Is Christopher Dunstch a “stone cold killer” as he described himself in an email? Did the former neurosurgeon intentionally maim one of his patients in a botched surgery?
Or was he just the misunderstood badly trained, poorly skilled surgeon who never should have been allowed into North Texas operating rooms as his defense attorneys contend?
After four hours of deliberations, a 12-member jury came back with their conclusion. They found Duntsch guilty of first-degree felony injury to an elderly person in the botched 2012 surgery that put Mary Efurd in a wheelchair and left her in constant pain.
Duntsch showed no emotion as the judge read the verdict.
Efurd was all smiles as she wheeled out of the courtroom.
“Finally justice has been done after four and half years,” she said. “I hope I’m speaking for all of the other families and their loved ones also.”
Prosecutors contend Duntsch's weapons were his hands, surgical tools and hardware. They presented over eight days of testimony, a litany of patients, doctors and other medical professionals to prove their case. Two of his patients died after botched surgeries. Others were left maimed or paralyzed.
“A medical license does not keep you from prosecution if you maim and kill people. It's not a literal get out of prosecution free card,” prosecutor Stephanie Martin told jurors in closing statements.”
In July 2012, Duntsch operated on Floella Brown. It went terribly wrong. Brown lay bleeding to death as he began operating on Efurd hours later. It was the last of a string of botched surgeries that jurors heard about.
“The doctor with a conscious stops, but it's not his fault,” Martin told jurors. “It's everybody else's.”
Jurors heard how there were holes in the Efurd’s bones that shouldn’t be there, holes in the outer membrane surrounding the spinal cord causing spinal fluid to leak and an amputated nerve root, that a screw had been put in the wrong place and an implant device that wasn’t even in the spine. It was lying in the muscle.
Duntsch had destroyed the muscle to make a tunnel to put the device into.
Prosecutors portrayed Duntsch as a serial liar and a sociopath.
They reminded jurors that he lied in Efurd’s post-operative report saying that the surgery had gone well.
They reminded jurors that he had tried to sedate his friend Jerry Summers after he began claiming that he had used drugs with Duntsch the night before the surgery at Baylor Regional Medical Center in Plano. That surgery left Summers a quadriplegic. Summers later denied that they had used drugs. However, jurors also heard how Duntsch turned in tap water when he was asked to take a drug test by Baylor officials.
That surgery was about six months before Efurd’s surgery.
“If you have one outcome, ok. Two, ok. Three where you make your best friend a quadriplegic, four you kill someone else and while that woman is dying, ….he chooses to go into the sixth surgery,” Martin said. “He walked into that surgery knowing that he was going to cause serious bodily injury to Mary Efurd.”
Jurors also heard testimony from those who were present during Efurd’s surgery. They testified that they tried to tell Duntsch that he was putting the surgical hardware and screws in the wrong place.
“These are catastrophic, worst possible things that could happen happening over, over and over again,” Martin said.
Lead defense attorney Robbie McClung called upon jurors to set aside their emotions and sympathies, telling jurors that prosecutors were trying to distract them with dramatic appeals to their emotions.
“Yes, they were suboptimal surgeries. They were not good surgeries,” McClung said. “Everybody agrees that they were bad outcomes.”
She told jurors that Duntsch’s intention was to help people but that the problem was that he “was not a trained surgeon” and that he was “not a skilled surgeon.”
She agreed that he made a bad choice to go ahead and do the surgery on Efurd after botching Brown’s surgery. But said he went into it with good intentions.
McClung cast blame on the residency program that graduated him and on the hospitals that employed him but didn't report him.
“You still have the right to know what they didn't do because you still to know they put the almighty dollar before your protection,” she said.
She faulted Baylor for not reporting Duntsch to the national practitioner database and for giving Duntsch a letter that allowed him to get privileges at Dallas Medical Center.
McClung described Duntsch as being distracted during Efurd’s surgery because he had been contacted by hospital management about Brown’s case. She also said that he was distracted by the people yelling at him during the surgery.
“I believe what happened in that operating room was (caused by) distractions and all sorts of things that doesn’t say that what he did to Mary Efurd was intentional,” McClung said.
Prosecutor Michelle Shugart called the notion that Duntsch was poorly trained “absurd” considering that he had 17 years of medical training before he ever operated on Efurd.
“Distraction is not what caused this. Stress is not what caused this,” Shughart said. “Even a poorly trained surgeon knows by the time they get to Mary Efurd they should not be in the operating room.”
She agreed, however, with McClung that there’s plenty of blame to go around for the hospitals that “failed our community” and to the Texas Medical Board that “should have moved faster" to stop Duntsch.
“But don’t think for one second that exonerates him,” Shughart said. ‘He’s the one who went into all of those operations. He’s the one that puts a knife into the patients back.”
Jurors had been deliberating for about an hour when they asked for a timeline of the botched surgeries, giving some indication of which way the verdict might go.
Duntsch could be sentenced to live in prison. Dozens of witnesses are scheduled to testify in the punishment phase of the trial which is expected to go until at least the end of the week.
Efurd says she cried for days when the medical board took away his license. She says she has no doubts that the tears will soon fall now that she’s being held criminally accountable for his actions.
“I thought when I first met him for the first time what a nice, compassionate, caring person,” Efurd said. “He fooled me.”
Efurd said she has no idea why Duntsch did what he did. She’s just hoping that there will be tighter controls in the medical community to prevent something like this from happening again.
“It shouldn’t happen,” she said.