Yes the medication has to have approval from pharmacy, however it’s not grabbed from pharmacy. You’re a nurse, how many times do you get an order from the doc then just have to walk to the Pyxis. It’s “reviewed” by the pharmacist with a click of the mouse and they’re not even on the same unit or floor. In house Pharmacy is tucked in the basement and they click “yes, safe to administer” because they trust that a doctor is doing the right thing, then they go back to reconstituting cefazolin with NS. Also there’s no max for fentanyl because it’s used for conscious sedation and some people (opiate addicts) can tolerate a shit load of fentanyl and still have normal respirations.

I’m not defending his actions, I’m stating there’s holes in the system and usually it’s never one person that the entire blame is for.

@@BrocKelley Meh, that’s not true. As a nurse, I always know what’s going on with my patient. Sometimes more so than the Doctor, that’s our job. Doctor’s are smart as hell, however we’re the ones with them all day. There wouldn’t be the Recommendation part of SBAR if that were the case.

@@raymackattack I am glad you said "sometimes". Most of the time not. In fact, without the education and training the nurse is in fact incapable of understanding more than the doctor most of the time. And I am an RN and an MD, so I am in the unique position to know firsthand what I am saying is absolutely true. In my experience as an RN and MD a physician understands more quantitatively and qualitatively about a patient in a few minutes than the RN understands after hours with the patient. That's just the nature of the two fields. No worries, physicians don't know anything about nursing either.

All palliative care is patient assisted suicide. Morphine and Ativan ALWAyS cause death. My grandfather suffocated to death recently because of aspiration pneumonia and his last coughing fit he was never able to take a full breath. Imagine dying like that. Fentanyl suppresses respiration just like morphine so giving any fentanyl whole extubation would be causing death. What do we do instead? What kind of comfort measures? Hope we die in our sleep peacefully if there is such a thing.

I totally agree with you.

It's one thing if you have put down these wishes on paper before you die (it's called Advanced Care Planning), or have told your loved one(s) whom you've authorized to make decision for you when you cannot (aka Health Care Proxy), it's another thing altogether when the patient is in the ICU where they are supposed to be receiving life-saving treatment attempts, and the physician took it upon himself to make that decision for you. Plenty of people believe in not giving up hope or rejects brain death in total given belief or religious reasons. According to this video, some patients may not have been brain dead - now we'd never know. And fentanyl is strong enough that 100, 200mg will knock you the heck out, on top of that, patients are intubated, meaning they are on sort of sedation already. Besides, if patient's brain dead already, what would they feel anything at all?

What is being discussed here is not whether a person passes peacefully or not. What’s being discussed is the dosage of medication actually hastening death which is illegal. Medication should be given to allow a person to peacefully and with dignity to transition from life to death naturally without pain. Not to have a dose so large that it hastens and causes the actual passing of the patient. Palliative care is just that. It provides terminal patients with relief from pain and suffering when life isn’t expected or suffering is inevitable as it might be with terminal cancer for example.

@@hocyee just so you know, fentanyl is dosed in mcg which is 1/1000 of a mg. Much much smaller dose. But I get what you’re saying. It’s potent. Palliative care is usually discussed between the patient and/or family if the patient cannot speak for themselves and the doctors as well as others who might have a part in it say the clergy if they’re requested, etc. Usually at that time, the patient’s care is withdrawn and comfort measures are employed. It really depends on what the patient and family wants for end of life as you mentioned in the patients advanced directives.

👏👏👏👏👏👏

Practically the first thing taught in nursing school is that "Unit Dose Medication" exists for safety. ANYTIME you think you need to pull multiple vials you STOP because something is wrong. It only takes a second to stop and think. I once stopped a Nursing student (And her instructor!) coming out of the med room with two FULL syringes of an insulin type med. (It is no longer used in hospitals due to high error rates.) You had to do calculations to get the ordered dose equivalent to use a standard insulin syringe. They obviously got the math wrong. But TWO entire syringes was the red flag they ignored.

@@theresalero7039 yikes!

If he was found not guilty that is a shame.

