Husel trial updates: Jury deliberations begin after judge denies defense mistrial motion

Former Mount Carmel Health System doctor William Husel is facing trial on 14 counts of murder for allegedly hastening the deaths of patients in the intensive care unit by prescribing excessive doses of painkillers.

In the first two weeks of his trial, the jury has heard from investigators, medical experts, and Mount Carmel employees and executives about what is known about the doses and their impact on the patients.

The trial was expected to last two months and include dozens of witnesses. The Dispatch has been covering the trial since its start and updating this blog with happenings of note.

Judge denies motion for mistrial; jury has begun deliberations

Franklin County Common Pleas Judge Michael Holbrook told prosecution and defense attorneys Tuesday morning that he had reviewed a defense motion to a declare a mistrial over alleged "burden-shifting" comments made during closing arguments by the prosecution on Monday, but ruled that it didn't warrant a mistrial.

Holbrook said he understood the concerns from Husel attorney Jose Baez related to shifting the burden of proof from the prosecution to the defense. But he didn't receive any further evidence including emails that both sides were invited to submit Monday.

Following brief jury instructions that included advising the jury they could consider murder or attempted murder charges against Husel in each of the 14 patient deaths provided they believe the prosecution provided intent, Holbrook excused the jury to begin their deliberations at 10 a.m. Tuesday.

The jury was told they could deliberate until 5 p.m. each day as they have been appearing for court during the trial or they could go longer into the evening if they wish, but they will not be sequestered until they reach a verdict. It appears the jurors will maintain a Monday to Thursday schedule for deliberations and go home with the judge's admonishment that they not discuss the case with anyone or view or listen to any media coverage.

- Dean Narciso

Did the prosecution engage in 'burden-shifting'? Defense thinks so

In a development late Monday afternoon after the closing arguments concluded and the jury was dismissed, Jose Baez, lead defense attorney for former Mount Carmel Health doctor William Husel, called for a mistrial after accusing the Franklin County prosecution of "burden-shifting" in its closing arguments and rebuttal.

Burden-shifting is when one party in a trial attempts to shift the burden of proof by making a so-called "argument from ignorance" in which something is assumed to be true because it has not yet been proven false, or it is assumed false because it has not yet been proven true.

In this case, the defense is arguing that the closing argument and rebuttal presented by the prosecution to the jury Monday attempted to shift the burden of proof on the defense. By law, a defendant in a criminal matter is presumed innocent until the prosecution provides sufficient evidence to a jury to prove the defendant guilty.

Franklin County Common Pleas Court Judge Michael Holbrook indicated he expected to receive arguments from both sides Monday night by email. The matter is expected to come up Tuesday morning before the jury would be brought into court again.

If the request is rejected, the judge will proceed with instructing the jury before they go into deliberations.

Holbrook ruled earlier that the jury may now consider the lesser charge of attempted murder as well as murder in each of the 14 counts, though conviction of either charge would require that the prosecution prove Husel intended to kill the patients involved.

Judge rules jury may consider attempted murder charge; closing arguments underway

Common Pleas Court Judge Michael Holbrook ruled Monday that the jury may consider a lesser charge of attempted murder instead of murder when it begins deliberating, provided it believes the prosecution has proven intent by the former doctor to kill his patients.

Closing arguments began this morning with the prosecution and were expected to take up most of the day, Holbrook said.

"What did he intend to do when he administered those doses," Franklin County assistant prosecutor David Zeyen told the jury to ask themselves of former Mount Carmel doctor William Husel's decisions to order up to 10 times higher doses than typical of fentanyl, along with other painkillers, for his dying patients.

"You've got to get in his mind ... You have to figure it out from all the facts and circumstances."

Zeyen was the first to consolidate five weeks of testimony and rebuttal into 2 1/2 hours of closing arguments Monday morning. Husel's defense team will present their closings this afternoon,

Common Pleas Court Judge Michael Holbrook ruled Monday that the jury may consider a lesser charge of attempted murder instead of murder when it begins deliberating, provided it believes the prosecution has proven intent by the former doctor to kill his patients.

The closings come after four delays last week, setbacks that mean that 11 days of being "on ice," as Holbrook called the jury's idle time, will have passed between when the defense rested its case and when the jury begins deliberations.

Some of the delay is related to attempts by Husel attorney Jose Baez to disqualify Holbrook. That filing on Tuesdwas denied by Ohio Supreme Court Chief Justice Maureen O'Connor,

Before anything began, Holbrook told attorneys from both sides that one of the 12 jurors was going to be replaced with an alternate.

Over the weekend, "Clearly he was paying attention to the media," Holbrook said.

More than 40 people were in the gallery, most of them packed in benches behind Husel's defense team.

Zeyen told the jury that Ohio law doesn't allow doctors to kill or hasten the deaths of even dying patients.

"That is what you do to sick animals," he said. "That's fine in veterinary science. That is not fine in the ICU at Mount Carmel."

The defense arguments are scheduled to begin at 1 p.m., to be followed by a rebuttal argument by prosecutors.

After closing arguments are completed, the jury will get instructions from Holbrook and then begin deliberations. That may not occur until Tuesday because closings were expected to take most if not all of the day Monday.

Closing arguments were expected to begin April 4, but were delayed 3 times

After the defense rested its case Thursday, March 31 after calling only one witness, Franklin County Common Pleas Court Judge Michael Holbrook scheduled closing arguments in the case to begin at 9 a.m. Monday, April 4.

