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Fentanyl dosing habits remain central to prosecution’s case against former Mount Carmel doctor

Dr. William Husel is accused of killing his patients through overprescribing fentanyl and other drugs.

COLUMBUS, Ohio — Three more physicians with ties to Mount Carmel Health System and a toxicologist with the Franklin County Coroner’s office took the stand Tuesday during the third week of testimony in the murder trial of Dr. William Husel.

Husel, the former Mount Carmel critical care physician, is accused of killing his patients through overprescribing fentanyl and other drugs.

He’s pleaded not guilty. His defense team has argued that Husel was providing comfort care to his patients and that while he was aggressive with his dosing, he did so to prevent them from suffering “a bad death.”

Prosecutors allege the dosages were excessive and accelerated the deaths of these patients.

Their case so far has been built around comparing the dosing habits of Husel with those of other physicians – all of whom have testified they didn’t use fentanyl when removing breathing tubes from palliative or critically ill patients and that when they did use equivalent painkillers – they did so at much lower doses.

The defense has repeatedly countered with questioning physicians about if doctors with similar training can have differing opinions. All have agreed with that statement. And some physicians – including Dr. David Ralston – testified Monday that he’d previously said he didn’t want to judge another physician’s decision if he wasn’t at bedside.

Those who testified Tuesday were asked various questions by prosecutors about specific patient care.

Husel’s defense team, meanwhile, has attempted to raise questions about if these other physicians reviewed the patient drug orders, why then was Husel the only person criminally charged.

During one such exchange Tuesday, Husel’s defense attorney Jose Baez said asked Dr. Tom Brady, Baez said: "Now sir, you're aware that Dr. Husel sits here today because he gave 600 micrograms of Fentanyl to this patient. Correct?

Brady: “Since, yes… since then.”

Prosecutor: “Objection.”

Judge Michael Holbrook: “Okay, I'll permit that question. Let's see where he goes with it.”

Baez: “Sir, you have not been charged with murder have you?... You were part of that bedside, and you reviewed these notes….”

That prompted another objection.

Husel was fired in December of 2018 after an internal hospital review raised questions about his patient care. While the hospital ultimately identified 35 patients who may have received “excessive” or “potentially fatal” doses of medication.

Prosecutors initially chose to focus their case on 25 patients who got 500 micrograms of fentanyl or more. In January, they chose to dismiss 11 charges – focusing on 14 patients – most of whom got 1,000 micrograms of fentanyl or more.

Testimony is expected to continue this week.

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