Hey y’all, it’s Julie Mattson, and in this week’s episode of Pushing Up Lilies, we're examining the case of a 66-year-old Houston physician, John Stevenson Bynum Jr., who has been charged with falsifying medical records, records that allegedly rendered transplant patients ineligible for life-saving organ donations. According to federal charges, patients who should have qualified for liver transplants were marked in their medical files in ways that disqualified them. Families, care teams, and even the patients themselves were reportedly unaware that these changes had been made. For months, some remained on transplant lists without knowing they had been effectively removed from eligibility. This case raises unsettling questions about trust, oversight, and the immense power carried in documentation. In the medical world, a single notation can determine access to treatment, survival, and hope. When the pen becomes the gatekeeper of life, who is watching?
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00:06
Welcome to Pushing Up Lilies. I'm your host, Julie Mattson. Pushing Up Lilies is a weekly true crime podcast with spine tingling, unusual and terrifyingly true stories from my perspective as a forensic death investigator and a sexual assault nurse examiner. Do I have some stories for you? Are you ready? Hi guys, welcome to another episode of Pushing Up Lilies. I want to talk to you this week first real quick about a couple of events coming up. We're having a true crime club, which is meet and greet night at our blended table beverage bar inside the McCart Street Mercantile and Crumb. The address is 137 West McCart Street, and we are going to have crafted drinks. We're going to talk about cases and we're going to pore over the evidence. We're going to listen to one of my podcast episodes and you'll have the opportunity to shop my murder merch booth, which is inside the mercantile as well. That's going to be Friday, February 27th at 6 30.
Also, I will be on the first annual Women in Podcast and Cruise this year. This is going to be a four-night Catalina Island Ensenada cruise selling from Los Angeles, California from May 18th to the 22nd. And this is for podcasters of all levels, from beginners to seasoned hosts. So, you can perfect your skills, you can connect with people, collaborate, and just grow through shared experiences and learning. The topics are going to really be podcast creation, structure, voice, presence, equipment, technical setup, how to monetize your podcast, and how to get visibility. So, this will be a great opportunity for you to meet other women who are interested or are already podcasting. Go to podcastingcruise.com and book your ticket now. This is filling up fast. Again, it's only four days and it's going to be a great opportunity to network. So just want to kind of tell you about those couple of things that were upcoming.
I want to talk to you this week, and this is about a surgeon out of Houston. His name is John Stevenson Bynum Jr. So, he is a 66-year-old Houston physician, and he's actually been charged with falsifying medical records. What that did was it made transplant recipients ineligible for organ donation. And the power is in the pen. This doctor falsified records to make it look like people who should have gotten transplants ineligible so that other people would get them. He has now surrendered to federal authorities and is set for his initial appearance or was, it looks like, on February 5th. But according to the indictment, the charges allege that even though patients should have been able to receive donations that he made false statements in their medical records, which made them ineligible. So, patients and their families and other members of the medical care team were completely unaware that he had done this. And so many patients remained ineligible for months, not knowing that they couldn't receive a liver transplant during that time. Again, this is about a surgeon, a system, and patients who waited for a phone call that never came. So, Dr. John Stevenson Bynum Jr. actually, falsified these medical records in ways that received liver transplant offers.
04:16
So, this is not about his personality, but it's about power over paper and how paper decides who lives long enough to matter. This is such an unfair case. I cannot believe that a doctor would do this. It's terrible because the people that were waiting on transplants were waiting on that call. And it was never going to come because he made it look like they weren't ineligible so that other people could get the organ.
So, in the United States, more than 100,000 people wait for organ transplant at any given moment. Nine to 10,000 of them are waiting for a liver. And each year, there are about 9,500. But that means that thousands of patients will die while still listed on the transplant list. And liver failure is not slow. It's volatile, and the margin for delay is very thin. The allocation is driven by urgency, measured through a score called the Meld score. And that score predicts the short-term mortality of a person. And it checks their lab work. It checks their bleeding time, their sodium levels, their creatinine levels, and their bilirubin. And the higher their Meld score is, the higher the risk of death, and the higher the priority for them to be a recipient. But Meld is only part of the equation.