On Friday, April 1, however, Holbrook's office moved the start of closing arguments to Tuesday, April 2, explaining the delay was due to "legal matters." They were delayed again two more times before beginning Monday, April 11.

Why the delay in closing arguments in the William Husel trial? What we now know

Husel trial: It's easier to remove judge in Florida than Ohio

Judge denies defense motion for acquittal

Defense attorney Jaime Lapidus made a "Rule 29 motion" on Tuesday, March 29, asking Franklin County Common Pleas Judge Michael Holbrook to acquit former doctor William Husel on all 14 murder counts against him.

The motion is standard in criminal trials after the prosecution rests its case. In his argument, Lapidus said the 14 patients Husel is accused of killing by allegedly hastening their deaths with large doses of fentanyl suffered from a variety of other medical conditions that caused their deaths, rather than the fentanyl.

"Absent these medications, the state has not proven that these patients would not have died once the life support is turned off," Lapidus said in his more than 20-minute argument before Judge Holbrook.

Lapidus also said the prosecution had not proven that Husel had any motive for taking the lives of the patients. Prosecutors are not required under Ohio law to prove a motive.

Assistant Franklin County Prosecutor David Zeyen responded that the sole evidentiary issue in dispute is Husel's intention when ordering the doses.

"He came up with this on his own," Zeyen said of Husel's high dosing habits. "Nobody else is doing this.

"This is about speeding people along as they're dying," Zeyen said. "You can't metaphorically step on their neck and speed it along so the family feels it was peaceful."

Zeyen also addressed what the defense has stated is Husel's motive, saying even if Husel was acting out of what he believed to be compassion and mercy, his actions were still illegal under Ohio law.

"Even if Dr. Husel had in his mind a pure motive, you still cannot purposefully cause the death of a dying person," Zeyen said. "Not every one of them had to die that night."

Holbrook denied the defense motion on all 14 counts. Following his ruling, the attorneys had arguments behind closed doors related to the testimony of defense witness Dr. Joel Zivot, who is scheduled to testify on Wednesday, March 30, as the defense presents its ca.

--Bethany Bruner

Prosecution formally rests their case

At 9:50 a.m. Tuesday, March 29, Assistant Franklin County Prosecutor David Zeyen stood before Judge Michael Holbrook and announced:

"For the record, your honor, the State of Ohio rests."

After calling 53 witnesses, including loved ones of all 14 patients involved in the case, prosecutors rested their case-in-chief. The remainder of Tuesday, March 29, is expected to involve arguments and rulings on multiple motions pending before Holbrook, including motions to exclude testimony from three defense experts.

Earlier Tuesday morning, March 29, Brian Mollette, the son of Danny Mollette, testified as the final witness for the state. The younger Mollette said Husel had approached his family on Dec. 5, 2017, told them his father was "severely brain damaged or dead" and that his organs were failing.

"We decided to put it in God's hands," the younger Mollette testified.

The jury was dismissed for the day following Mollette's testimony. The defense will begin calling witnesses for their case on Wednesday morning, March 30.

--Bethany Bruner

Prosecution expected to call final witness Tuesday morning

After calling 52 witnesses, prosecutors intend to call their last witness Tuesday morning, March 29, believed to be a family member of one of the 14 patients former Mount Carmel Health doctor William Husel is accused of killing.

Franklin County prosecutors said Monday, March 28, that they then intend to rest their case-in-chief.

Three family members of alleged victims testified Monday. One of those family members, James D. Allen, the son of James G. Allen, testified that the family had asked for Husel to wait about 20 minutes to withdraw care from the elder Allen because he would be celebrating his 81st birthday on May 29, 2018.

"We wasn't given a choice," the younger Allen testified.

Husel told the family that "his experience" told him the elder Allen would pass quickly and wouldn't suffer. A dose of 1,000 micrograms of fentanyl was given to the elder Allen.

The younger Allen engaged in a testy cross-examination with defense attorney Diane Menashe, who has been questioning many of the family members in the case.

Family members of Bonnie Austin and Sandra Castle also testified on Monday.

After the prosecution's final witness on Tuesday morning, Judge Michael Holbrook and the attorneys are expected to debate a number of motions outside the jury's presence. The defense is likely to verbally ask for the case to be dismissed, which is standard procedure in criminal cases after the prosecution rests, in what is called a Rule 29 motion.

Other motions that will be discussed involve the prosecution's request for the dismissal of three of the defense's expert witnesses. The prosecution will be able to call rebuttal witnesses after the defense rests their case.

--Bethany Bruner

Family member accused of tampering with pill bottle evidence during testimony

On Monday morning, March 28, the daughter of one of the 14 patients former doctor William Husel is accused of killing was accused of tampering with evidence while she testified on the stand last week.

The issue was raised before the jury was brought into the courtroom.

Beverly Leonhard, daughter of Melissa Penix, was handed a pill bottle by Assistant Franklin County Prosecutor Janet Grubb during her testimony on Wednesday afternoon, March 23. The bottle was for a morphine prescription Penix was given about three weeks before her death in November 2018.

Someone watching a video feed of the trial sent emails to Husel's defense team and Franklin County Judge Michael Holbrook stating that while on the stand, Leonhard appeared to peel something off the label of the pill bottle and then placed the pill bottle on a low ledge inside the witness stand, outside the view of anyone in the courtroom for several seconds. She then put the bottle back up on a ledge where it could be seen.

Holbrook said he received an email Sunday, March 27, from someone concerned about Leonhard's actions. Attorneys for Husel said they also received an email from the same person. The prosecution was not emailed.

