The Texas Medical Center is world-famous for heart surgery, but the receipts show Dr. Denton Cooley performed illegal surgeries. In 1968, Cooley did the first successful US heart transplant. But in 1969, he implanted an artificial heart into Haskell Karp without FDA approval. It kept Karp alive for 64 hours, then Cooley replaced it with a human heart. Karp died 32 hours later. The FDA investigated. Cooley bypassed all regulations. Karp's widow sued. The case settled out of court. Some called him