nurses put on paid leave for carrying out orders for potentially fatal doses of fentanyl

Home Health Columnist / Guide · Jul 12, 2019

Update:

CEO, VP resigned and admin staff responsible for physician, nursing and pharmacy medication administration/oversight fired. Eleven others currently on leave (nurses) will be allowed to return after completing training and education. Karen

ABC News: Karma Allen

Jul 11, 2019

Mount Carmel Health CEO resigns, 23 hospital workers fired over excessive doses, deaths
.

Quote
..Mount Carmel Health System CEO and President Ed Lamb said he planned to resign by July 25, officials announced on Thursday, just weeks after the hospital's former intensive care doctor, William Husel, pleaded not guilty to murder charges in 25 deaths....
...In addition, Richard Streck, the hospital's executive vice president and chief clinical officer, will retire at the end of September, Lamb said....
...The Columbus-area hospital also said it fired 23 employees -- including five physician, nursing and pharmacy management team members -- as a part of its investigation into the potentially fatal doses. Husel's attorney has repeatedly denied claims that the doctor ever intended to kill patients....
...All told, Mount Carmel Health System identified 35 patients who received what the hospital called "excessive" or "potentially lethal doses" of fentanyl, the hospital said.
"We have also undertaken a careful case-by-case examination of the role of every colleague who was a part of the medication and administration of the affected patients, and the members of the management involved in oversight of those colleagues," Lamb said, noting that it would "take time for Mount Carmel to restore our patients...

Akron Beacon Journal:

Mount Carmel fires 23 employees, two execs leaving in wake of patient deaths

Quote
...Mount Carmel has previously said that 48 pharmacists and nurses had been reported to licensing boards, including 30 who were still with the health system.
The state Board of Nursing has issued notices to 25 nurses, saying they could lose their licenses for their roles in the care of Husel patients. A spokeswoman said nine have scheduled hearings.
The State of Ohio Board of Pharmacy has taken no public action.
The State Medical Board of Ohio has suspended Husel’s license, and he faces an October hearing...

OUxPhys, BSN, RN · Jul 17, 2019

On 7/12/2019 at 6:30 AM, NRSKarenRN said:
Update:
CEO, VP and admin staff responsible for physician, nursing and pharmacy medication administration/oversight fired. Eleven others currently on leave (nurses) will be allowed to return after completing training and education. Karen
ABC News: Karma Allen
Jul 11, 2019
Mount Carmel Health CEO resigns, 23 hospital workers fired over excessive doses, deaths
.
Akron Beacon Journal:
Mount Carmel fires 23 employees, two execs leaving in wake of patient deaths

Nah, no executives were fired. They got to retire or "step down".

Home Health Columnist / Guide · Jul 17, 2019

Edited above post to clarify CEO/VP resigned.

Mount Carmel doctor sidestepped pharmacists, persuaded nurses

This article explains how overly large doses of fentanyl were able to be given in ICU for those being removed from a vent due to terminal illness.

Physician worked night shift, gave verbal/written STAT orders allowing for PYXIS override.without pharmacist overview of order.

Quote
If he was challenged by nurses or pharmacists over his prescriptions for pain medication, the doctor often would tout his residency work as an anesthesiologist at the Cleveland Clinic, then offer long medical explanations to justify his decisions, the staff members said...
.... Husel’s behavior went undetected for nearly four years because of hospital policies that were loose enough to allow Husel to work around them and go unchecked.

Post review Dr Husel's prescribing, health system has instituted stricter limits on narcotic medication orders and dispensing across their hospitals. Facility now requires that nurses and doctors receive pharmacy approval before administering drugs during the removal of a ventilator. Additionally, Health System has a pharmacist Medication Safety Officer position posted.

25 nurses cited by Ohio nursing board in Mount Carmel investigation focusing on nurses failure to question excessive dosing, not following chain of command to report their dosing concerns or confer with other staff. News reports high fentanyl dosing-- I wonder if nurses considered opiod naivety or chronic opiod use which would support need for higher that average fentanyl dose during med retrieval & administration.

Quote
Nurses, the letters say, knew or should have known that the drugs would be harmful and that there is no documentation that they questioned orders or consulted with others involved in patient care.
Most patients referenced in the nursing board letters received single doses of fentanyl ranging from 200 micrograms to 2,000 micrograms, along with other drugs....
...In three patient cases, the board also questions the use of paralytics, twice with no documentation of a need for such drugs and once listed as necessary for a CT scan. One nurse was said to have failed to question the removal of a breathing tube after administration of a paralytic, which could cause respiration to stop...
,,,Many of the now 25 wrongful-death lawsuits filed in the matter have named nurses and pharmacists, but attorney Craig Tuttle of the Leeseberg & Valentine firm said Mount Carmel has agreed to accept liability for the employees, so they will be dropped from the several suits filed by that firm