In a split decision, Dallas’ Fifth Court of Appeals has affirmed the unusual criminal conviction of a medical doctor who was sentenced to life in prison last year for intentionally or knowingly causing serious bodily injury to an elderly patient during surgery.

The decision concerns the career of Christopher Daniel Duntsch, a former Plano neurosurgeon who bounced around hospitals in North Texas until his medical license was revoked in 2013. Duntsch’s medical misdeeds later became fodder for a popular six-episode podcast called “Dr. Death,” which was released by Wondery earlier this year.