The AdvoKayte Podcast: Holding Healthcare Accountable!

Summary (51m 58s).
Episode 4 - Dr. Lazar: Neurosurgeon & Expert Witness In Dr. Death's Trial.

This episode is a long conversation between two reasonable and competent professionals about things that can only be described as profoundly incompetent and indescribably unreasonable. Dr. Martin Lazar was one of the first medical professionals to call attention to the disastrous outcomes produced by the unreasonable incompetence of Christopher Duntsch. 

Warning: This episode contains graphic descriptions of botched or badly performed operations. In the calmest and most reasonable voices, Kay and Dr. Lazar talk through several cases describing exactly what Duntsch did to his victims.

Dr. Lazar introduces himself by talking about what attracted him to his career, describing the elegance and precision of practicing neurosurgery. Dr. Lazar has had a career that has been very rewarding and a great deal of fun, describing it as, “... a love affair and hobby for a very long time.” He has been a leading neurosurgeon for over thirty years. 

He talks about how he originally got involved in the Dr. Death case when he received two phone calls from friends who were also attorneys who both told him hair-raising stories about a neurosurgeon who had recently come to Dallas and had perpetrated disastrous results. He didn’t know it at the time but this was the beginning of Christopher Duntsch’s downfall. 

Dr. Lazar goes on to describe the process of complaints in the Texas medical system, how it prioritizes cases, and how it eventually makes decisions. Even after several complaints, the Texas Medical Board took no action. Dr. Lazar tells us what eventually did force the system, the hospitals, the medical board, and the courts to take action. It took a couple deaths and a few acts resulting in patient paralysis but eventually Duntsch lost his license in a dramatic series of hearings in which Dr. Lazar played a large role.

“This was profound negligence. There was no possible way that a reasonably competent surgeon could end up doing the same things he did. Wrong diagnosis resulting in an operation the patient didn’t need and having disastrous repercussions, in one case paralysing in another killing the patient. Operating in the wrong place and doing the wrong operation and getting a disastrous result is not something within the realm of leeway for malpractice.” Dr. Martin Lazar.

Later, Dr. Lazar became an expert witness in Duntsch’s criminal and civil trials. He graphically describes the injuries inflicted by Duntsch, the anatomical ignorance he brought to dangerous and invasive operations, and Duntsch’s overall lack of care for his patience or their outcomes. 

Duntsch could have been stopped several times before he actually killed anyone but, he wasn’t. Dr. Lazar outlines how this could happen in a modern residency training program. Dr. Lazar talks about how incompetent and poorly trained surgeons move through years of work on real patients in a high-pressure system without long-term accountability from their residencies or training programs. He describes outright conflicts of interest and how in one case, a trainer’s investment in experimental spinal technology Duntsch was working on appeared to take priority over patient care. 

This program failed that responsibility, but there are other levels of failure in Duntsch’s case. Some of those failures have been changed. Lazar describes how the American Board of Neurological Surgery changed its requirements and rules to make training far more robust for every certification. No other branch of medicine has as stringent testing during training. Those changes happened because of Dr. Lazar’s work in pursuing and exposing Christopher Duntsch

More change needs to come. Kay and Dr. Lazar talk about how those changes might happen moving forward. Part of it will need legislative change, so part of the responsibility rests with the voters. 

Dr. Lazar: “Change will take a lot of time and education.”
Kay Van Wey: “It might even happen in our lifetimes.”