OH - Dr. William Husel accused of murdering 25 patients w/ Fentanyl Overdoses, Franklin Co, 2019 *not guilty*

This article answers a lot of the “How” questions to RNs and others in the hospital environment.


Fentanyl is commonly stored in 50 microgram bottles, and nurses and pharmacists from large area hospitals in Cleveland, Cincinnati and Columbus said that any nurse should question why more than two bottles are being opened.

If Husel ordered 1,000 micrograms, as he is accused of doing for James "Nick" Timmons, that meant a nurse would have had to open 20 bottles. Timmons, who died Oct. 24, was the only Husel patient identified to date for whom an autopsy was performed by the Franklin County coroner. The coroner listed the cause of death as cocaine and fentanyl.

He definitely knew what he was doing..
Staff members who worked in the ICU in the past five years said Husel often would give emergency orders for the powerful opioid fentanyl or some other painkiller. Those emergency orders, meant to be used in certain urgent situations, would allow him to bypass a pharmacist's pre-approval, giving the medical staff access to drugs stored in a Pyxis machine, or secure cabinet, on the ICU floor.

Husel sometimes would tell families agonizing over removing a loved one from a ventilator that he would ease the patient's suffering with pain medication, but he didn't tell the families he was prescribing potentially lethal dosages, family members said. Other times, the doctor would just order the large doses of opioids without informing families or consulting with anyone else in the hospital, families have said in lawsuits.


So we know he was the night shift intensivist, and it appears that as these patients came in, they were admitted directly to ICU. Are they tracking these deaths (back to 2015) by his signature on the death certificate?? Or is this in defense of physicians who signed the certificates without doing a thorough chart review? Why else mention this?
Each patient who died under Husel's care would have originally been assigned another Mount Carmel doctor when they were admitted, as is normal procedure for hospitals. Those doctors would have had access to the patient charts before signing the death certificates.



Mount Carmel doctor sidestepped pharmacists, persuaded nurses, sources say
 
I do remember that back in the mid 1980's, Ohio State University Hospital in Columbus had the same problem with an intern by the name of Michael Swango.

Several patients had died at University Hospital under mysterious circumstances where Michael Swango worked as a floor intern.

But due to lack of physical evidence, prosecutors in Columbus weren't able to charge Michael Swango with murder.

I also remember that this was a major story all over the Columbus news media back then.

Source:

Michael Swango - Wikipedia
 
I wonder if they are investigating his wife? I know she gave at least one of the deadly shots. IMO she knew what was going on
Apparently this is his THIRD wife...and they now have 2 children. I wonder what the other two wives have to say about his personality and the type of person he was.
Wife #3 (MB) is being investigated along with all the others involved who provided care to these patients.

Updated lawsuit says former Mount Carmel doctor's wife administered fatal dose
 
I was looking at the death dates listed above and was curious as to the gaps in time as he was employed by Mount Carmel Hospital since '13 and then I found this article from June 5 2019.
Of course there were more deaths then the 25, this article states why.

It also states other medical staff was not being charged. Are there any other ramifications other then being placed on leave? No infraction on their license? The second article I included says that those staffers would be open and honest about what happened, does that mean testify against Husel under a plea bargain?

Ohio doctor pleads not guilty to murder charges in 25 painkiller overdose deaths

A slew of lawsuits ensued against Husel, the hospital and staff. Husel's medical license was suspended. A criminal investigation was launched. At least 30 nurses were placed on leave.

Columbus police and prosecutors chose to focus on deaths where 500 micrograms of fentanyl or more were administered. Several families have filed lawsuits after their relatives were given 200 micrograms of fentanyl or another drug.

Franklin County Prosecutor Ron O'Brien said the nurses and pharmacists who administered or approved the drugs will not face criminal charges.

Another article:

Hospital officials said earlier this year that 30 employees, including nurses and pharmacists, were placed on leave, while 18 others with ties to the case no longer work there — with many of them having already left in prior years. The officials have said they would be "open and honest about what happened," and have installed safeguards to prevent a recurrence.