Not if he was lying to their families about their condition. You can't tell someone that their loved one is brain dead to get them on hospice. Doctors can not lie. It's is a families right take the decision based on real facts. He is a murder.

I guess you have your medical license and know all about it?

@@robmullin1128 a do tor lead to us about my fathers condition Just like this scum bag. I am going to do everything I can to get her in prison. If you have a GOD complex someone might be coming. after you soon. Then you will see a law license Trumps a medical license.

@@FGuilt you'd rather they experience pain while dying?

As a vet I agree. Sometimes I’m very thankful for having humane euthanasia as an option for some of my patients that are suffering. My father died from cancer in a very painful and slow way and I kept asking myself why we could not give him the same help and comfort we do with pets right at the end. It was just unnecessary long suffering….

Yes, 30 yrs ago hospice nurses didn’t have control to give lg doses of some drugs. As an RN, I remember distinctly a patient crying to be put out of his misery, he was in so much pain. I spoke with the hospice nurse and she couldn’t give him any more meds, and told her what the patient was saying. She said, “oh, we can’t do that”. I answered, we do it to animals bc it’s humane. Poor patient died in unbearable pain. Now, hospice KILLS patients every day. Murdered my mom by giving OD of Ativan IV, even after we requested not to.

From the moment I heard about this case, I suspected that he was being railroaded and maligned. One thing I know for sure is that if you are unconscious (and therefore unable to communicate suffering or pain or the sensation that you are suffocating) and have been on a ventilator for a prolonged period of time and you are so critically ill that family and your doctor has determined that further life support is futile and that the right thing to do is to take you off the ventilator because being on the ventilator is just prolonging your suffering I would much rather my doctor not be questioning whether they were giving too much sedative or too much pain medication to a person who is literally, actively dying. These are patients for which death is eminent who cannot tell you they are in pain. They are also patients who likely have been on opiate drips to prevent pain while on the ventilator and have at least some level of opiate tolerance. This prosecutor should be disbarred. I’m 100% sure that many of these families have been traumatized by an overzealous prosecutor with an agenda and now think that their family members were somehow murdered by the ICU Doctor Who was simply trying to keep them from experiencing extreme agony and distress in their final moments on this earth. During a palliative excavation, we should be giving opiates with the soul intention of preventing and minimizing suffering without any regard as to whether or not that might shorten someone’s life. The dosing is not intended to shorten someone’s life, but if keeping someone comfortable results in them taking 20 less respirations, then they would have otherwise I think that ethically that is exactly what we should be doing. The hospital administration and their lawyer should be ashamed.

That's why ones who disagree with a verdict. Need to actually look at the evidence. When Evidence in court is presented..before we the public should give an opinion. We need to do our job to know all the facts. The logical conclusion isn't always correct.

AMEN!!! Theses families have no idea what this physician spared them from. As a provider, it is insulting to read the headlines on newspapers “36 died in kill mill” when it came time to present evidence 14 people were palliatively extubated, kept comfortable with families at the bedside to say a peaceful good bye and now they see dollar signs. These patients were suffering from such advanced stages in their disease processes. Septic shock with multi system organ failure, strokes, stage 4 cancer, Diabetes with wounds and a blood sugar of over (I believe the number was 899). They were all on vasopressors among other drips to keep them alive- all life saving interventions were removed at once. Of course they died.

@@doctordoctor7813 I agree to an extent, while they may have been spared from needless agony (both family and patient), their is not PAS in Ohio.

@@doctordoctor78133

@@raymackattack I don’t believe this was a PAS. If all of the evidence would have been admitted- the biased judge blocked much of it. Dr. Husel was not only a Critical Care physician , but an anesthesiologist. So he was comfortable with medications many of us shy away from. Dr Husel began giving the smaller doses of fentanyl- and then he had a patient initials TY. She was young. She had a bad death after being told palliatively extubated. She gasped and sat up tried to get out of the bed- she suffered and so did her family watching her die. It traumatized her family as well as the nurses & Dr Husel. He gave the higher doses after that. One patient he gave 1,000 mcg of dental to lived for 2 weeks. The doctor had coded many of these patients and brought them back to life. At times he would spend HOURS treating these patients aggressively. I can not tell you what a let down it is to work on a patient like that only to lose them. When efforts became futile, he wanted them to be comfortable. Comfort Care. There is no proof that any of these patients died of a drug over dose. They were dying. Just As the physicians agreed to- removing a ventilator can “hasten death” removing pressors can “hasten death”

These apparently been dying ICU patients who haven't suffered much because of Fentanyl. Victimless crime.

