After her husband’s failed heart transplant at Baylor St. Luke’s Medical Center last year, Judy Kveton received an anonymous letter that left her in tears. It claimed that the physician who performed her husband’s surgery was allowed to continue operating even though he’d had “mishap, after mishap,” and despite warnings to hospital administrators that “he was not competent.”

Now, nearly two years after David Kveton’s death, his widow and adult children are citing the unsigned letter, an expert review of medical records and an investigation by ProPublica and the Houston Chronicle in a lawsuit against the hospital and its affiliated medical school.

In the complaint, filed late last month in Harris County District Court, Judy Kveton alleges that her 64-year-old husband died as a result of mistakes by Baylor College of Medicine doctors and St. Luke’s nurses during and after his transplant in January 2017.

It asserts that hospital leaders should not have allowed the surgeon to continue operating after receiving complaints about his performance. And it accuses the hospital of fraudulently marketing its heart transplant program, exaggerating the quality of its outcomes and “luring” patients “into a deadly situation.”

Officials from St. Luke’s and Baylor declined to comment for this story. In an email to reporters, hospital spokeswoman Marilyn Gerry wrote, “Our prayers remain with the Kveton family, however, we are unable to comment on litigation.”

Kveton’s story was detailed in an investigation in May by ProPublica and the Chronicle that found a high rate of patient deaths and unusual complications following heart transplants at St. Luke’s in recent years. Several physicians had left the renowned heart program after raising concerns about its lead surgeon, Dr. Jeffrey Morgan; a couple of cardiologists were so concerned that they began referring some patients to other hospitals for transplants.

In a previous statement, St. Luke’s defended the care it provided to Kveton and other patients who died or suffered complications after receiving new hearts: “Heart transplant patients often are very sick individuals who have undergone years of prior heart procedures, and sometimes even previous transplants or device implants to keep their heart beating, and often battle other illnesses and diseases — all of which can complicate a heart transplant,” the hospital wrote.

Morgan is named throughout the complaint but is not listed as a defendant. Through an attorney, he declined to comment on the lawsuit. In a previous interview and in responses to written questions this year, Morgan defended the quality of care provided at the heart program.

“We are all committed to providing heart transplant patients the most effective treatment options to meet their needs, and our recent record bears that out,” Morgan wrote in May.

Morgan performed David Kveton’s heart transplant on Jan. 25, 2017, about a year after joining the heart program as its surgical director.

By the time Kveton’s surgery was complete early the next morning, his new heart was struggling, according to the lawsuit. That was likely because it took Morgan and his team too long to implant the heart, the lawsuit alleges, leaving the donor organ on ice for more than four hours and increasing the risk for a complication known as graft failure.

Morgan didn’t mention the problem when he spoke with family members after the surgery, the lawsuit says. Morgan recalled the conversation differently in a written response to questions in May.

“After the surgery,” he wrote, “I thoroughly explained to Mrs. Kveton that her husband was critically ill and was on a lot of medication to keep his blood pressure up.”

Despite the initial problems, the donor heart began to rebound, according to the lawsuit. But before long, David Kveton suffered another serious setback. Medical records show that a nurse turned Kveton in bed, according to the lawsuit, “despite the fact he had an open chest.” That caused pacing wires to become detached from his new heart, medical records show, and caused his blood pressure to plummet.

That mistake was exacerbated, the lawsuit says, because Morgan or his surgical assistant had failed to connect backup pacing wires to the heart during the transplant, a violation of the standard of care.

“Mrs. Kveton was never told this event occurred,” the lawsuit states, “but the medical records show that after this event the heart was no longer improving but instead was getting much worse.”

The downward spiral that followed is detailed in Kveton’s medical records: A day after the nurse turned him over, doctors inserted a balloon pump into the donor heart, an attempt to increase its pumping strength, but improvement was marginal. Three days later, a CT scan revealed Kveton had likely suffered a stroke, though family members say they were not told.

Kveton suffered another stroke and endured additional surgeries before family members made the decision to remove him from life support on the morning of Feb. 2, about a week after his transplant.

John Brothers, the Houston lawyer who filed the lawsuit on behalf of Judy Kveton and her children, said his clients aren’t motivated by money.

“Judy has always been about answers, accountability and change,” Brothers said. “This is really just another step in that process.”

The lawsuit follows months of changes at St. Luke’s.

On June 1, two weeks after the Chronicle and ProPublica investigation was published, the hospital suspended the heart transplant program to study what led to two additional patient deaths. The program reopened two weeks later after officials said they made staffing and policy changes.

Later that month, the Centers for Medicare and Medicaid Services announced it was cutting off federal funding to the program after concluding the hospital had failed to fix problems that endangered patients. St. Luke’s is appealing the decision.

And in October, the hospital announced it had hired a new administrator to oversee its transplant programs and had recruited two additional heart surgeons, effectively replacing Morgan as the program’s surgical director.

Morgan remains on the faculty at Baylor, where he holds the academic title of chief of cardiothoracic transplantation and circulatory support.