Mine had been deleted by a previous owner. The thing that wasn't mentioned was that it had a tune in it. It had no tuner in it so it was "stealth", but in retrospect, my guess is it was at least a +100 HP tune, probably 150. Thing was quick. And that's why it ended up a 7-cylinder. Really more of a 7.5 cylinder, it worked fine under power but the rings on the one cylinder were shot enough that at idle you'd notice.
I suspect that if it had been left stock other than the deletes, it probably would've been fine.
The EGR cooler that I think was novel on the 6.0 became common, my Ram has one as well. But EGR on diesels hasn't been a good thing, and if I recall correctly Cummins figured out how to pass emissions with elimination of EGR and essentially more DEF on the next generation engines, which is a major win for diesel reliability if they did.