I doubt your wife would do it

Eternity misery is dying without Jesus not living on this Earth being sick..

The discussions are important & so is having all the legal documentation in place as well.

@@316JOHNLT Amen Spot on

@@ChildofGod71 Know the devil is killing those people like he's caring but the truth is the thief comes only to kill and to steal and to destroy!

I watched the trial and it was a witch hunt. There’s a reason why the jury found him not guilty on all 14 charges. I would have done the same.

Attorneys probably approached the family. They prey on these types of people and fill their head with lies for a payday. More likely than not, the lawyer convinced them that their loved one "could have been saved earlier if x, y, and z had been done".... by spewing nonsense, and then offering Them a chance at some solace by filing a lawsuit, they make a living out of this kind of work. Then proceed to find any little blemish on the patients notes to have a basis for the lawsuit. In this case the fentanyl dosage, which honestly could have been agreed upon by the pt and the physician without the family knowing.

@@daddy3484 interesting!

I'll tell you what was going on; Hospital Admins panicked and were looking for a scapegoat.

I don’t think the case here is that death came as a shock after palliative extubation but rather excessive doses were used that hasten the process. The physician’s intentions were questioned because the doses he used seems to be out of the range of what is typically used for these procedures. If you watched the trials, two expert witnesses with long term experience of performing these procedures testified saying the doses used in these cases were unnecessary and uncalled for after extensively reviewing the medical records of these patients. Might I also add that the experts also testified that in some of these patients, palliative extubation was called prematurely

what is ACLS ?

This ICU RN of 22 years agrees. I've seen everything..Every case is different- No RN would push that much- unless they were suffering, " guppy ing" hospice, etc.ppl develop a tolerance, thus it takes more meds to be effective. I had covid pts on ATIVAN GTT, MORPHINE GTT( which I never had prior unless pt dying),DIP, ketamine, 2 percocet Q4, xanax Q6.. via peg-ETC..TRACHED,wide awake, and restless. . Withdrawal of care is not ONE persons decision, they need 2 attendings, apnea tests, etc... if DNR- then we don't escalate or increase pressors..etc.Ive held many hands during a terminal withdrawal from the vent.. no such thing as too much med when someone is GASPING for air.

I’m an RN since 2001. I would never administer these ridiculous doses. I would have told that doctor to go xxxx himself

Sounds good to me honestly.

I have been intubated without meds because they had to. Mercifully I passed out just as they cranked my head back but suffocating is not a pleasant way to die. It felt like my blood was burning and a weird ache in my bladder. It was confusing and scary and painful with people pulling on me like that. I would hope that when my time comes, they'll just put me out. Because like I said, that was plenty bad enough and I live to tell the story. When I woke up and starting fighting because, who wouldn't under the circumstances, then they snowed me and the lights went out. I'd rather the lights just go out.

@anita thank you for your service and honesty. You literally save so many lives with your service and integrity i know i would be dead without good docs and nurses thank you

As a potential ICU patient with a terminal prognosis, I would rather be given too much than too little. What is the use of prolonging suffering?

Agreed, But, who would push that?! ...unless they ordered that much- but did not 'use' that much? Brain dead pt would not be "guppying" ..would not need much..I dunno.I've seen WAY MORE SUFFERING,& false hope,then I cared to.But, I ALWAYS have hope& never Tell anyone to make That decision. I WOULD HOWEVER, answer truthfully if they asked me what I "would"do IF this were my mom?" ..

My parents were both against being kept alive "on machines." Each one, when the time came, went on hospice and accepted natural death. I had to sign a "do not resuscitate" order for my uncle, as I was his healthcare power of attorney. I helped my mother make the decision for my father, far gone in his dementia and "failure to thrive." to discontinue his antibiotics. My daughter inlaw was there caregiver for her grandfather who made three decision to stop dialysis and accept death. I visited my husband's 18 year old friend in the hospital who had broken his neck and was a paraplegic--completely dependent for the rest of his life, however that long it might be. At no time is this an easy decision. But never would I ever consider hastening death for myself or anyone to "spare them."