A clip from the livestream video feed of the trial was played in the courtroom. Holbrook said the video did appear to show something was peeled off the label on the pill bottle, but he said he did not know what it was.

Husel's attorneys have requested that Leonhard's testimony be stricken from the record for tampering with evidence.

Grubb argued that the prosecution has photographs of the pill bottle that could be supplemented into evidence to show what was on the bottle before Leonhard handed it. He said those questions about the bottle could be stricken, while allowing the remainder of Leonhard's testimony to be considered by the jury.

Holbrook did not immediately rule on whether the jury would be told to disregard the testimony, but apparently later decided against the defense motion to do so.

Leonhard was in the courtroom on Monday morning, March 28, while the issue was discussed and the video was played.

After the jury had left for the day on Monday, March 28, defense attorney Diane Menashe said she had subpoenaed Leonhard to testify as a witness during the defense's case. Holbrook has not yet rendered a decision on how the situation will be handled, but said Menashe was able to subpoena Leonhard.

--Bethany Bruner

Prosecutors challenge third defense expert

In a third motion filed Friday, March 25, prosecutors asked Holbrook to exclude the testimony of Dr. James Claude Upshaw Downs, a forensic pathology consultant who also is the medical director for physicians assistants at Charleston Southern University in South Carolina.

The motion said Downs has no experience in providing palliative or end-of-life care and any testimony he provided about dosing, medications, end-of-life decisions or timing would violate Ohio's evidence rules.

"Dr. Downs admits in his report that 'the propriety of medication use, dosing, and scheduling' is more appropriately ascertained by 'active practitioners' in the field," the motion said. "Dr. Downs is not an active practitioner in this field. His lack of expertise in this area makes any opinion he offers on this topic unreliable."

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

Prosecutors want two defense experts disqualified

The prosecution team filed a motion on Wednesday afternoon, March 23, and another on Thursday, March 24, seeking to disqualify and exclude the testimony of two witnesses that former doctor William Husel's defense team had planned to call to testify.

The first motion asks Franklin County Common Pleas Judge Michael Holbrook to bar testimony from Dr. Joel Zivot, an associate professor and senior member of the Department of Anesthesiology and Surgery at Emory University School of Medicine in Atlanta, saying Zivot violated state legal procedure and relied on improper information to form his opinion.

In its motion, the prosecution said Zivot "improperly bases his conclusions" regarding Husel's care on conversations with Husel, which Zivot references in an affidavit attached to the motion.

"The Ohio Supreme Court has made it abundantly clear that expert witnesses are not permitted to opine on the credibility of individuals," the motion said. "Dr. Zivot is relying upon Defendant's out of court statements to which no hearsay exception applies. Dr. Zivot's opinion on Defendant's intent must therefore be excluded."

The prosecution said they were not able to bring the motion sooner because Husel's defense team had not provided the state with the names or reports of their expert witnesses prior to trial, as is typically required. The motion also says having Zivot testify would "blatantly" violate Ohio's rules of evidence for criminal trials.

"Whether this was done out of strategy or ignorance does not matter and does not make it any less improper," the prosecution's motion states.

The second motion seeks to exclude the testimony of Guorang Patel, a pharmacy supervisor from Chicago, saying if Patel were to be allowed to testify he would be "offering opinions outside of the area of (his) expertise" which is barred by Ohio's evidence rules.

In the 51-page motion, prosecutors cite 12 examples of Patel's testimony in a civil deposition related to more than 30 lawsuits filed against Husel in which Patel deferred to a physician's expertise in dosing, end-of-life care and decisions, as well as what caused a patient's death. Those same areas of testimony are what Patel is expected to be called to testify to in the criminal case, prosecutors said in the motion.

"Setting aside the ethical concerns of knowingly proffering an unqualified opinion, it is self-evident that Mr. Patel is not qualified to opine on the issues contained in this section of his report," the motion said, noting that Patel's testimony as an expert was also excluded from a trial in Illinois.

"Mr. Patel’s expert report (in the Husel case) offers no explanation for how he can reliably opine on cause of death or rule out potential causes of death with his training and experience as a pharmacist," the motion said. "His deposition testimony makes it clear that he recognizes he is unable to reliably do so. It is abundantly clear that Mr. Patel lacks the qualifications to reliably opine on any issues of causation in this case."

Lawyers from both sides met in chambers with Judge Holbrook after testimony for the week concluded Thursday. Afterwards, Holbrook said that hey had discussed the two motions and other ways to expedite the pace of the trial.

Holbrook said a third motion would be filed sometime Friday, March 25, but would not say by which side or about what, only that it would likely make the issue more complicated.

--Bethany Bruner

Wednesday, March 24 afternoon update

Beverly Leonhard recalled having a normal breakfast with her mom, Melissa Penix on Nov. 15, 2018.

But shortly afterwards, her 82-year-old mom complained of stomach pain, and went to the living room to sit down.

"I laid down on the couch and put my head on her lap," Leonhard recalled.

It would be one of the last normal mother-daughter moments she would recall having.

Her mom began having shortness of breath and had to be taken to Mount Carmel West hospital's emergency room.

Five days later, after daily visits from her family, Leonhard again lay her head on her mother and grasped her hand.

Only this time, Melissa Penix's body was lifeless.

Leonhard has been in court for Husel's trial every day but one, often taking notes, glancing occasionally at Husel and his wife.

She had earlier told a Dispatch reporter that not all of his patients should have died the way they did, including her mother.