MOO
I noticed those gaps as well and wondered the same thing. He more than likely was on his best behavior when he came on staff (2013) and then was busy as a first time dad (2016), sealed the deal with (MB) wife #3 (married Oct. 2, 2017). The article states they have 2 children, first was born in 2016.
MOO...
Gets married 10/2/17 and returns to work a week later and 3 patients die—every other day that week (10/9-10/13 was Monday-Friday)
 
Snipped and BBM
These are the death dates. I wanted to see what it looked like isolated on paper.
One 2 occasions, he killed 2 people on a single day. Same nurse?
This isn't including the people that were overdosed and lived.

Feb. 11, 2015
March 1 2015
May 3-4 2015
May 10 2015
April 3 2015

Oct 9 2017 fent shortage mentioned
Oct 9 2017
Oct 11 2017
Oct 13 2017 one pt who died at Mount Carmel St. Ann's

Nov 20 2017
Nov 25 2017
Dec 5 2017
Dec 10 2017

Jan 14 2018
Jan 14 2018

March 25 2018
April 1 2018
May 28 2018
July 15 2018

Sept 25 2018
Sept 30 2018
Oct 24 2018
Nov 13 2018
Nov 15 2018
Nov 19 2018


MOO
Yes and this date just happens to be exactly 1 week after getting married to the RN that is now his wife.

Two more deaths occurred on Dec. 10, 2017
“The firm says Brigner died on the same shift as Janet Kavanaugh” Updated lawsuit says former Mount Carmel doctor's wife administered fatal dose
 
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I noticed those gaps as well and wondered the same thing. He more than likely was on his best behavior when he came on staff (2013) and then was busy as a first time dad (2016), sealed the deal with (MB) wife #3 (married Oct. 2, 2017). The article states they have 2 children, first was born in 2016.
MOO...
Gets married 10/2/17 and returns to work a week later and 3 patients die—every other day that week (10/9-10/13 was Monday-Friday)

I wonder if he has ever been on good behavior? Per the statement in the article, there were numerous other deaths linked to Husel but they are only prosecuting him on incidents where 500 mcg of fentanyl or more were administered.

Several families have filed lawsuits after their relatives were given 200 mcgs of fentanyl or another drug.

I wonder what the "other" drug was he used? Besides fentanyl, his go to seemed to be versed and hydromorphone.

MOO
 
I wonder if he has ever been on good behavior? Per the statement in the article, there were numerous other deaths linked to Husel but they are only prosecuting him on incidents where 500 mcg of fentanyl or more were administered.

Several families have filed lawsuits after their relatives were given 200 mcgs of fentanyl or another drug.

I wonder what the "other" drug was he used? Besides fentanyl, his go to seemed to be versed and hydromorphone.

MOO
Possibly paralytics? I posted an article that mentioned Nimbex and Rocuron being given with the Fentanyl and Versed. It may have been the one case at St. Ann?
 
1st marriage - 8/2005 - 7/2016
-4/2008 he filed for “incompatibility” and complaint was dismissed 9/2008.
- 7/2012 both filed for joint petition for dissolution. Final agreement reached 9/2012

2nd marriage - 9/2013-4/2016
- Wife was a RN in Ohio

3rd marriage - 10/2017
- RN in Ohio; involved with at least one case
- Mother of his 2 children
- Child #1 born 2016. Child #2 unknown date

MOO...he was busy in 2016 finalizing a divorce with wife #2 (RN) having an affair, and becoming a first time father with soon to be wife #3 (also RN). Maybe wife #2 knew what he was up to, possibly threatened to alert or did report and he stopped?

Former Mount Carmel doctor William Husel has complicated past
 
This will be very interesting to watch. Laws change, decades ago, integrated marrige was illegal, abortion was illegal, doctors who performed abortions were sentenced to prison sentences.

As the Baby Boomer population continues to age, the Boomers are approaching 72, still fairly healthy. If we add 15 years to this, it will be the oldest Boomers will be in their 80's, approaching 90's. I believe that these laws will change, the Supreme Court will have more cases regarding Self Determination for Choices in Healthcare, Euthanasia and Rational Suicide. I have no doubt a libertarian government will prevail.
 
