Murder by Opioid: The Case of the Ohio Doctor Charged With 25 Counts of Murder

Lin Rice

October 01, 2019

Dr William Husel (right) shown leaving Franklin County court. Photo by John Futty/Dispatch

On June 5, Dr William Scott Husel, 43, was indicted by a grand jury on 25 counts of murder—making him the target of one of the largest murder trials in the state's history. Husel is accused of ordering opioid doses in such large amounts "that the only rational purpose could be to shorten a person's life," according to prosecutors.

The charges followed a 6-month investigation initiated by Mount Carmel Health System, where Husel worked as an intensive care physician, after a pharmacist alerted hospital staff about high doses of fentanyl ordered by Husel. The hospital concluded that the medications resulted in the deaths of at least 25 patients.

Has the widely publicized case against Husel caused Ohio medical professionals to look over their shoulders, worried that their own opioid prescribing might draw new levels of scrutiny?

The Charges Against Husel

The incidents involving Husel took place over a span of 4 years at Mount Carmel St. Ann's hospital and the now-shuttered Mount Carmel West hospital. An acute care physician with a certification in anesthesiology, Husel ordered excessive and potentially fatal doses of fentanyl for inpatients who were already near death, according to the hospital.

Husel was originally investigated in connection with 35 patient deaths. Ultimately, he was charged with murder in 25 patient deaths, as a result of a decision by prosecutors to only charge instances in which patients were given a dose 5-10 times higher than that usually required to control severe pain. Some patients were ordered doses of 1000-2000 µg. The family of one patient alleges that Husel encouraged them to agree to removal of life-sustaining care, and then ordered that a dose of 2000 µg of fentanyl be given. The patient died within 5 minutes of receiving that dose.

Staff at the facility were placed under a microscope as the administration and law enforcement tried to determine how this happened and whether current prescribing practices were abused, broken, or simply ignored. The Ohio Board of Nursing alleged that 25 nurses at Mount Carmel violated the Nurse Practice Act by failing to question "excessive" fentanyl doses.

Altogether, 23 nurses, pharmacists, and managers who had been involved at some level with administering these doses to the affected patients were fired. Eleven others were allowed to return to work with additional training. Mount Carmel Health System president and CEO Ed Lamb also resigned.

Franklin County prosecutor Ron O'Brien.

No other healthcare professionals at the hospitals were charged with murder. "In our view, the doctor who issued the order is the person that caused the chain of events to occur, and therefore that responsible person would be who we'd look at in terms of a criminal investigation," Franklin County prosecutor Ron O'Brien said.

However, many were named in civil wrongful death suits. Unlike murder charges in criminal courts, which must be brought by the state, wrongful death suits are filed in civil courts by families on behalf of the deceased.

Some families claimed that Husel informed them that their family member was brain dead and the doses were necessary to ensure comfort at the end of life. Several of the suits involve patients who died within hours—sometimes minutes—of each other. At least one death occurred after the hospital had received a formal complaint concerning Husel. The health system says in all cases, family members had decided to withdraw life-saving measures.

Both Husel and his attorney declined requests for an interview. But in statements to the press, they asserted that "at no time did Dr Husel ever intend to euthanize anyone." Whether or not these doses can be justified will probably be the subject of dueling testimony by medical experts at trial. None of the physicians with whom Medscape spoke defended Husel.

The Ohio Board of Pharmacy and Ohio Board of Nursing also declined to comment for this story. Tessie Pollock, director of communications for the State Medical Board, said Ohio law prohibits the board from discussing how many or which employees were reviewed, the results of any reviews, or whether those reviews are still ongoing.

In August, Husel sued the hospital's parent company for breach of contract, asserting that although the hospital has defended him in the 36 civil proceedings arising from these allegations, it and its insurance carrier have refused to cover the costs of his criminal trial, thus limiting his ability to mount a defense. To date, Mount Carmel has paid $13 million dollars to settle wrongful death suits filed by the families of the patients who died. The hospital counters that Husel is not covered by the institution's malpractice policy because he was charged with "purposeful murder." Husel was accompanied by a new defense team during his last court appearance. A trial date is set for June 2020 and is anticipated to last several months.

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