Penix wasn't a complainer, Leonhard testified. And her mother didn't until she arrived at the hospital and was admitted into the intensive care unit, where back pain, overheating and thirst took hold.

"She's literally begging for water," Leonhard testified. But nurses declined because Penix was connected to oxygen equipment.

On the last of of her five days at Mount Carmel, Penix was placed on a ventilator.

Janet Grubb, an assistant county prosecutor, asked Leonhard if she had had end-of-life discussions with her month.

"Just that she would never ever want to live on a ventilator," Leonhard replied.

When the hospital later called about her mother's decline, she returned quickly, walking into her mom's room.

"I remember looking up at the monitors to see her blood pressure and nothing was on." A syringe was going into her elbow, she testified.

"Who was applying that syringe," Grubb asked.

She said it was Husel, recalling a tattoo on his arm.

Leonhard had been told there was virtually no chance of survival, and she said she wondered aloud, "If there's no hope, why was something being put in her arm when I walked in?"

She said Husel replied, "Oh, we never stop trying."

After being asked to step out for a few minutes, Leonhard said she was allowed to return to her mom's room. Tubes had been removed. The monitors were quiet.

"I remember putting my head on her chest and rubbing her hand," she said. But Penix was dead.

Husel never discussed pain medication with her or her relatives, Leonhard testified.

As Leonhard spoke to the jury, Penix's husband, other relatives and their attorney in a civil lawsuit, listened.

Later that year, Leonhard testified, Mount Carmel Health called.

"My understanding was that my mom had been overdosed," she testified of that conversation.

On cross-examination, Husel defense attorney Diane Menashe asked about all the testimony Leonhard has heard and medical records that were reviewed while she was sitting in the courtroom listening before she was called as a prosecution witness.

"You've heard it all, right? And your (civil) lawsuit is still pending?" Menashe asked.

"Yes," Leonhard replied.

Menashe pressed Leonhard about her mom's declining health, and Penix's inability to walk more than a few feet prior to being hospitalized.

She asked if Leonhard would be surprised to know that her mother's pneumonia was in both lungs and all lobes, not just one side, as she testified.

"Yes, I would be very surprised," Leonhard replied.

Menashe also asserted that many others at Mount Carmel had contact with the family, including a pastor, not just Husel as Leonhard had testified.

"My mom was a very spiritual person who read the Bible daily," Leonhard said.

- Dean Narciso

Wednesday, March 23 afternoon update

Attorney Diane Menashe, a member of former doctor William Husel's defense team, continued Wednesday to attack the credibility of Dr. John Schweiger, a critical care and anesthesia expert witness for the prosecution, about errors found in his reports and inconsistencies in his testimony during his full day of testimony on Tuesday.

Each of the 14 patients Husel is charged with killing was placed on a ventilator and later withdrawn by the former Mount Carmel West doctor, who worked third shift in the hospital's intensive care unit. Menashe noted that other Mount Carmel doctors had reported that several of the 14 patients had little, if any, chance of survival, prior to coming under Husel's care.

Schweiger testified that each of the 14 would have survived, for either minutes, hours or days, if not for Husel removing them from ventilators while prescribing high doses of fentanyl or other opioids.

In one case, a Husel colleague noted that surgery was not recommended for a patient with a severe brain hemorrhage.

Under questioning, Schweiger said he has testified in 35 civil trials. This is his first criminal trial.

Schweiger had testified that most of Husel's patients and relatives had inadequate consultation with Husel and other staff about end of life decisions, but Menashe noted that other doctors or spiritual care personnel had met with patient families prior to Husel's involvement.

Menashe asked Schweiger if he agreed that giving pain medication to a dying patient, even if that results in death, is part of the doctrine of double effect, which is one of Husel's defenses. He agreed.

In summary, Menashe asked Schweiger if any of his patient review reports had included anything that Husel had done to assist patients and save their lives up until their deaths.

"That was not the focus of my report, to include interventions," Schweiger said.

Franklin County Judge Michael Holbrook again updated attorneys after an assistant prosecutor had tested positive for COVID-19. He cautioned jurors to be mindful of their health.

"I don't think you guys are in danger right now, but we have to be careful," he said. "This isn't time to be proud or hide things," he told jurors on Tuesday.

Two jurors have not been vaccinated and a juror testing positive could delay the trial by 10 days, Holbrook said.

Tuesday, March 22 afternoon update

After reviewing ten sets of patient records, Dr. John Schweiger, an intensive-care specialist and expert on anesthesia from Tampa, Florida, testified that Husel overprescribed fentanyl to each critically ill patient, intending to hasten their deaths.

In addition, he said, Husel should have had better contact with a team of peers such as family doctors or oncologists, not have removed breathing tubes before trying to stabilize the patients and had "no medical justification" for the large amounts of fentanyl and other opioids he ordered and had administered.

He also torpedoed one of Husel's main defenses, that harmful effects from medical treatment is permissible if it occurs as a side effect of a beneficial treatment — even if it results in death. The ethical concept is known as the doctrine of double effect.

In one patient analysis, Schweiger, who is being paid $550 per hour as an expert witness, said that Husel not only provided Joanne Bellisari's 10 times more fentanyl than appropriate, but also could have prolonged her life by not removing her breathing tube.

"There appears to be a relatively quick determination" to remove her breathing tube, Schweiger testified, stating that there was a "lack of formal consultation" to do so with Mount Carmel hospital staff and Bellisari's family.

"I don't believe that all medical intervention had been exhausted," Schweiger said of Bellisari's case.