This will be very interesting to watch. Laws change, decades ago, integrated marrige was illegal, abortion was illegal, doctors who performed abortions were sentenced to prison sentences.

As the Baby Boomer population continues to age, the Boomers are approaching 72, still fairly healthy. If we add 15 years to this, it will be the oldest Boomers will be in their 80's, approaching 90's. I believe that these laws will change, the Supreme Court will have more cases regarding Self Determination for Choices in Healthcare, Euthanasia and Rational Suicide. I have no doubt a libertarian government will prevail.
We will literally be living in hell if that ever happens....MOO
 
This will be very interesting to watch. Laws change, decades ago, integrated marrige was illegal, abortion was illegal, doctors who performed abortions were sentenced to prison sentences.

As the Baby Boomer population continues to age, the Boomers are approaching 72, still fairly healthy. If we add 15 years to this, it will be the oldest Boomers will be in their 80's, approaching 90's. I believe that these laws will change, the Supreme Court will have more cases regarding Self Determination for Choices in Healthcare, Euthanasia and Rational Suicide. I have no doubt a libertarian government will prevail.

I very much hope that legal euthanasia such as California's Aid in Dying law becomes nation wide. My Aunt is a hospice social worker in CA and has not had any patients use it yet but says it brings peace to terminal patients to know that if their suffering becomes to much that they have a way to die on their own terms.

However legal euthanasia has absolutely nothing to do with this case. These patients were murdered by a physician and hospital staff end of story. This is not a Dr. Kevorkian situation where patients came to him asking for help ending their lives.
 
Nick was a drug addict with high tolerance that came in with AMS. How much did he weigh, was he obese?
Although not stated, it sounds like he was being sedated for intubation to be placed on a vent or the like and due to his high tolerance needed additional doses? Was the fentanyl an IV infusion?

If that is the case, the dosage is nothing like it would be in a PCA pump, or bedside setting via IV push, it is dosed as an anesthetic via continuous infusion ie: a 70-kg ( 154 lbs) patient would receive 700 mcg/hr fentanyl (see below)

**If they noticed respiratory depression after dosing why didn't they have Flumazenil the reversal agent for versed or Naloxone for fentanyl and dilaudid? Did they perform CPR?

James Nickolas Timmons, 39, of Hilliard, who went by Nick, arrived at the hospital on Oct. 22, 2018 with an altered mental status due to drug abuse. On Oct. 24, he was given 1,000 micrograms of fentanyl and 10 mg of Versed at 3 a.m. and 10 mg of hydromorphone and 10 mg of Versed after that. He died at 3:13

Here are the victims in the Mount Carmel criminal case


"Unlike most drugs, Versed dosages should be based upon the effect of the drug, rather than the weight of the patient. The dose should be adjusted based on the result of the initial dose, meaning that the patient should be given more or less of the drug based on how effective it is.

A patient's ability to tolerate alcohol consumption often gives a hint of their likely tolerance for Versed. Individuals who are a "lightweight" and become intoxicated easily may require less medication than someone who can "hold their liquor."

Surgery and Versed (Midazolam)


Drawbacks of prolonged fentanyl infusions

The recommended dosage of fentanyl is enormous.
The recommended infusion rate for fentanyl in the SCCM guidelines is 0.7-10 mcg/kg/hr. At the upper end of this range, a 70-kg ( 154 lbs) patient would receive 700 mcg/hr fentanyl, equivalent to 3,360 mg of oxycodone daily.

opium.gif

PulmCrit- Fentanyl infusions for sedation: The opioid pendulum swings astray?
It appears this was IVP. I think this particular case is what prompted the first “formal” complaint against Husel. Timmons died 10/24/18 and the first complaint reported occurred on 10/25/18

“Timmons, who died Oct. 24, was the only Husel patient identified to date for whom an autopsy was performed by the Franklin County coroner. The coroner listed the cause of death as cocaine and fentanyl.”
Mount Carmel doctor sidestepped pharmacists, persuaded nurses, sources say
 
I very much hope that legal euthanasia such as California's Aid in Dying law becomes nation wide. My Aunt is a hospice social worker in CA and has not had any patients use it yet but says it brings peace to terminal patients to know that if their suffering becomes to much that they have a way to die on their own terms.

