When Medicine Protects Its Own, Patients Pay -By Fransiscus Nanga Roka

Randall Kirby, M.D. The most troubling lesson is not that such a celebrated physician can fall. That is that American hospitals may still quietly expel a potentially harmful doctor yet leave patients in different places perilously oblivious.

Famous Dallas vascular surgeon Kirby helped bring down Christopher Duntsch, the “original Dr. Death” whose surgeries ruined 33 of 37 patients in shocking career moves Before Duntsch was sentenced to life prison term in 2017, Kirby warned regulators, helped victims and took the witness stand against him. Christian Slater then played him in Peacock’s Dr. Death

Then came a brutal reversal.

The deaths involved a pair of patients who died after having back surgeries in autumn 2021, with Kirby at both hospitals. The 45-year old Robert Rodriguez developed chronic internal bleeding after undergoing spinal surgery and died prior to a second scheduled procedure, according to allegations in a medical-negligence lawsuit. Thomas Grimes, the second patient, died days later after undergoing another spinal operation.

Who is a now reviled whistleblower and those institutions that canonized him. The what is a 2-death controversy involving allegations of neglect, evidence covering alcohol treatment and contested institutional oversight. The where is the patchwork of hospital systems in Texas. The when ranges from as early as the 2021 operations all the way through litigation and investigations disclosed in 2026. Here, the how is credentialing, silence among peers and incomplete data-sharing. The why is likely a system that incentivizes hospitals for quietly offloading risk instead of openly risking it.

But legal fairness is indispensable. First, Kirby has never been convicted of a crime and the reporting does not establish he was drunk at either surgery. A cooperating surgeon testified that he did not suspect Rodriguez was impaired at the time of an operation performed on him. Evidence of rehabilitation, including testimony and records, may be admissible but not evidence that drug/ alcohol use caused the death of either person.

During the course of the litigation, Kirby requested unprecedented appellate relief. In August 2025, Texas’s Fifth Court of Appeals rejected his mandamus petition; the Texas Supreme Court denied a subsequent petition and emergency stay that October. Those findings of procedural denials were not findings that Kirby was negligent.

Still, the institutional evidence is disturbing. Kirby was also reported to have lost privileges at several hospitals, although by July 2026 his state physician profile still listed eight hospital affiliations. Multiple hospitals said he had lost privileges. This contradiction renders sensible patient due diligence virtually impossible.

Federal rules stipulate that hospitals must report any restrictions on the privileges of a provider starting or lasting more than 30 days for reasons related to competence and also any surrender or restriction of privileges in connection with, or to avoid, an investigation. But expiration, agree-to-disagree departures, and intricate maneuvers may reflect treacherous lacunae between compliance on paper and protection of patients.

The US Congress and states need to act by requiring hospitals, licensing boards and the National Practitioner Data Bank to synchronize in real time; levying meaningful penalties for strategic non-reporting; mandating independent review following clusters of unexpected surgical deaths; protecting clinicians who report their colleagues; and granting patients access to readily verifiable information about current hospital privileges/responsibility of physicians along with disclosure of final disciplinary actions taken.

Substance use disorders deserve treatment without stigma and due process. However confidential rehabilitation cannot become confidential risk.

But the last thing America needs is a fourth dramatic Dr. Death. It calls for a system where no physician be they villain, celebrity or ex-hero is more shielded than the patient knocked out cold under the knife.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya and Managing Partner Law Firm Victorious Indonesia