Every transplant program sets specific criteria for individual patients. And those criteria actually decide which donor organs are even considered. So the age of the donor, whether they're obese or not, if they've had recent or current infections, the cause of their death, the size, of course, matters, compatibility, the amount of time that the organ has been without blood flow and oxygen, and the risk tolerance. So, one line in that system can eliminate hundreds of people. Now, here's the part that the patients never see. You can be active on the list and still be invisible. If donor criteria are narrowed without your knowledge, which is kind of what happened in this case, offers pass silently. So, these patients wait, and the families wait, and the clock just keeps ticking.
So, Dr. Bynum was not a peripheral figure. He actually served as director of the abdominal organ transplantation and surgical director for the liver transplant program at Memorial Hermann Texas Medical Center in Houston. Now, he trained surgeons and he shaped a lot of the policies, and he controlled access and he was very trusted. Now, outside of the hospital, he lived a private life with his family. He was embedded in the Houston medical community for years. And inside the hospital, his documentation carried extraordinary weight. Federal prosecutors are actually alleging that between March of 2023 and March of 2024, Dr. Bynum entered false or misleading information into patient medical records and transplant systems. Now, those entries allegedly altered donor acceptance criteria for five patients without their knowledge. Their family had no idea, and no other members of the care team were aware that he was doing this.
07:58
So, the patients appeared to be listed, but they weren't getting offers. They were being overlooked because he altered the criteria. So according to the indictment, one patient became ineligible for liver offers for about 149 days and actually ended up dying in February of 2024 because of this doctor. Another lost eligibility for about 69 days and died in December of 2023 during surgery. And a third patient described as urgently needing a transplant died in December 2023, only two days after his criteria was changed. So had the doctor not made that change, he very well could have been a recipient. Two other patients later received liver transplants, but that was after they transferred to different hospitals. Now, I need to pause and speak to you a little bit from the forensic nursing standpoint. Documentation is evidence. We are trying to assume that every note may one day be read in court or seen by a jury or seen by a family that's looking for answers.
So, we document facts, we document changes, and we chart time and intent in communication. And when documentation is altered, it does not disappear. It calcifies and it becomes the truth. And people rely on that. From a clinical standpoint, liver failure is actually brutal. Patients deteriorate unpredictably. They get a lot of fluid in their abdominal cavity that compresses their lungs. Their vessels rupture, their ammonia level rises, and that makes them become confused and sometimes combative and scared. Their kidneys fail. They get infections easily because their immune system's not good. There aren't a lot of steroids and medications that makes their immune system more fragile. And when donors stop coming, bodies keep failing. Families, unfortunately, have to watch this decline in real time while they're being told they're still on the list and they're being told to wait. Timing matters, days matter, weeks matter. If a patient is rendered ineligible for offers for weeks or months, the disease doesn't stop.
So, the body doesn't wait for an audit. So, when prosecutors allege false documentation, they are alleging interference with time. And time is actually the cause of death in these patients with liver failure. Now, about disqualification, there are a lot of ways that people can be disqualified for liver transplant. One is if they actively use substances and there's no documentation of them ever trying to become sober. Uncontrolled infection, advanced cancer, severe cardiopulmonary disease, and those people may not survive surgery. So that's the reason for that. Or somebody that just can't follow the rules after transplant. Relative disqualifiers sometimes morbid obesity, lack of social support, psychiatric illness, frailty, poor functional status, and the decision as far as who can donate and who can receive these organs involve multiple disciplinary teams. They're discussed by people and everything is documented and communicated, or it's supposed to be. Altering donor acceptance criteria outside that process doesn't de-list a patient, but it starves them of opportunity, and it creates a situation where they die anyway.
