Christopher Duntsch, M.D., left several patients dead or disabled over years of incompetent practice before his license was pulled, say authorities. 
 
A horrifying Texas Observer story chronicles years of questionable practice by the Plano, Texas neurosurgeon before his license was suspended by the Texas Medical Board in June 2013. “Dr. Duntsch’s lack of competence, impaired status and failure to adequately care for his patients poses a continuing threat to the public welfare,” the Board reported.
 
We’ll say: Investigators found two deaths under Duntsch’s surgery suspicious, and his other “botched surgeries,” reported in part by Outpatient Surgery magazine, included:
 
…a spinal fusion in which an artery was sliced, ultimately resulting in paralysis; a microlaminectomy that culminated with another sliced artery and the death of a patient; a case in which spinal fusion hardware was sunk into the muscles of a patient's lower back instead of her spine, and a nerve root was amputated; and another in which Dr. Duntsch cut into a patient's throat 2 or 3 inches lower and an inch midline from where the incision should have been made…
 
Amazingly, Duntsch had been at it since 2011.  He was suspended from Baylor Regional Medical Center in 2012, but later got privileges at Dallas Medical Center, where he was reported to the Board by a colleague.
 
Why wasn’t he stopped sooner? At the Dallas Morning News, Ralph De La Cruz blames “the increasingly-discredited state experiment in non-regulation.” But he refers solely to examples outside of medicine, such as the May 2013 fertilizer plant explosion in West, Texas that many blame on lax inspection and regulation standards.
 
The Observer is more specific, citing “a series of conservative reforms have severely limited patients’ options for holding doctors and hospitals accountable for bad care” in Texas, such as a pain-and-suffering damages cap and, more to the point, laws “allowing hospitals to, in most cases, keep credentialing information confidential,” making suits against doctors hard to pursue. “This has freed hospitals from the fear of litigation,” says the Observer, “but it’s also removed the financial motivation for policing their own physicians.”
 
Surgical blogger Skeptical Scalpel disagrees: “[the] average duration of a malpractice suit is well over 4 years… If the only way this doctor could have been stopped was by malpractice litigation, he would still be operating today,” he writes. He thinks everyone in the chain of responsibility, from Duntsch’s residency program to the Board, should have acted faster.
 
Physician performance is a major hospital issue, one of several tackled by Inside the Joint Commission, available from DecisionHealth.