More put on leave at Mount Carmel
Mount Carmel Health System has reported to state licensing boards that four dozen pharmacists and nurses were involved in the care of 35 critically ill patients who received excessive painkiller doses, the health system said Wednesday.
The announcement is the latest in Mount Carmel’s ongoing investigation of a former intensive-care doctor accused of ordering the inappropriate doses — many of them potentially fatal — over a span of about four years.
Thirty of the reported nurses and pharmacists have been placed on paid leave to remove them from patient contact “out of an abundance of caution,” said the statement issued on behalf of Ed Lamb, Mount Carmel’s president and chief executive. Eighteen have left the health system, some a number of years ago.
A spokeswoman confirmed that five managers also are on paid leave, bringing the total number of employees on leave to 35, up from the 23 Mount Carmel had previously said were removed.
Physician, nursing and pharmacy leaders at Mount Carmel West hospital are among the managers on leave, the statement said. Interim leaders have been appointed to oversee the hospital and key areas of the ICU.
The health system has said it is reviewing the records of all patients, numbering in the hundreds, who died under the care of Dr. William Husel, who was hired in 2013 and fired in December.
Mount Carmel has accused the 48-yearold doctor of ordering the excessive doses of pain medication for 34 patients at Mount Carmel West hospital in Franklinton and one at Mount Carmel St. Ann’s hospital in Westerville.
All of the patients died, and the doses given were potentially fatal for 29 of them, Mount Carmel has said.
Under normal procedures, pharmacists would have approved and dispensed Husel’s prescriptions and nurses would have administered the drugs.
Representatives of the State of Ohio Board of Pharmacy and the State of Ohio Board of Nursing, which issue licenses, said Wednesday that they are precluded by law from confirming the existence of complaints or investigations.
Cameron Mcnamee, at the pharmacy board, has said that pharmacists are held to a “corresponding responsibility” standard that says pharmacists who dispense drugs share an equal role to physicians in ensuring that the drugs are properly prescribed for legitimate medical purposes.
Lisa Emrich, program manager at the nursing board, has told The Dispatch that standards of practice say nurses are required to critically analyze orders for medications in relation to various issues, including whether the drug might be potentially harmful to a patient. Emrich Five managers in the Mount Carmel Health System are on paid leave, bringing the total number of employees on leave to 35, up from the 23 Mount Carmel had previously said were removed.
said nurses have the ability to decline to follow through with an order but that those who do so are required to notify the prescriber and document their reasoning.
A range of issues, including whether pharmacists were aware of the prescriptions before they were administered, need to be considered in each case, said Ernest Boyd, executive director of the Ohio Pharmacists Association, which advocates for the profession. He called the board “tough but fair” and said he thinks each individual case will be considered on its merits.
The matter highlights the importance of the checks that doctors, pharmacists and nurses have on one another when protecting patients, he said.
“Anytime there’s a patient death, we’re always concerned about how we as a profession can do a better job of making sure those patients are safe,” he said Wednesday. “When you have multiple situations like this, obviously it’s a system error.”
The interim CEO of the Ohio Nurses Association, a professional organization for registered nurses, was not available to comment.
The association has issued a statement calling the Mount Carmel matter a wake-up call and asking for a reexamination of how care is regulated in Ohio, noting it is the only state that does not license hospitals. That leads to scant oversight that creates a system that patients cannot trust, the association has said.
Bed-side nurses, the statement said, are “key to finding a solution to prevent this from happening in the future” and must be included at all hospitals in discussions about policies and procedures.
“These policies and procedures must include whistle-blower protection,” the statement said. “Nurses are committed to patient safety, are the last line of defense and the definitive patient advocate. Stifling nurses’ voice because of a restrictive workplace culture would be a disservice to Ohio’s patients and healthcare systems.”
Lamb’s statement said that placing employees on administrative leave “does not reflect final judgment on their actions.”
“It is the appropriate step to take while we continue our internal investigation,” the statement said, adding, “We anticipate some colleagues may return to work at the appropriate time.”
Several pharmacists and nurses have been named alongside Mount Carmel and Husel in wrongfuldeath lawsuits filed in Franklin County Common Pleas Court.
A lawyer for Husel, who lives in Liberty Township near Dublin, has said the doctor did not intend to kill anyone.
Law-enforcement authorities are investigating, and Husel’s license has been suspended pending a July hearing by the State Medical Board of Ohio.
Lawyers representing patient families have said Mount Carmel’s chief pharmacy officer has been dismissed, but the health system has not confirmed any firings beyond Husel’s.