12:00
So, the federal charges against Dr. Bynum include multiple counts of making false statements in healthcare matters. And each count carries potential prison time and financial penalties if he's convicted. So, these are criminal allegations, not malpractice claims and prosecutors are alleging that he intentionally falsified records. So, when the allegations became public, unfortunately Memorial Hermann paused its liver and kidney transplant programs for nearly a year. Patients were displaced and it really shook the staff up. Oversight organizations reviewed and audited and put in a lot of documentation safeguards and the hospital apparently cooperated fully and implemented some corrective actions to prevent this from happening again. The defense has denied wrongdoing, of course. Dr. Bynum has not entered a guilty plea, and he remains presumed innocent and the case continues through federal court. But we don't know the outcome yet, but what is known is this, 17 people die every day in the United States waiting for organ transplant. Liver patients often decline suddenly and there is rarely time to recover lost weeks. But this falsified medical information actually became lethal to all of these patients. And I'll tell you plainly, when you hold the pen, you hold power. When you control the medical record, you control the narrative of death. And when the system trusts one person too much, that's never a good thing.
Now we need to talk about the families, because transplant medicine doesn't happen to one person. It happens to everybody. Families of these patients are suspended basically. They have to keep their phone charged. They have to keep their bags packed. Their life narrows to lab values in waiting rooms and every unfamiliar number that calls them becomes hope. We're always declining our spam calls. They can't do that. That call might be the organ they've been waiting for. Every silent night becomes fear, and families are told to be ready at any hour. They rearrange their work schedules. They barely sleep. They learn words they never wanted to know, and they measure time and ammonia levels in hospital admissions. So, when a patient is listed, families obviously are going to believe that the system is moving. It might be slow. It might be a while before they hear, but they believe that their loved one is on the list and could possibly be next in line for receiving an organ. They trust that no news means no match. And what they don't imagine is that matches may be passing without their knowledge, which is what happened in this case.
They don't imagine a scenario where eligibility exists in theory, but not in practice, and they don't imagine documentation or false documentation closing the doors. And clinically, the families have to watch their loved one decline in real time. They get confused, and confusion replaces conversation. Personalities change as toxins build up in their brain, and they become frightened of the patient they love because they're confused and sometimes belligerent.
15:47
ICU admissions kind of become routine, and families learn to recognize the look of someone who's dying, even while being told to wait. So, a lot of times, too, these families hold guilt, and they don't deserve that. They wonder, did I miss a call? Did I wait too long to take them to the doctor? Should I have pushed harder? And we see this repeatedly in forensic work. When systems fail quietly, families blame themselves. Now, if prosecutors are correct, some of these families waited during periods when donor offers were functionally impossible because of what this doctor did. They waited, and the disease continued to advance, and they waited while time ran out. So, from a family's perspective, death feels sudden, even when it was unfolding slowly behind the scenes. So after a death, families look for meaning, and they want records. They reread notes, and they try to reconstruct timelines. We see this moment often in forensic nursing. Documentation is sacred, and it's the last place families search for truth. But when records don't match the experience, grief turns into something sharper, and that's why transparency matters. This is why documentation integrity matters. Families can't advocate if they don't know what's happening. They can't consent to risk that they're not told even exists, and they cannot grieve cleanly when the story keeps changing.
For families who later learn eligibility may have been altered, the injury doesn't end with death. It follows them forever. And who's going to trust medicine anymore when something like this has happened to them? It's very scary. And it definitely affects how they tell the story of their loved one's life and death, unfortunately becomes a part of the legacy. So, in forensic nursing, we say the dead still speak. They definitely speak through charts and timelines and decisions made when they were too sick to speak for themselves. And families are the ones who listen the hardest. And this is why the case matters beyond the courtroom, because behind every transplant statistic is a family who believes that the system was doing its job. And when the system fails silently, the family carries that noise forever.
I can't even imagine being a family member of someone who thought they were on the list for a transplant, met all the eligible criteria, and were overlooked because this doctor falsified their records. I hope that he is prosecuted to the extent of the law. It looks like he was responsible for the death of at least three people. And to me, that makes him a serial killer. I don't know about you all, but I'm like, he's responsible for that. We don't know that the liver transplant would have necessarily given them a long healthy, productive life, but we do know that it would have prolonged their life. And so, these people died waiting and they thought the system was working for them. Just think of all the sleepless nights that these families suffered through when they could have actually experienced the joy of organ transplantation and had their loved one just a little bit longer.
