Second lawsuit filed alleging deadly dosage of fentanyl by Mount Carmel doctor – News – The Columbus Dispatch

Still reeling with grief over the death of his wife, David Austin said he was “dumbfounded” when he received a call from Mount Carmel Health System in December to tell him that she had been given an overdose of drugs.

“In other words, they killed her,” Austin said in an interview Tuesday night with The Dispatch.

Now Austin, 64, of the West Side, has become the second to file a wrongful death and negligence lawsuit this week against Dr. William Husel and Mount Carmel. Austin said that Mount Carmel called him again this week to tell him that 27 people could have received an overdose from Husel, 43, of Liberty Township, located in southern Delaware County near Dublin.

Bonnie Austin, 64, died at Mount Carmel West on Sept. 30, 2018, after Husel ordered a 600-microgram dose of fentanyl and a large dose of anti-anxiety medication, Versed, through her IV. With a history of heart and lung problems, Bonnie Austin had arrived at the hospital by ambulance less than four hours earlier after having chest pains and trouble breathing, the lawsuit says.

Husel told David Austin that his wife was brain dead, according to the lawsuit, which attorney David Shroyer said he filed Tuesday in Franklin County Common Pleas Court. David Austin remembers being overwhelmed at the news: “I believed him. I had no choice. He’s a doctor.”

But what David Austin didn’t know was Husel had the dose of fentanyl administered five minutes before the two talked about removing life-support at 11:28 p.m., the hospital’s records show, Shroyer said. She died at 11:53 p.m. A medical expert is prepared to testify that Bonnie Austin’s death was caused by fentanyl, Shroyer said.

“The excessive dosage was grossly inappropriate given Bonnie Austin’s condition and was either ordered negligently and not properly reviewed or was intentionally prescribed by Dr. Husel for the purpose of ending Bonnie Austin’s life,” the lawsuit states.

David Austin told The Dispatch that Husel never mentioned that his wife had been given fentanyl, and Mount Carmel officials didn’t name the drug when they contacted him.

According to the other lawsuit, filed Monday and alleging wrongful death and negligence by Mount Carmel, Husel and others, Husel also prescribed 1,000 micrograms of fentanyl to 79-year-old Janet Kavanaugh of Grove City on Dec. 11, 2017 — just 18 minutes before she was pronounced dead at Mount Carmel West hospital in Franklinton.

The amount of painkiller that Husel allegedly prescribed to Kavanaugh was so high that it appears his intent was to accelerate her death, according to a critical-care professor who has researched end-of-life-care ethical issues.

“To give 1,000 (micrograms) is so far above and beyond what we would ever give that it is clear there the intent is to accelerate the death,” said Dr. E. Wes Ely, a professor of medicine and critical care at Vanderbilt University.

Husel, a critical-care osteopathic doctor, has been fired by Mount Carmel, and 20 other health-system employees have been placed on administrative leave.

Mount Carmel has said in a statement that Husel, who began working for the health system in 2013, might have been responsible for prescribing excessive and potentially fatal doses of fentanyl to 27 near-death patients between 2015 and 2018. All but one of those patients was at Mount Carmel West hospital; the other was at Mount Carmel St. Ann’s in Westerville.

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

The Cleveland Clinic, where Husel was a resident from 2008 to 2013, said Tuesday that a preliminary review of his medication-prescribing history didn’t turn up concerns about his work at the northeast Ohio-based hospital system.

“Withdrawing support is absolutely correct and appropriate, but never when you withdraw support are you intending death,” Dr. Ely said. “We should be intending for a human being’s life to take its natural course.”

Part of the doctor’s response to a patient being removed from support, Ely said, is managing the patient’s suffering.

In such situations, a doctor should always administer painkillers incrementally, given that drugs such as morphine and fentanyl can be lethal, said Dr. Lydia Dugdale, a physician and associate director of the Program for Biomedical Ethics at Yale School of Medicine.

“Anyone who deviates from that standard of care is doing the ethically problematic thing,” she said. Further, she said, such deviation is potentially a violation of law.

Ely said he’s never given a patient a single fentanyl dose of more than 100 micrograms.

With a dose 10 times that, Ely said, “that’s hitting a thumbtack with not even a sledgehammer. That’s hitting a thumbtack with a crane you’d see at a construction site.”

Ely said patients who build up a tolerance to a narcotic might have doses ramped up over several days to, perhaps, a “very, very high dosage” of 200 micrograms an hour, resulting in 1,000 over five hours.

Gerald Leeseberg, an attorney who filed the suit in Kavanaugh’s death, said that Kavanaugh would not have been desensitized to fentanyl.

“I’m not aware that she had ever received fentanyl prior to this,” he said.

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

Husel received his medical degree from Ohio University in 2008. He is the only doctor involved in the Mount Carmel overdosing, the health system said, but 20 other Mount Carmel system employees, including six pharmacists and 14 nurses, have been placed on administrative leave. One pharmacist, Taylon Schroyer of Marysville, is named as a defendant in both lawsuits. Two registered nurses who administered the doses also are named in the suits.

Franklin County Prosecutor Ron O’Brien has said that his office is investigating, after being contacted in December by Mount Carmel and its parent agency Trinity Health about the conduct of a medical employee. The Columbus Division of Police also said Tuesday that it was first alerted to the situation in December and is investigating.

Mount Carmel executives said changes made in response to their investigation include increased education on 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.

Both attorneys, Leeseberg and Shroyer, said they have other clients preparing to file lawsuits.

“There has to be a mechanism in place so that this kind of thing doesn’t happen again,” Shroyer said of the decision to take Mount Carmel to court. “There are ways to guard against rogue physicians.”

Still, he added, Mount Carmel deserves credit for “stepping up when they discovered this.”

Staff writers Bethany Bruner, Holly Zachariah and Mark Ferenchik contributed to this report.

jviviano@dispatch.com

@JoAnneViviano

jwoods@dispatch.com

@Woodsnight

kstankiewicz@dispatch.com

@kevin_stank

rprice@dispatch.com

@RitaPrice