COLUMBUS, Ohio — Prosecutors allege Dr. William Husel operated with little oversight inside Mount Carmel’s intensive care unit and that his use of “unwarranted and unprecedented” doses of fentanyl and other drugs resulted in the deaths of 14 patients.
Assistant Prosecutor Janet Grubb said that Husel’s prescribed orders were “grossly inflated” and went beyond “medical negligence… they were in fact murder,” she said.
The patients involved in this case died between 2015 and 2018.
The central question in the criminal case against Husel will be: did the dosages and the rate at which they were given hasten their deaths or did something else kill them?
Grubb described how each patient came to the hospital for various medical reasons but that they “all had one thing in common, Dr. William Husel was the nighttime ICU doctor…”
Prosecutors allege that Husel ordered excessive and potentially fatal doses for patients under his care.
Many of them were on ventilators and prescribed the drugs around the time their life support was being removed. The Franklin County prosecutor’s office alleges that Husel’s order of the drugs accelerated the deaths of his patients.
During Tuesday’s opening remarks, Grubb said that the hospital policies included a recommendation for morphine to be used when patients’ ventilators were being removed. The translation to fentanyl, she said, meant Husel’s orders were six to 20 times higher than the recommended dose.
Husel’s legal defense – which includes Miami defense attorney Jose Baez and Columbus defense attorney Diane Menashe – have argued that Husel was providing comfort care, that the patients’ disease and the removal of life support likely killed them.
Baez said that Husel’s orders – while “aggressive” – were meant to help the patients avoid a painful death.
“There is no such thing as a medical murder case,” Baez told jurors. “Husel was exercising compassion and trying to free them from pain.”
Baez also told jurors that Husel was trained at the Cleveland Clinic in anesthesiology and critical care medicine.
He also mentioned a patient who received 2,500 micrograms of fentanyl but lived several days before dying.
Baez alleged that the state’s case is absent from this case. He previously tried unsuccessfully to have the criminal charges against Husel dismissed.
Baez alleged the Mount Carmel Health System failed to disclose this case to the Columbus Division of Police, who investigated this case.
Baez also told jurors that there is no ceiling dose or max dosage guidelines inside the hospital.
Husel has pleaded not guilty to 14 counts of murder. Originally charged with 25 counts of murder, prosecutors chose to dismiss 11 of the counts last month. While they have not publicly stated why they chose to dismiss several of the counts, most of the 14 remaining cases include patients who received 1,000 micrograms of fentanyl or more.
Husel was fired by Mount Carmel in December 2018 following an internal investigation. Pharmacists raised concerns about dosing orders in October 2018. Between the time the first pharmacist raised questions about the dosing (thinking medications might have been stolen) and when Husel was suspended – three additional patients died under Husel’s case – including Melissa Penix – who received 2,000 micrograms of fentanyl.
Her family’s attorney also alleges that she was not brain dead but was given a paralytic drug that would’ve made it impossible for her to have a neurological response.
Part of 10 Investigates’ previous reporting noted how many of the doses were withdrawn through bypassing the hospital’s pharmacy by what’s called an “override” – withdrawing drugs from a medication dispensing machine.
After news of the scandal broke in January 2019, CMS sent in health inspectors from the Ohio Department of Health. They noted that an “override” was used in 24 of the 27 patient cases that they reviewed.
More than 50 witnesses are expected during what is expected to be an eight-week trial. Among those expected to testify include doctors, nurses, pharmacists and family members of the patients.
Husel is expected to have his own set of witnesses – including experts who are expected to speak to the dosing of medications.
After news of the dosages scandal broke in January 2019, the Centers for Medicare and Medicaid Services placed the hospital in “immediate jeopardy” status and threatened to withhold their federal funding. Ultimately, the hospital made a series of corrections and adjusted its own policies to ensure that large doses of fentanyl were capped and that they had to have pharmacy approval prior to palliative extubation.
With the hospital in danger of losing its federal funding, Baez showed jurors how Mount Carmel created internal communications with various scenarios as Husel and other employees were portrayed as “villains."
Baez said these internal documents were created after Husel was fired in December 2018 but before news of the patient dosing scandal became public when 10 Investigates was first to report it in January 2019.
Baez also accused the hospital of withholding information about a patient who received 2,500 micrograms but died several days later – adding she was not among the patients Husel is charged with killing.
Columbus Division of Police Det. William Gillette testified he met with Mount Carmel officials following the deaths of Melissa Penix and Rebecca Walls in late November 2018. But during cross-examination, Baez asked a line of questioning for more than an hour that picked apart if police did a thorough enough job or acted independently enough outside of the hospital.
Gillette at times had difficulty remembering who he interviewed and about what doses were approved by the pharmacy for which patients. After several objections, Gillette was able to refer to his summary of events.
Husel decides to proceed with trial, not take up potential offer to plead to reckless homicide
Prior to opening statements, Assistant Prosecutor David Zeyen said he approached Jose Baez about if Dr. William Husel would be open to pleading guilty to several – up to 10 counts – of reckless homicide. Baez said called those discussions “extremely reasonable” but that it was something he gave consideration to, but ultimately they declined because Husel said he maintains his innocence.
“Dr. Husel has expressed to me he is innocent and he trusts in the system,” Baez said.