19:30
Again, we're going to follow this case, but I had no idea y'all in looking up that there were 9,500 liver transplants performed every year. I know that we recently had lost here in our area, three young children between the ages of 15 and 17 to sledding accidents. And I think I mentioned this last week, but I believe every one of them were organ donors. And I think it would be so amazing as a parent, I mean, as unfortunate as it is to be on the other end. And to have your loved one get that organ and to meet the family that helped that to happen. I know that that has to be so hard to see someone else walking around with your son's heart or your son's liver, but also just so rewarding to know that even though they passed away, that they're saving a life.
A little bit about school, I'm in the middle of my last class. So, I only have four weeks left and I start clinical. And we are working on an education program on forensics. So if you're interested in forensics, if you love true crime or if you're a nurse who is interested in forensics, I'm going to give you direction and help you to get the training that you need to get into the field and give you pointers. If you're in law enforcement and you feel like you just need a little extra education on death scenes and what you're seeing, if you're a first responder, if you work EMS or fire department, you feel like you need some additional education, then these courses will be for you. There'll be a number of different things covered. And so, you'll have the opportunity to learn, which I love. I'm curious to see if anybody has been an organ donor and what their experience is and also maybe talking to families who have been on the other side and actually received a transplant and the donor walk. I did take part in one of those. We had a police officer here in our area several years ago that was shot and actually worked the case. And so, because it was a homicide, I went to the hospital, and it was just amazing to see all the officers like standing guard over his room. And even when he went to the funeral home, there was always an officer standing guard. But the donor walk I think was just the most compelling. So, this is also known as the honor walk. And this is basically a hospital procession that allows family and friends to accompany a deceased organ donor to the operating room. So, everyone shares final moments and recognizes the donor's gift. And the walk can serve a lot of purposes. This is closure for the family. Kind of gives them a moment to remind them that their loved one's life mattered. And it also reinforces the sacred nature of organ donation and honors the donor's legacy, and it represents the gift of another chance of life for the recipients. But it's basically a walk of respect. Usually, hospital staff, nurses, physicians, respiratory therapists, a lot of people line the hallways in a silent tribute. And family members and close friends accompany behind the hospital bed, many times holding hands and holding photos or mementos.
23:13
It's really cool to see staff members pause from their duties standing shoulder to shoulder in a show of respect. Some institutions will play music while others will just have silence. But sometimes families choose to share a few words or play a favorite song of the loved one. Sometimes they'll wear like matching shirts or pins or bracelets identifying the person. But these walks are heart wrenching because the staff and the family is emotionally united in honoring the lives lost and the legacy it leaves behind. You know when organ donors are, you know, you have to be kept on life support prior to the donation because you need the oxygen and the blood flow to continue to those organs. During that time, I mean, you know, this person's been in the hospital probably at that point for four or five, sometimes more days. And you definitely develop a relationship with the family.
As a nurse, definitely developed relationships with families who were in the hospital over long periods of time, waiting after an injury to see if there was any brain activity and then making the decision to donate. It's heart wrenching, but it's such an honor to watch too at the same time. So, this doctor, I hope… like I said, I hope he's prosecuted to the full extent of the law because his choice to alter documentation resulted in the loss of at least three lives.
We're going to follow this case. Again, this is a case here in Texas, so it's one that you may or may not have heard of, but we're gonna continue to follow it. Please share the podcast with all of your friends and let them know that we're available on Spotify, Apple, Google, Pandora, iHeartRadio, and all other platforms. If you go on and just subscribe, then that will allow me to get more listeners. Also, if you don't mind, go on my YouTube channel, Brains, Body Bags, and Bedside Manor and go ahead and follow there because when I start posting, you will be one of the first ones to be able to listen and see the videos. I appreciate y'all listening so much. I hope you have a great rest of your week, and I look forward to talking to you next week. Bye, y'all.
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