Husel Trial -- NOT GUILTY

[Birdstrike]

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I agree with you. "Murder" should require some form of "malice aforethought" and I do not believe Dr. H. had any malicious intent. The prosecutors are charging him with murder perhaps because they view him guilty of euthanasia which as their laws are written is "intentional murder" albeit without what many would consider "malice." Were I on the jury I don't think I could vote for a murder verdict.

I'm not a lawyer, but I didn't we already established that in Ohio, juries can vote either for murder, or lesser versions, such as reckless homicide, negligent homicide, voluntary manslaughter, involuntary manslaughter, etc? Is that correct, you Legal Eagles, out there?

Not all of those require "malice aforethought."

 

[Birdstrike]

Does anyone know if Husel elected to have the jury only consider the charged crime (murder) or to consider that plus lesser offenses?

I just asked the question to a lawyer in Ohio, and this was the response:

"I think that is up to the defendant, who can elect to have the jury consider only the charged crime or to consider that plus any lesser included offenses. It’s a matter of strategy, all or nothing go for broke, if you think the case is marginal, or give the jury an out with a lesser included option. Another thing, there was some comment about the hospital people having immunity deals in place in exchange for testimony. Unlikely, since the deals would have to be disclosed to the defense and also because they just would not be very attractive targets. I doubt there are any deals. But, I am a civil, not criminal lawyer."

 

[neurodoc]

I'm not a lawyer, but I didn't we already established that in Ohio, juries can vote either for murder, or lesser versions, such as reckless homicide, negligent homicide, voluntary manslaughter, involuntary manslaughter, etc? Is that correct, you Legal Eagles, out there?

Not all of those require "malice aforethought."

Correct, only murder requires malice aforethought, the others not. I believe the prosecution allowed for lesser charges like manslaughter but still left murder as an option for the jury. As I said I'd have a hard time voting to convict for murder but who knows what the jury will decide. All twelve will have to be unanimous to find him guilty of murder or any of the lesser charges.

 

[turkeyjerky]

Does anyone know if Husel elected to have the jury only consider the charged crime (murder) or to consider that plus lesser offenses?

I just asked the question to a lawyer in Ohio, and this was the response:

"I think that is up to the defendant, who can elect to have the jury consider only the charged crime or to consider that plus any lesser included offenses. It’s a matter of strategy, all or nothing go for broke, if you think the case is marginal, or give the jury an out with a lesser included option. Another thing, there was some comment about the hospital people having immunity deals in place in exchange for testimony. Unlikely, since the deals would have to be disclosed to the defense and also because they just would not be very attractive targets. I doubt there are any deals. But, I am a civil, not criminal lawyer."

I thought there was a post earlier in this thread citing an article saying the defense tried to have the jury only be able to consider murder, but the prosecution objected and the judge sided with the latter, so that lesser charges are included.

 

[Birdstrike]

I thought there was a post earlier in this thread citing an article saying the defense tried to have the jury only be able to consider murder, but the prosecution objected and the judge sided with the latter, so that lesser charges are included.

An update from the Ohio attorney:

“I looked into it a bit more. While it is true that a defendant must request a lesser included offense charge to the jury - or be foreclosed from appealing a verdict on that issue, the Ohio Supreme Court has also held that a trial court must weigh the evidence and charge the jury on lesser included offenses if any are present on the evidence. It looks like the Husel lawyers spatted about that pre trial, with the defense wanting only a jury charge on murder, and the prosecution wanting the charge to include both murder and reckless homicide. There won’t be a ruling until they have a meeting with the judge at the close of the evidence, called a charge conference, before the court actually reads the jury instructions to the jury.”

 

[Robotic Wis-Hipple]

An update from the Ohio attorney:

“I looked into it a bit more. While it is true that a defendant must request a lesser included offense charge to the jury - or be foreclosed from appealing a verdict on that issue, the Ohio Supreme Court has also held that a trial court must weigh the evidence and charge the jury on lesser included offenses if any are present on the evidence. It looks like the Husel lawyers spatted about that pre trial, with the defense wanting only a jury charge on murder, and the prosecution wanting the charge to include both murder and reckless homicide. There won’t be a ruling until they have a meeting with the judge at the close of the evidence, called a charge conference, before the court actually reads the jury instructions to the jury.”

