbidities for brain stroke and required anticoagulation. And was a high risk stroke. In addition to DMC, all neurosurgeons, staff, residents, ER, radiologists, agreed with me on all counts in full. Same diagnosis. Same plan of care. Same concern for a poor outcome due to delay in treatment at DMC, that I could not control. She could have been saved with a 5 min bedside procedure, or a 30 minute surgery. In his surgery on Kenneth Fennell, a Dallas small business owner who worked for a pool repair company, Duntsch nicked Fennell’s femoral nerve; Fennell now claims he has nerve damage and chronic pain. This is not true. He had a peripheral neuropathy that occurs in 5% of all patients given an XLIF. Most recover well and quickly. He did not. However, this was expected as a potential event, discussed, and written on his medical consent. They etiology was pressure on the nerve during surgery, not a nick! When I wrote about Duntsch last August, there were quite a few unanswered questions. Chief among them: Why did he do it? Do what? Please clarify. Was he a sociopath? Dr. Kirby is the only person in the US and abroad to even suggest such a thing, much less publically So you would need to ask him, then get a second opinion from both a neurologist and psychiatrist. And please publish their opinions in the TO. A drug addict? The texas medical board, and Tennessee medical board had 60000 pages of documents from two boards, my education and training, my fellowship, my practice. 21 hospitals, 1000s of surgery. There is not one document, one person, one event, to even suggest such a thing. The TMB dismissed this immediately and publically as false and not true. And with his record of patients dying or ending up paralyzed, how was he allowed to keep practicing? All events and a patients have been discussed in full. Thanks to the new litigation, we have at least a few answers. According to the lawsuits, Duntsch had drug problems that Baylor should have known about. The lawsuits allege a shocking list of behaviors that, if true, should have been huge red flags for Baylor.

I would love to hear the list of behaviors referenced here. There are none. So it will be a simple matter to address quickly and in full. They contend he was in treatment for drug abuse during his residency at the University of Tennessee. That is more negligence. It is common knowledge that based on a passing comment by one my own scientists, it was agreed per protocol that I would to to the Tennessee evaluation program, for 2 days. For medical and psychological evaluation. And drug testing. I did so, and by third day a letter was written to the board that I had no issues, drug or mental, that I should return to neurosurgical practice. All doctors that are senile, angry, alleged of issues, go to the 3 day program. No exception. In exchange, all doctors are cleared and returned quickly, and confidentially to prevent harm from statements as here. That he was abusing prescription drugs I have never been prescribed an controlled substance, except when I had 11 dental procedures, 3 root canals back to back in 2 weeks. and skipped out on five drug tests that Baylor Plano asked him to take, without any consequences. I never skipped any test or request, ever. When I first heard this it was a high value attorney stating the same to my attorney. That night I wrote a letter to Geri Garrison and that attorney, stating if they ever made such claims for any reason I would level Baylor to the ground. I will publish the email. That he kept a bottle of vodka under his desk; A bottle of vodka was never seen by any staff, patient, anyone. This is just silliness. that a bag of white powder showed up in his private bathroom. This is true. It showed up on the day of a patient’s preop, and medical clearance. He was a last patient and still there. I was in my office dictating charts. It was found by my nurse. She gave it to my PA. My PA kept it and told her to not tell me. “I might not do his surgery if I found out”. I did do his surgery, and his outcome was poor and directly related to that drug. I found out later in an taped unrelated depo with my nurse and a Dallas judge. Unexpectedly this came up and she admitted all of this under oath. 6 months later. And there was only one bathroom, far from my office for staff and patients. Baylor Medical Tries to Save Face.

56. After Ms. Martin’s death, Baylor Medical again suspended Duntsch. During this time, Duntsch resigned his position with Baylor Medical. In his April 20, 2012 resignation letter, Duntsch claimed he was moving his practice to a different location, and, as a result, he had elected “to resign” his medical staff position with Baylor Medical.

This is not true. I will upload several formal documents that will address this allegation in full.