Doctor charged with killings brought trouble to colleagues
Stephanie LeChard was a registered nurse working the late shift in the intensive care unit at Mount Carmel West hospital when she encountered her first end-of-life case.
Sandra Castle, 80, of Columbus, who had suffered a cardiac arrest and had myriad health issues, “was grimacing and struggling to breathe,” LeChard later recalled in testimony.
Dr. William Husel, the intensive care physician in charge the night of Nov. 13, 2018, had ordered LeChard to give Castle 1,000 micrograms of the painkiller fentanyl and 10 milligrams of the sedative Versed.
Since LeChard, 27, had been with Mount Carmel only a few months and was new to working in the ICU, she asked two colleagues about the amount of fentanyl prescribed. Fentanyl is a powerful painkiller, and 1,000 micrograms was four times what would be considered a high dosage. But she said she was assured that this was standard procedure for Husel.
Castle died within 23 minutes after receiving the drug. Eight days after her death, Mount Carmel Health Systems fired Husel.
Husel, 44, of Liberty Township, near Dublin, is now facing 25 counts of murder in connection with the deaths of Castle and 24 other patients. All occurred at Mount Carmel West with the exception of one case at Mount Carmel St. Ann’s in Westerville.
Husel has pleaded not guilty. His attorneys say he was providing comfort care to dying patients. His trial in Franklin County Common Pleas Court will probably occur in 2021 because of the COVID-19 pandemic.
Mount Carmel Health System already has paid millions in settlements to some of the survivors of 35 patients — including 29 deaths — whom its internal investigation has connected to Husel.
The Dispatch reviewed sworn statements given under oath by several Mount Carmel employees who worked with Husel. Those depositions recently were filed in connection with wrongful-death civil suits still pending in Franklin County Common Pleas Court, and are the basis of this story.
The sworn statements paint a picture of Husel as a calm, courteous and professional physician whose credentials included a residency at the prestigious Cleveland Clinic. They also indicate there was little oversight of Husel on his late shifts in the ICU.
On a routine basis, said those who gave sworn statements, Husel would bypass or override the pharmacy to obtain fentanyl and other medications by declaring that it was an emergency. Some of those patients would die within minutes after receiving the fentanyl, sometimes in combination with another drug.
Nurses, such as LeChard, and pharmacists who crossed paths with Husel became caught in the whirlwind of the investigation that engulfed the hospital during the winter of 2018-19. Mount Carmel West was preparing to close because its operations were moving to the new Mount Carmel Grove City hospital in 2019.
In December 2018, LeChard said in her statement, she was surprised to learn that she was one of 35 employees put on paid leave. She was interviewed by Columbus police Detective Anne Pennington in January 2019, who informed her that the State Nursing Board would be looking at her case.
LeChard was reinstated by Mount Carmel and began working at St. Ann’s hospital in July 2019. But she said she still must go through a hearing with the State Nursing Board to review her decisions in the Castle case.
Attorney Gerald Leeseberg asked LeChard if she would have objected if she had understood then that the fentanyl and Versed that Husel ordered would hasten Castle’s death.
“Yes,” LeChard replied. Jamie Alisabeth Bourke is another former ICU nurse from Mount Carmel West who was put on paid leave by the hospital in December 2018 in connection with its Husel investigation. She now works outside the nursing field and is awaiting a hearing before the State Nursing Board.
Bourke, 43, was an ICU nurse on two cases in which Husel has been charged with murder: Michael Walters, 57, of Columbus, who died on Oct. 11, 2017, and Brandy McDonald, 37, of London, who died on Jan. 11, 2018.
Walters was going through brain swelling and respiratory failure when Husel made the decision to remove him from a ventilator, Bourke said in her deposition. She testified that she saw no problem with Husel’s order to inject
Walters with 500 micrograms of fentanyl.
“If you are on full ventilator support and I take away your breathing and shut off all the drugs that are keeping you alive, what happens is you suffocate to death. That’s why you’re given pain medication,” Bourke explained.
It was a different story when Husel ordered Bourke to give 1,000 micrograms of fentanyl to McDonald. She said she consulted with a supervising nurse who told her that Husel had administered similar dosages. In retrospect, Bourke said, she should have recorded that conversation in McDonald’s records.
Bourke told attorneys when questioned that she believed she was doing the right thing because she “was giving comfort care.”
Pharmacists had fewer direct interactions with Husel than the nurses.
Pharmacist Megan Ruffner was working during the early morning hours of Oct. 9 , 2017, when she received an order for 1,000 micrograms of fentanyl from Husel.
“It was well-known throughout the pharmacy that he used large doses of fentanyl,” Ruffner said, noting that she knew Husel only by reputation.
At the time, the country was going through a fentanyl shortage, the pharmacist said, so she phoned Husel and asked if a lower dosage was possible.
Ruffner said Husel explained that the patient, 55-year-old Timothy Fitzpatrick, was going through heart failure and being withdrawn from a ventilator. Fitzpatrick was a physically big man and already had been treated with large doses of opioids.
“I don’t want the patient to be drowning for air after we withdraw care,” Ruffner said Husel told her.
“And so to me, that signaled his good intentions,” Ruffner said, noting that she believed Husel was providing comfort care.
Ruffner agreed to prescribe 500 micrograms of fentanyl. Fitzpatrick died seven minutes after receiving the drug, and his death is one of the 25 murder cases.
Ruffner, 30, said she was surprised when she was put on paid leave by Mount Carmel in December 2018. She later had a meeting with three Columbus police detectives.
“I walked in, and they said they were doing a homicide investigation for William Husel. And that about knocked me off my chair,” she recalled.
Ruffner said she was fired by Mount Carmel Health in July 2019 and was told the Fitzpatrick case was one of the reasons. She said she has since been cleared by the State Pharmacy Board and retains her license as a pharmacist but is currently staying home to care for her three children.
Pharmacist Gregory Dresbach had questions when he saw a medication order from Husel for 1,000 micrograms of fentanyl pop up on his computer screen during the early morning hours of Nov. 19, 2018.
Dresbach said in a deposition that the amount concerned him because of the potential for a diversion of fentanyl for recreational use or sale. On the streets, fentanyl is frequently mixed with heroin, which has been a huge factor in increased overdose deaths in Ohio.
So Dresbach, 43, said he rejected Husel’s request. He later learned that Husel had ordered an override and proceeded to administer the 1,000 micrograms of fentanyl to Rebecca Walls, 75.
The next day, when reviewing records, Dresbach said he learned that Husel had again bypassed the pharmacy in filling an order for 2,000 micrograms of fentanyl to treat 82-year-old Melissa Penix, of Grove City.
After each of these incidents, Dresbach wrote an email to a supervisor, expressing his concerns. The supervisor didn’t reply, Dresbach testified, and when Dresbach saw him later, that supervisor declined to answer questions.
Dresbach soon learned that both Walls and Penix had died and Husel had been fired on Nov. 21, 2018.
Ruffner declined comment when contacted by The Dispatch. Attempts to reach LeChard, Bourke and Dresbach for comment were unsuccessful.
Mount Carmel Health later revealed that it had initiated an investigation of Husel after a complaint on Oct. 25, 2018, the day after the death of James “Nick” Timmons, 39, of Hilliard. The health system apologized for the additional three deaths of Castle, Walls and Penix before Husel was fired.