Dr Husel trial begins

[coffeebythelake]

Remember prosecution has to prove beyond a reasonable doubt that the defendant intended to kill his patients with fentanyl. This isn't medical malpractice where if it kinda sorta seems like maybe something happened you convict, with criminal murder you need to be 100% sure

Will see how it plays out. If this is truly the standard then having a couple medical experts on the defense side say what happened was not unreasonable should be enough to create "reasonable doubt". Unfortunately I think that biases, preconceptions, pro life religious connotation and other factors will end up playing a big role in this case
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[deleted875186]

Remember prosecution has to prove beyond a reasonable doubt that the defendant intended to kill his patients with fentanyl. This isn't medical malpractice where if it kinda sorta seems like maybe something happened you convict, with criminal murder you need to be 100% sure

I agree l, the witness agreeing that he would give more fentanyl based on the nursing notes seals the deal. This case is ridiculous, frankly seems un winnable for the prosecution. Why are they prosecuting?

 

[Southpaw]

pro life religious intonation

yeah that is concerning. That may be why prosecution picked Ely for a case in Ohio - he's one Jesus lovin' dude. Not sure that has the same effect on a trial in California. If there was no hope for me, and there wasn't for those patients, I'd want what Dr. Husel ordered as opposed to what Dr. Ely would offer. Still, starting with 1000mcg is a stretch. That doesn't mean it's not defensible, and it doesn't mean he's guilty of murder, but 1000mcg as a starting dose is a lot of fentanyl. This is a public forum, and there's no way to know who reads this stuff, so I'm not going into greater detail than I already have. Regardless, what I would start with would greatly depend on how long the patient had been in the hospital, if they came in opioid dependent, and if they'd be on a fentanyl gtt for a long time already. There are a lot of situations where starting with a very high dose is defendable.

 

[deleted875186]

yeah that is concerning. That may be why prosecution picked Ely for a case in Ohio - he's one Jesus lovin' dude. Not sure that has the same effect on a trial in California. If there was no hope for me, and there wasn't for those patients, I'd want what Dr. Husel ordered as opposed to what Dr. Ely would offer. Still, starting with 1000mcg is a stretch. That doesn't mean it's not defensible, and it doesn't mean he's guilty of murder, but 1000mcg as a starting dose is a lot of fentanyl. This is a public forum, and there's no way to know who reads this stuff, so I'm not going into greater detail than I already have. Regardless, what I would start with would greatly depend on how long the patient had been in the hospital, if they came in opioid dependent, and if they'd be on a fentanyl gtt for a long time already. There are a lot of situations where starting with a very high dose is defendable.

To me, proving fentanyl killed a patient requires the patient to receive a dose, which is deemed to be inappropriate, then promptly die 10 mins later, we are talking about respiratory arrest from fentanyl.

 

[Southpaw]

To me, proving fentanyl killed a patient requires the patient to receive a dose, which is deemed to be inappropriate, then promptly die 10 mins later, we are talking about respiratory arrest from fentanyl.

Some of the patients died within 10 minutes. I'm not sure how many, but some definitely did. However there's no way to prove they wouldn't have died within 10 minutes if they received no fentanyl. Put another way, since the honus is on the prosecution to prove the fentanyl caused the death, I really am not sure how they can do that. Yet Dr. Ely said repeatedly in his opinion the fentanyl dose caused death when patient specifics were discussed.

I guess this is the problem with operating outside of what many deem to be the standard. Most would say a starting dose of 1000mcg fentanyl isn't the standard. So it's easy the point the finger at that as the cause if something bad happens, when in reality the bad thing could've happened regardless. Dr. Ely contends they would've lived longer (hours? days?) without the fentanyl dose. I really don't know how anyone could say that as sick as the patients were prior to terminal extubation.

 

[futureapppsy2]

Euthanasia is legal in a couple of states but the patients must have a very short life expectancy and initiate it, the patient must be counseled about alternatives eg palliative care, and give consent. Finally the patients need to be able to self administer the medications.

Euthanasia is, by definition, physician-administered and not legal in any states. Physician aid in dying (PAD), the prescription of lethal medication to people with a diagnosed terminal illness and an estimated life expectancy of <6 months, is legal in a few states. The self-administered v. physician-administered piece is a huge distinction, both legally and ethically, especially because data show that a sizeable amount of PAD-related prescriptions are never actually filled, even though the process to get one has a fair amount of safeguards (multiple independent requests, spaced apart in time, multiple physician involvement, etc).