All of the patients suffered dire medical complications, from drug overdoses and heart disease to cancer and infections.

Bellisari, 69, had chronic kidney disease, pneumonia, septic shock and a lung tumor when admitted on April 22, 2015.

Schweiger said that Bellisari's pain was being treated well in the 2 1/2 weeks she was hospitalized. and that the decision to remove her from life support was premature. "I didn't see that death was imminent," he testified.

Schweiger said that if he had given any fentanyl at all, it would have been no more than 100 micrograms, or one-tenth of what Husel ordered injected at 11:32 p.m. on May 10. Bellisari died eight minutes later.

Janet Grubb, a Franklin County assistant prosecutor, asked if Husel's actions were protected by the concept of double effect.

No, Schweiger testified, explaining: "You can cure cancer by giving a patient cyanide," but there has to be a "concept of moderation or proportionality."

Because most of the patients had no apparent pain, the opioids were unecessary, he said.

Schweiger said that the only plausible explanation for Husel's courses of treatment would be to expedite Bellisari's death.

"That is, in fact, what occurred," he said.

Schweiger's analysis of Bellisari's care by Husel took about an hour.

In each, he said that Husel should have had better contact with a team of peers such as family doctors or oncologists, removed breathing tubes too hastily and had "no medical justification" other than hastening death for the large amounts of fentany and other opioids he ordered and administered.

In addition, Schweiger said that each patient should have been stabilized and a course of treatment planned for the next day.

During a short break, Husel attorney Jose Baez objected to Judge Michael Holbrook about Grubb describing the case as "murder" loudly enough for the jury to hear.

"That's why we're all here, for a murder trial," Grubb said.

Baez told Holbrook that Grubb's conduct was inappropriate. He said Grubb's remark was "unnecessary commentary ... solely for shock appeal," and shouldn't be allowed because it would prejudice the jury.

Holbrook responded that Grubb had said "alleged murder" to describe what the trial was about. But he told the prosecution, "I would ask that the state not highlight it on every count."

And assistant prosecutor David Zeyen asked Holbrook for permission to ask Schweiger questions related to Husel being reckless, proposing "If it's not purposeful, is it at least reckless."

Husel attorney Diane Menashe objected saying that the case is built around allegations of intentional murder.

Holbrook agreed saying that the question would not be relevant.

At the end of the day, he announced that an assistant prosecutor had tested positive for COVID-19 and cautioned jurors to be mindful of their health.

"I don't think you guys are in danger right now, but we have to be careful," he said. "This isn't time to be proud or hide things."

-Dean Narciso

Monday, March 21 afternoon update

A Florida-based medical intensive care expert discussed the "sacred oath" of putting the patient's wishes first, while giving an overview of basic care for critically ill patients and recommended dosing of fentanyl

For about three hours, Franklin County Assistant Prosecutor Janet Grubb asked Dr. John Schweiger to explain CPR, brain function, respiration and dangers of high or low acid levels in the body.

Schweiger later testified about research showing that combining fentanyl and other opioids was dangerous and another study indicating that muscle rigidity occurred with 1,000 microgram fentanyl doses, causing patients to struggle to breathe.

Husel prescribed doses up to 2,000 micrograms.

Asked if it was appropriate to accommodate families of patients who "just wanted it over" for their loved one. Schweiger said the goal of providing comfort care is to treat the patient, not "doing it for the family."

Ultimately, he said, medication should be used carefully, based on the patient's history, "to provide pain relief, anxiety relief and then to let the natural dying process to continue."

He testified that he rarely uses fentanyl, except in cancer patients at Tampa General Hospital where he works. Those patients have typically built an immunity. And when he does, he administers oses no greater than 250 micrograms.

- Dean Narciso

Monday, March 21 morning update

It's a striking example of a story being told in different ways.

Christine Allison and her 44-year-old husband had been at home watching TV when he began hyperventilating July 15, 2018. She offered him a bag to breathe into and the issue subsided. Still, paramedics called earlier suggested he be checked at the hospital.

Allison's daughter, Mariah Havens, had previously testified that she arrived at the hospital prior to her mom.

Allison had been treated in the emergency room, and had been sent to a critical care room when his health declined.

Mrs. Allison testified that Husel approached her at one point and said "I'm 99.9% sure that he's brain dead and that his organs have failed.

"I'm going to pull the tube and give him something to make him comfortable."

Allison said she was never told about that day's hospital test results, including a CT scan, and she said she was confused about Husel's bluntness.

"You take tests to verify it right?" she testified. "You don't go by what you think."

She testified that within a few minutes, the curtain was opened in the ICU room and her husband was dead.

"I looked at Mariah and said "We didn't see his last breath," Allison testified. "I've seen a person die before and it wasn't like that. I was so confused."

About five months later, a hospital official called her to discuss her husband's death.

Allison testified "The light went on and it all made sense. He told me what had happened. Troy had been given an overdose of a narcotic."

On cross-examination, Husel attorney Diane Menashe questioned almost everything in Allison's story, noting that Troy had had repeated visits to the hospital for a variety of medical issues including a leg wound that wouldn't heal.

She referred to notes from hospital staff asked Allison to verify that she did not want him resuscitated. That the family had gathered around him and had invited a hospital chaplain to continue praying for him. That staff had done chest compressions and other life saving measures.

"So all the notes ... all wrong," Menashe asked.

"I'm sorry. I did not agree with anything you said on that paper," Allison replied.

Menashe asked if she had a "vested interest" in maintaining her story since she's one of several family to have sued Husel and the hospital.

