The family of Robert Osuna has filed a wrongful death lawsuit against Dr. J. Steve Bynon, a transplant surgeon associated with UTHealth Houston and Memorial Hermann – Texas Medical Center, alleging that improper manipulation of a national transplant database contributed to Osuna’s death from end-stage liver disease on December 26, 2023.
The complaint asserts that Bynon repeatedly altered donor acceptance criteria in the database, restricting Osuna’s eligibility for a liver transplant as the patient’s condition worsened.
The lawsuit claims that Dr. Bynon initially listed Osuna as eligible to receive livers from donors up to 80 years old and between 60 and 300 pounds but later changed the criteria to much narrower donor characteristics that are unlikely to occur. These changes allegedly continued over several months before Osuna’s death, limiting his chances of receiving a life-saving transplant.
Dr. J. Steve Bynon Jr. was long the chief of abdominal transplantation at Memorial Hermann and a contracted surgeon with UTHealth. Allegations first surfaced in 2024 when Memorial Hermann temporarily suspended its liver and kidney transplant programs after discovering “irregularities” involving how transplant candidate information was entered into the United Network for Organ Sharing (UNOS) database, the system that matches donors with recipients.
The practice at issue relates to donor acceptance criteria, medical and demographic parameters (such as donor age, weight, and blood type) used to match donor organs to potential recipients. During the investigation, hospital officials found examples where patients were assigned unrealistic criteria, such as accepting organs only from donors with highly restricted characteristics, effectively making them ineligible for offers through the standard matching process.
Federal agencies, including the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration, also investigated the case. Regulators found evidence that at least a dozen patients were affected by record manipulation, which inactivated them on the waiting list without proper notification. Donor criteria changes sometimes coincided with periods when patients were hospitalized or critically ill.
In April 2024, Memorial Hermann paused its liver transplant program upon uncovering the irregularities and later halted its kidney program because both shared the same leadership. Patient waiting lists were frozen, and hundreds of candidates had to be referred to other centers while the hospital reevaluated its procedures.
By early 2025, the hospital system had reactivated the abdominal transplant program with new governance and enhanced documentation and auditing safeguards to prevent unilateral database changes without oversight.
Data reported by transplant registries indicated rising numbers of patients on the liver transplant waitlist who either died or became too sick for transplantation over several years, with higher mortality figures in recent years compared to earlier periods, though direct causality between database changes and outcomes remains part of ongoing legal and regulatory scrutiny.
Following Mr. Osuna’s lawsuit, other families of patients who died while waiting for transplants have sought legal orders to preserve evidence and pursue wrongful death claims against Dr. Bynon. In April 2024, courts granted temporary injunctions preventing him from deleting or altering texts, emails, and other materials that may be relevant to these cases as civil litigation proceeds.
Earlier in 2024, a widow filed a separate suit alleging her husband’s eligibility or transplant opportunities were impacted by the same issues in the liver transplant program. That complaint stated that the patient was told at one point he was not sick enough to be listed, and later deemed too sick for transplant after removal from the active waiting list.
Liver transplantation is a surgical procedure that replaces a diseased liver with a healthy one from a deceased or living donor. Eligibility for transplant depends on clinical indicators, such as MELD score (Model for End-Stage Liver Disease), patient condition, donor-recipient compatibility, and criteria established by transplant programs and national organizations like UNOS. Donor acceptance criteria help ensure that organs are matched safely and appropriately to recipients to optimize outcomes.
Alterations of such criteria outside accepted protocols can disrupt fair matching and delay or prevent organ offers. Organs are scarce resources, and transplant programs follow standardized procedures to prioritize patients based on medical urgency and likelihood of benefit.
(Rh/TL)