 

[nimbus]

Euthanasia is, by definition, physician-administered and not legal in any states. Physician aid in dying (PAD), the prescription of lethal medication to people with a diagnosed terminal illness and an estimated life expectancy of <6 months, is legal in a few states. The self-administered v. physician-administered piece is a huge distinction, both legally and ethically, especially because data show that a sizeable amount of PAD-related prescriptions are never actually filled, even though the process to get one has a fair amount of safeguards (multiple independent requests, spaced apart in time, multiple physician involvement, etc).

You are correct. I was using the term very loosely. I should have been more precise.

 

[PpfSuxTube]

In the 1990s, a typical heart would get midazolam 20mg and fentanyl 2000-3000mcg (40-60ml) for their anesthetic but definitely not on the floor. And that was the whole anesthetic. No vapor, no propofol although some perfusionists would crack a little forane on pump.

I just took a job in a new place where we're slowly changing the guard. 5 of the original cardiac anesthesiologists remain (vets of 20 years since this place started doing hearts) with 5 new guys.
Its kinda funny to see diff patients come out.

Some get 10midaz,2000 fent.
Some get no midaz, a little ppf for lines, 75 suf...

 

[Arch Guillotti]

I just took a job in a new place where we're slowly changing the guard. 5 of the original cardiac anesthesiologists remain (vets of 20 years since this place started doing hearts) with 5 new guys.
Its kinda funny to see diff patients come out.

Some get 10midaz,2000 fent.
Some get no midaz, a little ppf for lines, 75 suf...

A dinosaur once told me they used to give 100 cc’s of fentanyl back in the day.

 

[nimbus]

A dinosaur once told me they used to give 100 cc’s of fentanyl back in the day.

Fentanyl 50-150mcg/kg is describe here.

https://journals.sagepub.com/doi/pdf/10.1177/0310057X8701500107

Before that, morphine 1mg/kg.

The Birth of Opioid Anesthesia

Received from Harvard Medical School and the Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, Massachusetts.Click on the links below to access all the ArticlePlus for this article.Please note that ArticlePlus files may launch a viewer application outside of...

pubs.asahq.org

I used to work with a ortho trauma doc who had his prescription pad stolen. An astute pharmacist sent him a fax including a copy of a prescription written on one of his prescriptions with a note saying “I don’t think you actually wrote this.” The prescription read “mofine 1 kilo”.

 

[Arch Guillotti]

The prescription read “mofine 1 kilo”.

Urban legend tells the story as “10 pounds mofeen”.

 

[nimbus]

Husel’s patients were beyond this but here is a different approach.

Why this French hospital serves dying patients wine and caviar

Should hospitals add wine bars for dying patients? One palliative care unit in south-central France is using neurological research to do something of the like.

www.popsci.com

 

[chessknt]

Three defense experts should be barred from testifying in Husel trial, prosecutors argue

In the trial of former doctor William Husel, prosecutors have asked that three proposed defense expert witnesses be prohibited from testifying.

www.dispatch.com

Do his lawyers suck or something? Why didnt they use these same arguments to take out the pretend witness/hacks the prosecution conjured up that don't even practice clinical medicine any more...

 

[gcc322]

Three defense experts should be barred from testifying in Husel trial, prosecutors argue

In the trial of former doctor William Husel, prosecutors have asked that three proposed defense expert witnesses be prohibited from testifying.

www.dispatch.com

Do his lawyers suck or something? Why didnt they use these same arguments to take out the pretend witness/hacks the prosecution conjured up that don't even practice clinical medicine any more...

His defense team only called one witness and then rested. Granted I know nothing about court room matters or law in general, I expected more from such a high profile team. Beyond reasonable doubt is tough to prove but if I were Husel I’d be a little nervous.

 

[CHARLESTONMMM]

https://www.usnews.com/news/us/articles/2022-04-20/ohio-doctor-found-not-guilty-in-14-hospital-patient-deaths

 

[Dr. Rude]

His defense team only called one witness and then rested. Granted I know nothing about court room matters or law in general, I expected more from such a high profile team. Beyond reasonable doubt is tough to prove but if I were Husel I’d be a little nervous.

They obviously felt they did a good enough job savaging the prosecution’s witnesses. They were right. Any witness the defense called the prosecutor would get a shot at savaging. He won. Don’t need to Monday morning quarterback anything.