However legal euthanasia has absolutely nothing to do with this case. These patients were murdered by a physician and hospital staff end of story. This is not a Dr. Kevorkian situation where patients came to him asking for help ending their lives.

Valid point. If this doctor killed people, he is a serial killer.

If a law is passed, that gives doctors legal authority to end life for people who are brain dead based on empirical evidence, a doctor would use the designated medical procedures. Not a serial killer.
 
It appears this was IVP. I think this particular case is what prompted the first “formal” complaint against Husel. Timmons died 10/24/18 and the first complaint reported occurred on 10/25/18

“Timmons, who died Oct. 24, was the only Husel patient identified to date for whom an autopsy was performed by the Franklin County coroner. The coroner listed the cause of death as cocaine and fentanyl.”
Mount Carmel doctor sidestepped pharmacists, persuaded nurses, sources say

Thanks @Bryant_Denny

My post was made before the additional documentation and details were released and I was brainstorming possible scenarios.

It is obvious to me now what the situation is.
 
I wonder how many deaths in total Husel was responsible for? I'm guessing hundreds.
This article notes that the hospital has been settling with families, and that the medical boards were notified of medical staff involved in this situation. MOO


Ohio doctor accused of murder in 25 patient deaths


Mount Carmel has publicly apologized and settled some of the cases for hundreds of thousands of dollars.

Mount Carmel has said it should have investigated and taken action against Husel more quickly. It said that the doctor wasn’t removed from patient care until four weeks after concerns about him were raised last fall, and that three patients died during that gap after receiving excessive doses he ordered.

All told, 48 nurses and pharmacists were reported to their respective professional boards. Thirty of those employees were put on leave, and 18 no longer work there, including some who left years ago, officials said.

In one of the biggest such cases on record, Donald Harvey, a former nurse’s aide dubbed the Angel of Death, confessed in 1987 to killing 37 people, most of them hospital patients, over the span of two decades in Ohio and Kentucky.


Donald Harvey - Wikipedia
 
It appears this was IVP. I think this particular case is what prompted the first “formal” complaint against Husel. Timmons died 10/24/18 and the first complaint reported occurred on 10/25/18

“Timmons, who died Oct. 24, was the only Husel patient identified to date for whom an autopsy was performed by the Franklin County coroner. The coroner listed the cause of death as cocaine and fentanyl.”
Mount Carmel doctor sidestepped pharmacists, persuaded nurses, sources say
Timmons was the youngest of the victims, age 37. Not all of the patients were terminal, some could have survived with treatment-perhaps he is one of those patients.
 
Timmons was the youngest of the victims, age 37. Not all of the patients were terminal, some could have survived with treatment-perhaps he is one of those patients.
My thoughts exactly. I don’t know the specifics of this case, but more than likely it was a suspicious death which lead the coroner to perform an autopsy.
I just do not see how this went unnoticed by risk management and other leadership. Not to mention this is also an academic hospital. The hospital is quite large with 672 beds and 3 ICUs for a total of 160 ICU beds.

ETA: American Hospital Directory - Mount Carmel West (360035) - Free Profile
 
My thoughts exactly. I don’t know the specifics of this case, but more than likely it was a suspicious death which lead the coroner to perform an autopsy.
I just do not see how this went unnoticed by risk management and other leadership. Not to mention this is also an academic hospital. The hospital is quite large with 672 beds and 3 ICUs for a total of 160 ICU beds.

ETA: American Hospital Directory - Mount Carmel West (360035) - Free Profile

This is what my daughter says. She worked there as an RN. She said every single med they gave was tracked. one time she accidentally messed up disposing of a medication (her first few weeks working there) and was written up immediately.

Now they have patients dying of legionnaires disease. People that worked on that building locally kept saying how poorly it was built and that something was going to happen.
 

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