DALLAS -- Criminal cases against doctors like the one that sent Christopher Duntsch to prison for life on Monday are rare, but an attorney with experience trying malpractice cases thinks they could become more common due to protections and limitations in the civil court.

“Certainly this is a case that is opening the door to criminal prosecution in Texas,” said attorney Chris Hamilton with Standly Hamilton LLC. “I do think we may see it more often if we continue with the caps that do not allow these cases to be civilly prosecuted.”

Just last year, Hamilton represented the family of a woman who died following a medical procedure in a malpractice suit against a doctor. The family was awarded $19.7 million in damages by a Dallas County jury, but Hamilton says such large verdicts are made much more difficult by a 2003 law capping certain damages.

If the caps were not in place, Hamilton believes Duntsch would not have been allowed to keep operating on patients.

“It is almost certain there would have been a significant liability lawsuit against one of the hospitals for an early patient,” he said. “I cannot imagine a circumstance where the hospitals would not have kicked out a doctor like this much sooner.”

Caps on malpractice suits are designed to keep medical malpractice premiums from skyrocketing. Non-economic damages, or those not including lost income or medical bills, are capped at $250,000. Because of that cap, Hamilton says many of the bigger lawsuits, which are also more expensive to prosecute, are never filed or brought to trial. Without the threat of lawsuits or high-dollar liabilities, Hamilton believes hospitals might not be as reviewing doctors who could be performing bad operations and procedures.

“A lot of times, hospitals only find out about poor outcomes when a lawsuit is brought.”

The constitutionality of lawsuit caps has been successfully challenged in other states, however, the Texas Supreme Court has upheld the caps against similar challenges in the Lone Star State. The $250,000 cap has also not been adjusted for inflation since their inception 14 years ago.

Though criminal cases against doctors require prosecutors to prove an element of intent to injury, Hamilton says they may become more necessary if roadblocks in civil court are not eased.

“It think that is exactly what you are seeing [with the Duntsch case], a circumstance where the civil system was not able to weed out a bad apple because of the damage caps and the situation go so bad, the criminal system had to take over.

Even though Duntsch was sentenced to life and doctors might be held criminally responsible, Hamilton points out the hospitals still do not face liability. He does not feel criminally prosecuting doctors is going to be an adequate deterrent for hospital supervisors in a position to review and help prevent such malpractice from happening in the future.

“While there is a legit concern we could be criminalizing medical practice, we need hospitals to stop doctors before patients get hurt," he said.