Good for your mother but this situation is much different than yours.

For me, one of the biggest concerns I have is whether Husel was following the desires of his patients or if he was simply making the decision for them. I don't have enough information to know for his cases, but the fact that the families have sued and the nurses have been disciplined leaves me thinking that he seriously failed in communication with the families and with perhaps with the hospital. I am all for allowing death with dignity, but no one should be imposing it. In your mother's case, you clearly knew your mother's needs and wishes better than the medical staff, and you made the choice that brought your mother seven more loving years. It doesn't sound like Husel had these conversations with the families, and I have trouble believing he had these conversations with the dying patients. Besides which, the doses being described sound far beyond what's necessary for comfort. He wasn't giving doses that bring unconscious slumber - he was giving doses that bring death. And regardless of whether he made the “right” call for these seriously I'll patients, I don't think that was his call to make. Not without the family. 😔

That's great for your mom.. this was not at all even comparable to to this story. Not guilty was the right decision. But now his life is over, even after he was found not guilty

​@@MB-ke9miit was literally the same.

I watched a friend slipping away on a respirator. He passed shortly after they removed the tubes. It was necessary; he had no future remaining. Family and friends sadly 'waved goodbye'. 😔

​@Bub Brett Then give it yourself so the nurse doesn't get her license taken when a lethal dose is given because you want to play God and alleviate time.

thats NOT the point.Did he have permission from the patients FAMILIES?? NO he didnt. He shouldnt be above the law..

make sure you advocate death with dignity laws in your state!, i completely understand your point of veiw!

OJ Simpson was also acquitted in a court of law !

All he need to be a quit in America is you need to have a good lawyer and a lots of money and be withe...

​@@316JOHNLTLMAO. No. You need to be rich OR A DEMOCRAT. If you're a black democrat, just claim racism and BLM will be right there to raise money that you'll never see a penny of🤣 fun fact. The organization "Black Lives Matter" has never donated a penny to any victim they're "stood up for" and democrats don't give a shit. Hell, Obama dropped more bombs than any president in history, killing countless innocent women and children...and he received a Nobel piece prize instead of prison. Democrats like Antifa caused billions of dollars in damages across the country with their riots. Not only was nobody charged, rioters who were arrested were later given $10,000 each by our corrupt government. Rioters were REWARDED WITH 10 THOUSAND DOLLARS. If that was a white republican (like the people involved in January 6th where literally nobody was hurt except a woman that was killed by the police), they'd still be going to court of the charges (again, just like the January 6th people" Now please, quit saying white people get away with shit when you couldn't be more wrong in 2024.

You did a beautiful thing for your brother, and it doesn’t happen often enough. (I am an ICU nurse)

It has everything to do with this case

He also tried to frame someone else...…..that's a big character flaw...….

@@Anniefawesome sociopath. How did he get accepted to medical school with that HUGE flaw in his past? You would rather not have obvious personality disorders in med school

I don’t think you get that from in house pharmacy. Fentanyl is found right in the Pyxis and can be taken right from floor stock in most hospitals once a doctor has an order in for it. Once the order is in from the doc, the nurse just grabs it from the Pyxis and administers.

Yup! Good grief!

@@raymackattack I'd still think there would/should be some kind of limit to the amount that can be taken. Idk 🤷‍♀️

Overdressing patience with pain medicine is not caring even if they're too sick. It's so scary that doctors could medicate you to death...

@@316JOHNLT would you rather have pain at a level 8-10 while you are dying? The families give permission to end their lives by removing everything keeping them alive. Unless you have experience with palliative care in an ICU setting, you don’t know what you are talking about. Not being critical, just stating facts.

Most of the people objecting on this post are, I am almost certain, Roman Catholics, whose punitive views on the nature of life and death they are currently trying to make the law of the land. The greater the suffering, the closer to God is their universal motto.