That sparked an outburst.

"He killed my husband."

"That's your belief," countered Menashe.

"It's not my belief. That's what happened. I was there. You were not."

Menashe asked about previous interviews on CNN and other news outlets and how she's watched live coverage of the trial from her home.

Allison said she's committed to getting justice.

"I will tell anybody who will listen because the whole place needs to be shut down ... and that man needs to go to jail" she said of Husel and Mount Carmel Health System.

After her testimony, Allison told a Dispatch reporter, "I think my emotions totally took over," adding "I just wanted him (Husel) to look at me at least once. He didn't look at me."

dnarciso@dispatch.com

Wednesday, March 16 update

Kathleen McDowell, a former nurse who worked the night shift, was asked by assistant prosecutor David Zeyen on Wednesday, March 16, about the relationship Husel had with the pharmacists at Mount Carmel West hospital. She was twice interrupted in responding by objections from defense attorney Jose Baez.

After Judge Michael Holbrook overruled both objections, McDowell replied:

"The pharmacist would tell him not to use certain drugs or don't use this much, and he would tell them OK and just say, 'I'll do what I want to do, give what I want to give.'"

McDowell testified that she was involved with the palliative extubation of Corrinnia Blake, who died at the hospital on Sept. 17, 2018, after being given 500 micrograms of fentanyl. Blake was one of the 25 patients Husel was initially charged with murder in connection with her death, but that charge was among 11 murder counts the prosecution asked to be dismissed in January.

McDowell said she questioned Husel one time about his medication dosing, but never took it to her chain of command, saying she feared she could be reprimanded if she were to raise concerns with her supervisor that turned out to be wrong.

Husel was described by McDowell as breeding a boys club culture of a boys club and having a "bromance" with male nurses in the hospital's intensive care unit. She testified that Husel favored several of the nurses who have already testified in the trial, and would "put the boys against each other."

When Baez cross-examined McDowell, he asked her about her decisions to hire a criminal defense attorney three days after being interviewed by Columbus police homicide detectives and to agree to a formal proffer of information to former Franklin County Prosecutor Ron O'Brien.

McDowell is the only nurse that has testified thus far who has acknowledged hiring an attorney.

Baez also questioned McDowell's motivation, asking whether she was bullied or teased by the male nurses she worked with in the ICU. McDowell said she wasn't aware of being teased.

"You like yourself a lot more than you like Dr. Husel don't you," Baez asked, before withdrawing the question after an objection from the prosecution.

McDowell was further questioned by Zeyen, who asked her why she became emotional after her interview with detectives and hired an attorney.

"I was terrified," she said.

--Bethany Bruner

Tuesday, March 15 update

When Geraldine Brown took her partner's daughter, 37-year-old Brandy McDonald, to Mount Carmel West hospital on Jan. 11, 2018, Brown testified that McDonald was laughing.

She was talking. She walked herself into the hospital.

"She seemed fine to us," Brown said.

But three days later, Brown testified, McDonald died after being given 1,000 micrograms of fentanyl and six milligrams of the painkilling relaxer Versed, at Husel's order.

McDonald is the youngest of the 14 patients for whom Husel is on trial for murder, accused of prescribing doses of fentanyl and other painkillers that hastened their deaths.

McDonald had been taken to the hospital at the request of her primary care doctor because some bloodwork had revealed elevated liver enzymes. The doctor wanted McDonald to get checked out to be safe, Brown said, since McDonald had been battling ovarian cancer for several years and was undergoing treatment with an experimental medication.

After two days in the hospital, in which McDonald was speaking to her family members by phone and visiting in person, McDonald had insisted that her family members leave the hospital on Jan. 13, 2018, because it was snowing.

It was the last conversation she'd have with her loved ones.

A few hours later, between midnight and 1 a.m. on Jan. 14, 2018, Brown said McDonald's mother received a phone call that McDonald had gone into respiratory distress and was placed on a ventilator.

Once McDonald's family and friends had gathered at the hospital, Brown said a meeting was had with a doctor — she didn't remember if it was Husel in particular — about removing life support.

"Her mom and dad didn't believe she wanted to live on a ventilator," Brown said.

"Did the doctor inform you Brandy would be given 1,000 micrograms of fentanyl," Assistant Franklin County Prosecutor Taylor Mick asked.

"No," Brown replied.

The family stepped out of McDonald's hospital room while medical staff extubated her from the ventilator and then "went right back in," Brown said.

"It seemed like it only took 10, 15 minutes" for McDonald to die, Brown said.

At no time during her hospital stay did McDonald appear to be in pain and her family never requested pain medication for McDonald, Brown testified.

About a year after McDonald's death, Brown said the hospital contacted McDonald's family, followed by a call and interviews with Columbus police. McDonald's family has filed a civil lawsuit against Husel and the hospital system, which is still pending.

--Bethany Bruner

Monday, March 14 afternoon update

Prosecutors said Monday afternoon they could rest their "case in chief" as early as next week. The case in chief refers to the party in a trial with the burden of proof — in this case, the prosecution — presenting its evidence.

Following the conclusion of testimony Monday, Assistant Franklin County Prosecutor Janet Grubb said the prosecution has another expert witness set to testify on Monday and Tuesday of next week, but "would like to finish early next week if at all possible."

Should the prosecution rest their main case, Husel's defense team would begin calling their witnesses to testify in the case. Prosecutors would have the chance to call rebuttal witnesses after the defense rests their case.

Family members of the 14 people Husel is charged with murder for allegedly hastening their deaths, are expected to begin testifying this week.

