Mount Carmel says doctor gave 27 near-death patients potentially fatal doses of pain medication

Columbus Dispatch ^ | January 15, 2019 | JoAnne Viviano

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Mount Carmel Health System says one of its intensive-care doctors gave "significantly excessive and potentially fatal" doses of pain medication to at least 27 near-death patients between 2015 and 2018.

Dr. William Husel, who had worked for the system since 2013, has been fired, and details of an internal investigation by Mount Carmel have been turned over to authorities, the health system's top executive said in a statement Monday.

The statement was released after a lawsuit was filed earlier in the day in Franklin County Common Pleas Court against the health system, the doctor, a pharmacist and a nurse in the 2017 death of a 79-year-old Grove City woman who was allegedly administered a fatal dose of the powerful opioid fentanyl at Mount Carmel West hospital.

The families of all patients involved had requested that lifesaving measures be stopped, but the amount of painkiller prescribed was beyond what was needed to provide comfort, said Ed Lamb, president and CEO of the Columbus-based health system.

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"The actions instigated by this doctor were unacceptable and inconsistent with the values and practices of Mount Carmel, regardless of the reasons the actions were taken," the statement said. "We take responsibility for the fact that the processes in place were not sufficient to prevent these actions from happening.

"We’re doing everything to understand how this happened and what we need to do to ensure it never happens again."

Along with Husel's firing, 20 employees have been placed on administrative leave, among them pharmacists who were involved with related patient care, and nurses who administered the medication, Mount Carmel executives said. The health system said only one doctor was involved.

The lawsuit names the health system; Husel, 43, of Liberty Township outside Dublin; pharmacist Talon Schroyer, 31, of the Marysville area; and nurse Tyler Rudman, 32, of Grove City.

Neither Husel nor Rudman could be reached for comment Monday by The Dispatch. Schroyer declined to comment when contacted.

Franklin County Prosecutor Ron O'Brien said Monday night in a statement that Mount Carmel and Trinity Health systems contacted his office and other authorities in December about "conduct by a medical employee" and an investigation is being conducted.

"This office met with doctors, executives and attorneys for the hospital and been in contact with other law enforcement and state regulatory agencies. Mt. Carmel and Trinity Health systems have been fully cooperative and responsive to lawful requests for additional information and documents," O'Brien said, adding his office cannot answer questions until the investigation is completed.

Attorney Gerald Leeseberg filed the lawsuit on behalf of the estate of Janet Kavanaugh, who had been transferred to the hospital from an assisted-care center with serious health issues.

"She was an old woman with some health issues. That's really not in dispute," Leeseberg said. "The problem is, somebody or some people in the medical field appear to have made a unilateral decision about terminating her life or hastening her death."

Leeseberg, a partner in a Columbus law firm, said he has talked with families of other patients, and there were differing circumstances. He said additional lawsuits will be filed.

Executives of the health system said its internal investigation determined that the series of incidents began in 2015, and the latest was in November 2018. All involved patients who died, and all but one of them received care at Mount Carmel West in Franklinton; the exception was a patient at Mount Carmel St. Ann's in Westerville.

Lamb said executives were alerted to Husel's alleged misdoings by an employee in October 2018. Lamb said he suspects the reporting stemmed from a "zero harm" initiative that began 18 months ago and helped change culture to make people more comfortable about speaking out.

Changes made in response to the Husel investigation include increased education on standards and best practices regarding end-of-life care, an additional protocol to set maximum appropriate painkiller doses in the electronic medical-record system, and required approval from clinical leadership if there is any deviation, said Dan Roth, executive vice president and chief clinical officer for Trinity Health, a Catholic health-care system of which Mount Carmel is a member.

The suit says Kavanaugh was given 1,000 micrograms of fentanyl through an IV on Dec. 11, 2017, and died within 18 minutes. The opioid is about 100 times stronger than morphine.

Dr. Steven Bird, a Massachusetts doctor certified in emergency medicine and toxicology, filed an affidavit with the lawsuit stating that the amount of fentanyl given to Kavanaugh was inappropriate and excessive, according to Leeseberg.

The suit accuses all defendants of battery, medical negligence, negligence, wrongful death and intentional infliction of emotional distress. It also accuses Mount Carmel of negligence in supervision and in allowing Husel to practice in the health system. The suit seeks monetary punitive damages.

The health system had planned to announce the investigation publicly on Wednesday after contacting families and informing employees.

Kavanaugh's daughter had been contacted in December and told that her mother had been given an excessive dose of fentanyl, according to the lawsuit, and she was contacted again on Monday and told that other patients were involved in incidents.

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“Correlation is not causation.”

Yes, but there are increasingly prevalent errors of both omission and comission on the part of hospital staffs are giving rise to the notion that beyond the fact that sick people go to the hospital and some don’t make it, some go there, get maltreated and die. The other part of it is doctor’s refusal to offer further treatment to someone who is both ill and aged.
My wife and I had dinner last Saturday with a couple who have been friends for a number of years. They are both in their mid-80s ( we are in our 70’s). Last year, the wife needed to have a heart valve replacement. In her “team of doctors” there was only one who thought that they should do the surgery. The others said essentially, “put her in hospice care and let her DIE!” Needless to say, the surgery was a complete success, and this lovely woman can look forward to any number of good years of life left to live. Sadly, we are to the point where “economics and physician risk” are bigger impediments to getting decent healthcare.