Would you resolve to say, that unhealthy eating will in common cases, bring you to this end 🤔???

@@uplift56 well, I can’t say that is true. Healthy people who exercise and stick to a stringent healthy diet often die of a heart attack in their 40’s all from genetics. A couple of these pts overdosed on recreational drugs. Vascular disease is often hereditary and diabetes can happen at any age even kids less than 5 unrelated to diet. Sepsis, which is an overwhelming infection from any source will kill you, and is completely unrelated to diet. Just the luck of the draw.

Retired RN here. Opening 10 amps would raise my suspicion level. Where was the ICU manager in all of this? I was a Hospice nurse, and it was made clear to us not to overdose patients. There is a fine line, often difficult to navigate.

It got passed the pharmacist because they clicked “reviewed” and went back to mixing medications while the nurse grabbed it from the Pyxis. I agree as nurses we’re the last check before it hits the patient and no nurse in their right mind that is educated would give this. Laziness on the nurse’s part not looking at safe dose range if something looks fishy. And even if this were a state which participates in physician assisted suicide (which it’s not; California, Montana, Oregon, Vermont, and Washington) the ANA took a strong stance of NO to participating in such. There is no max dose on fentanyl because it’s used in conscious sedation, but there is a safe dose range and it’s splitting hairs, but there is a difference.

Exactly!!

They were overriding the pyxis and not all patients were terminal.

I followed this case closely as well and feel very differently about the families involved. Anyways, regardless of what the patients prognosis were and the intentions of the family members, it doesn’t give this doctor any right to deviate this much away from standard of practice. He can’t just decide and say they were dying anyways so why not just expedite it and give them insane amount of dose 1000 micrograms IV push of fentanyl…. If that was the case, doctors can just do anything they want and get away with it. They have to practice within the scoop of practice

I see what you’re saying. But the flip side is who else was going to fight for justice? I have some family I’m not close with but if I died unjustly at the hands of anyone I would hope they would speak up on my behalf. Money or not

@@bribri8232 That's fair. At what point does death become just or unjust? Ultimately, with whom does the responsibility lie? I don't think that any of these families were pressured by the doctor to stop life supporting measures and extubate the patients. They also didn't seem to have much interaction with the doctor at all. There were numerous mentions of a chaplain/spiritual advisor in the medical records who supposedly discussed things with the families for over an hour typically, yet none of those who testified said they remembered anything at all about a chaplain speaking with anyone in the family. There seemed to be some serious issues with documentation and the hospital is trying to place all the blame solely on this doctor. To me, the hospital should be the one under the microscope.

Subscribe this channel for Latest Medical Lectures.

@@cyllene2716 yes but deviating from standard practice does not mean out of scope of practice it also does not mean murder. They weren't able to prove beyond a shadow of a doubt that he actually expedited their deaths. I personally think he MAY have expedited SOME of these patients deaths, maybe by minutes, maybe by hours, but do I know for sure? No and the jury also was not convinced

I actually somewhat agree to this. In my experience it’s PICU/NICU nurses. I have no experience with ICU nurses. But nurses in intensive care are VERY independent. Questioning absolutely anything and everything that even seems “off”

I feel the excessive dose of fentanyl was actually killing the patient rather then being palliative. It is not okay for euthanasia of people. Animals aren’t people as much as I love all mine. But 4000 mcg of fentanyl is pretty excessive.

With those criminal charges, i agree. However criminal charges do not exempt you from practicing medicine. It’s a case to case basis on whether you’re granted a license or not. Criminal Charge/time frame/circumstances surrounding the act/considerations from recommendations of the court, all things taken into account by state licensing committees.

@@raymackattack makes sense, thanks

He’s white

@@inthebooks3947 Bro, you can’t explain it all by “he’s white” 😂😂😂 His skin color does help him. I agree, however there’s more to it than that sometimes. White privilege does exist, however it only gets you so far. Don’t pour fuel on the fire of racism by continuing to blame anyone for the color of their skin (black or white). Intelligently research and make an argument from facts other that race without prejudice (crime facts/guilty/not guilty) and we can all make a difference.

@@raymackattack if he was black with any back ground they woulda never been into medical school. They didn’t take it seriously cause he’s white.