--Bethany Bruner

Monday, March 14 morning update

Nurse Jacob Deemer testified Monday that he sought clarification from Husel about doses of 1,000 micrograms of fentanyl for three patients the pair treated together in the intensive care unit at Mount Carmel West.

Deemer, who described Husel as approachable and willing to pass on his knowledge to nurses and other personnel working in the ICU, said he wanted to understand Husel's mindset for ordering 1,000 microgram doses for Danny Mollette, James Allen and James Timmons.

"Anytime there's a new order placed, I want a contextual reason," Deemer said.

Deemer also testified about Timmons' death on Oct. 24, 2018. He said minutes after administering the 1,000-microgram dose as instructed by Husel, Timmons' brother called for Husel and Deemer to "do something" because Timmons was "in pain."

Timmons was turning "grayish-blue," had what appeared to be foam at the mouth and was breathing in a way that indicated distress, Deemer testified.

On cross-examination, however, Deemer acknowledged those details were not included in the medical report.

Additional morphine and benzodiazepines were given to Timmons at that time, Deemer said.

During his testimony, Deemer also said he alerted the hospital pharmacy on at least two occasions about high doses of fentanyl that were set to be administered.

Deemer was placed on administrative leave during a Mount Carmel investigation into Husel's conduct and resigned his position in January 2019.

--Bethany Bruner

Thursday, March 10 afternoon update

At the end of his testimony Thursday afternoon, Dr. Wes Ely, a physician and medical instructor at Vanderbilt University was asked about the large dosages of fentanyl and other painkiller medication ordered by Husel for 14 patients.

"There's no other reason to give those doses unless you're trying to end the life of the person," Ely said in of Husel patient Joanne Bellisari.

"The same explanation goes for (Husel patient) Ryan Hayes?" asked Assistant Franklin County Prosecutor Paula Sawyers.

"Yes," Ely responded.

Sawyers asked the same question about each of the other 12 patients Husel is accused of killing: Beverlee Schirtizinger, Danny Mollette, Brandy McDonald, Francis Burke, Jeremia Hodge, James Allen, Troy Allison, Bonnie Austin, James Timmons, Sandra Castle, Rebecca Walls and Melissa Penix.

For each, Ely responded: "Yes."

Ely was questioned for about an hour by Diane Menashe, one of Husel's defense attorneys, picking up where questioning had left off on Feb. 28, when Ely first testified in the case.

Menashe asked about notes in the medical records of some patients that indicated families had met with doctors other than Husel before agreeing to withdraw life support measures for their loved ones.

Ely confirmed that appeared to be the case.

Testimony is scheduled to resume at 9 a.m. Monday.

--Bethany Bruner

Thursday, March 10 morning update

A closed-door meeting between the attorneys, Husel and Judge Michael Holbrook took place for more than 40 minutes Thursday morning, delaying the start of testimony.

Around 9 a.m., Holbrook ordered all parties in the case back to his chambers. A member of Holbrook's staff said the discussion involved "logistics issues."

Testimony began around 10 a.m. Thursday, with Dr. Wes Ely, a doctor from Vanderbilt University in Tennessee, continuing his testimony. Ely first testified on Feb. 28.

--Bethany Bruner

Wednesday, March 9 afternoon update

The 14 patients at Mount Carmel West in Dr. William Husel's care were not in good shape, suffering from chronic disease, organ failure and drug addiction among others.

There have been descriptions of "bad death," which involve patients who hang on to life even as breathing tubes and other attempts to resuscitate are removed.

A former nurse, Stephanie LeChard, described a "death rattle," loud gurgling (audible throughout the intensive care unit), grimacing in pain and a tear running down the cheek of Sandra Castle, 80 when she worked with Husel.

Castle had worked only six shifts in the intensive care prior to Nov. 13, 2018.

The trial focuses on excessive drugs, specifically fentany, Husel prescribed and whether patient families were made aware of it.

Jose Baez, one of Husel's attorneys asked LeChard about Husel's demeanor during his work with Castle.

She testified that she understood Husel's intent as "not to hasten Castle's death but to make her (Castle) comfortable."

LeChard agreed, stating, "He was kind, patient, caring when talking to the family."

LeChard testified that Husel left dosing decisions for pain for the family, but she gave no specifics.

She testified that had Husel not provided to a patient's family important information about the drugs that he was prescribing she would have spoken up.

- Dean Narciso

Wednesday, March 9 morning update

Two former intensive care nurses at Mount Carmel Health explained how they each administered 1,000 micrograms of fentanyl to a patient in 2017, the second nurse testifying that he was unaware of the first dose.

Both dosages were prescribed by Husel who was the attending physician at the time for Ryan Hayes, an overdose patient who was considered comatose during his two day admittance to the hospital.

Tyler Springer testified that on April 3, 2017, he had no idea that 20 minutes before, that his colleague Troy Rudman had administered the same to Hayes.

Springer testified that he recalled the Hayes case as memorable, without reviewing medical records, because "it was the highest amount of medication that I had given."

Springer also testified that he recorded Hayes' pain as '0' on a 1-10 scale for hours leading up to the fentanyl dosage. During the removal of Hayes breathing tube at about 11:15 p.m., Springer said he had changed the pain score to '10,' anticipating that removing the breathing tube would be uncomfortable.

"I anticipated that he had pain. I noticed that he was turning blue."

Previous doctors have testified that fentanyl, if used at all, would be administered in smaller dosages over a period of time, for pain relief only and not in one intravaneous dosage as Husel has prescribed, in this case twice.

On cross-examination, Diane Menashe, Husel's attorney, asked Springer if he would have assigned a patient a pain score only if he believed it was warranted. Springer agreed.

Menashe asked both nurses if they like Husel and if he was responsive to change and easy to work with. Both replied yes.

She asked both if they recognized whether different doctors have different techniques. Both agreed.

Hayes had arrived at Mount Carmel in full cardiac arrest after being found in a bathtub. His son drove from North Carolina that day and, en route, agreed to the removal of his breathing tube, typically end a critical care patient's life.

- Dean Narciso

Tuesday, March 8 afternoon update

"You weren't charged with murder were you?" lead defense attorney Jose Baez asked Dr. Tom Brady, an internalist contracted to work at Mount Carmel West, Tuesday afternoon.

Brady helped to treat 64-year-old Bonnie Austin during her hospitalization in September 2018. He testified while he treated Austin and signed paperwork after her death, Brady was not involved in order the 600 micrograms of fentanyl that prosecutors allege killed her.

Brady was not able to answer the question, or a second question about whether he was named in a lawsuit filed by Austin's family against Husel and Mount Carmel in January 2019, as prosecutors objected. The objection led to an extended sidebar conversation.

Baez had several testy exchanges with Judge Michael Holbrook while questioning Brady Tuesday afternoon.

"You knew you were coming to testify in a murder trial, right?" Baez asked, prompting Holbrook to respond "Counsel, stop."

"Ask a proper question," Holbrook continued.

"I thought it was a proper question," Baez responded.

Brady was the fifth witness called Tuesday and the fourth witness to testify about the discharge summaries and death certificates prepared by doctors after the patients' deaths.

Two nurses involved in the retrieval and administration of the fentanyl doses are expected to testify, providing for the first time their accounts of what happened in the intensive care unit under Husel's watch.

--Bethany Bruner

Tuesday, March 8 morning update

The prosecution team is calling a series of attending physicians to the stand, bnning Monday and continuing into Tuesday, who signed off on the death certificates and other paperwork for the death of the patients Husel is accused of killing.

Dr. Caleb Wagner, an internal health physician, testified he "had no reason to question" the medication Husel gave to the patients whose paperwork he signed off on and whom he had not treated at all during their hospitalization.

On Monday afternoon, Dr. David Ralston, the medical director for the intensive care unit at Mount Carmel West during Husel's employment, said he had never given a dose of more than five or six milligrams of morphine. That dose would equate to about 50 or 60 micrograms of fentanyl, significantly less than the 500, 1,000 or 2,000 micrograms Husel is accused of ordering for patients who died under his care.

"You don't want to even be perceived as crossing that line," Ralston said.

--Bethany Bruner

Monday, March 7 update

The testimony of Dr. Dan Roth, chief clinical officer for Trinity Health — Mount Carmel's Michigan-based parent company — was the first thing the jury heard Monday morning. Much of Roth's testimony under cross-examination by lead defense attorney Jose Baez involved objections from the prosecution, an ongoing theme throughout the early stages of the trial.

During additional questioning from Assistant Franklin County Prosecutor David Zeyen, Roth said he and Trinity Health did not do anything to "frame" Husel. Attorneys for Husel had argued Mount Carmel had attempted to make Husel a "villain" in the public's eyes.

"Did you frame Dr. Husel for murder," Zeyen asked. "No," Roth responded.

The second witness to testify Monday was Dr. David Ralston, who was the medical director for the intensive care unit at Mount Carmel West while Husel worked there. Ralston detailed how he would give two or four milligrams of morphine to patients who are undergoing a palliative extubation. Those dosages would equate to about 20 to 40 micrograms of fentanyl — less than the 500 to 1,000 micrograms, and in some instances 2,000 micrograms of fentanyl that Husel is accused of ordering for patients under his care.

A shooting at the Franklin County parking garage across the street from the courthouse did not impact testimony Monday morning.

-Bethany Bruner

Why we haven't heard directly from attorneys

The attorneys on both sides of the murder trial for former Mount Carmel Health doctor William Husel underway in Franklin County Common Pleas Court are restricting their comments to the courtroom.

The team of prosecutors from the Franklin County Prosecutor's office has been following a long-standing tradition within that office of not discussing a case publicly with the media during the course of a trial.

Husel's Florida-based lead attorney, Jose Baez, who has handled many high-profile cases, also told reporters after the first day of formal jury selection on Feb. 14 that he would not speak to the media during trial, either.

There has not been a gag order issued in the case by Common Pleas Judge Michael Holbrook, which would prevent the lawyers from talking to the press.

Read more: When can we expect to hear comments from the attorneys?

Who are the victims?

The patients all died at Mount Carmel West between 2015 and 2018.

Husel, 46, was initially charged with 25 counts of murder, but 11 were dismissed in January at the request of the prosecution. He is now charged with 14 counts of murder for allegedly authorizing large doses of fentanyl that caused the deaths of Joanne S. Bellisari, 69; Ryan Hayes, 39; Beverlee Ann Schirtzinger, 63; Danny Mollette, 74; ; Brandy McDonald, 37; Francis Burke, 73; Jeremia Hodge, 57; James Allen, 80; Troy Allison, 44; Bonnie Austin, 64; James Nickolas Timmons, 39; Sandra Castle, 80; Rebecca Walls, 75; and Melissa Penix, 82.

This article originally appeared on The Columbus Dispatch: Husel trial: Jury deliberations begin after mistrial motion rejected