Exactly, since the entire horrific travesty of co & vid, and the vak seen, and all the ppl who were preyed upon by countless hospitals and their staff, all those ppl, everywhere, who walked into the hospitals but didn't walk back out...and it's THIS Doctor, who's just trying to alleviate suffering, that the system chooses to target? Upside down world!! How many medical staff all over the world actually deserve the verdict that his enemies tried to push on him??

Yep, how many are guilty of FAR WORSE since the beginning of the "new normal"??? I've never seen all of America be afraid to go to those systems before... But they are NOW.

Yep, almost all of America now, trusts our "healthcare" workers like we would trust Ted Bundy.

No matter how sick his patients were, he had no right to play God with these people's lives. Their deaths would have come when they did. Their families should have decided when to stop end of life care, not the doctor or nurse.

@@rain73ful That's your definition of God....

In 10 states, you can make your wishes known and decide for yourself your time of death. If this were legal in all states, there would not be cases like Dr. Husel's.

It’s common sense

It's about pain relief, not hastening death.

Greeeeaaaatttt question!!! I believe risk assessment advisors (usual have 10-20 years in nursing and fluent in legal) should be consulted about cases before official charges. They are the ones that advise hospitals on what standards are currently implemented from evidenced based practices. However, they make the big bucks from hospitals and probably would never get paid better from the prosecuting side.

I suppose it's possible that the prosecutor discussed this risk with the families and they were adamant about wanting murder charges. I don't know

Thanks so much!

Very well presented Doc

🥰

He didn't go to jail. He was found not guilty of all charges.

I’m surprised that they didn’t find some way to blame the nurses since they administered the large doses.

I'm a nurse too. No way would I give those doses either.

As a former ICU Registered Nurse, I was concerned about the dosages. Would never have given these dosages. Would have reported to Nursing Supervisor verbally and in writing.

Yeah I was kind of surprised by that

It was probably at a time where getting records was difficult, especially if the incident happened in a different state than the one he went to med school for

Here in Australia, before commencing a medical degree we need to provide around 5 different police/clearance checks

An excellent argument. Good point.

I applied 2022 cycle and had to go through many background checks and another one to the school that I’m going to. They do do this now.

Maybe you don't live in the US. New charges/appeal can't be filed. That would be double jeopardy.

They are extensive, and someone with this charge should not have been granted a license. However, when they find a charge (cause they will find it if you have one) it doesn’t automatically disqualify you. Depends on the charge/circumstances surrounding the charge/outcome and time frame and is decided on a case to case basis.

He was probably a solid Ç student with extensive help nonetheless

It was probably tannerite .

The pharmacy, ehh. They click a button that’s says reviewed, Not surprised. The nurses however. Tsk tsk. I’d be dammed if i gave 10 vials of fentanyl to one of my patients. 😅 That’s my license gone!!

Actually pharmacy was not aware until after the facts where the drugs were already administered. Nurses took out the drugs via Pyxis override… still doesn’t explain why they didn’t report it when they were verifying it retrospectively though

@@cyllene2716 pharmacists wouldn’t be reviewing prior orders for a patient that’s died, and seems they died pretty soon after the fentanyl administration

The orders were given verbally, the meds were pulled from the pyxis via override, bypassing pharmacy in almost all the cases.

@@fs6464 orders were given manually and pulled via Pyxis override. The orders were then entered into the system after the fact and in some of these cases pharmacy did “verify” retrospectively. Entire trial is on KZfaq

As a MD In the comments pointed out the accepted standard is to repeat doses vs one high dose. So would that make the pharmacists more comfortable to get repeated orders, vs one order for high dose?

great question and how was he accepted into medical school with that background?

if he was an Arab or muslim he would get a death sentence

Probably a rich family behind is back. We already know that not all people are treated equally under the law😡. Sad but true

White

@@inthebooks3947 Unfortunately I agree and that is sad. Bunches of white men like myself would have a hard time admitting that and they would even make every argument against it, instead of showing a bit of humility and accepting responsibility for our white privilege.

would you consider neglect intentional harm? if not, medical professionals shouldn't be punished for neglect?