So if the prosecution succeeds in getting all context providing notes, EMR/MAR data, and suppression of all non-cooperating witnesses then they get to tell the jury that he’s either a murderer or completely innocent?

Sounds about par for the course.

I feel like despite that being what the defense wanted to start with that will backfire. Psychologically alone the jury is giving him something…. If he only has the option of murder or innocent he’s going away for a long time. With multiple lesser charges I think he’ll get reckless homicide or manslaughter of whatever form Ohio has.

 

[Birdstrike]

An update from the Ohio attorney:

“I looked into it a bit more. While it is true that a defendant must request a lesser included offense charge to the jury - or be foreclosed from appealing a verdict on that issue, the Ohio Supreme Court has also held that a trial court must weigh the evidence and charge the jury on lesser included offenses if any are present on the evidence. It looks like the Husel lawyers spatted about that pre trial, with the defense wanting only a jury charge on murder, and the prosecution wanting the charge to include both murder and reckless homicide. There won’t be a ruling until they have a meeting with the judge at the close of the evidence, called a charge conference, before the court actually reads the jury instructions to the jury.”

Continued:

“Somebody just commented that the judge had sided with the prosecution on the reckless homicide charge to the jury. Not quite true, if the judge made a ruling it was in response to a “motion in limine”, literally a motion “at the threshold” of the courtroom. By definition, this is a preliminary, tentative ruling, subject to change as the evidence comes in. Here, it seems to me that the evidence thus far would support a charge on reckless homicide, so I’d not be surprised if it was given.”

 

[AlmostAnMD]

That makes sense, thanks. They've actually said very little about the charges during trial. Maybe that's why.

If it's murder or nothing I think he's off. Three weeks of prosecution witnesses and the defense hasn't even started their case yet. Not seen much to convince me of murder.

foggy otherwise. Crazy that the judge gets to decide based off of what was presented what possible charges can come. If he allows homicide he probably thinks even himself that murder won't stick, maybe?

 

[Birdstrike]

"Tuesday morning, Dr. John Walther Schweiger, a Tampa anesthesiologist and critical care physician, continued testifying as an expert witness for the prosecution.

Schweiger testified that he reviewed the medical records for Husel’s patients, saying that in 13 of the 14 cases he looked at, he believes the administration of medications given to them and prescribed by Husel hastened or caused their deaths.

Prosecuting attorney Janet Grubb asked Schweiger about the medical records of Danny Mollette, 74, who died under Husel’s care after receiving 1,000 micrograms of fentanyl in December 2017.

Schweiger said that Mount Carmel staff did not give Mollette, who suffered from diabetes and abnormally high blood pressure, enough time to determine whether the 74-year-old’s underlying symptoms would have been terminal.

He testified that there was no need for Husel to prescribe additional anxiety-reducing pain medications like Versed and Dilaudid, as Mollette was comatosed at the time he received the doses and thus could not feel pain.

“In my professional opinion, the intention was to rapidly terminate Mollette’s ability to breathe on his own and consequently hasten death,” Schweiger said.

Schweiger continued to testify Tuesday afternoon on the medical records and deaths of several other alleged Husel victims, including James Allen.

“Within a reasonable degree of medical certainty, the administration of the 1,000 mics of fentanyl in combination with the 6 milligrams of Versed at the time the endotracheal tube was removed did in fact hasten Mr. Allen’s death and thus prevent a natural death that would have otherwise occurred had these medications not been administered at these doses,” Schweiger said on the stand."

-Source: NBC4i News

 

[TJRock]

"Tuesday morning, Dr. John Walther Schweiger, a Tampa anesthesiologist and critical care physician, continued testifying as an expert witness for the prosecution.

Schweiger testified that he reviewed the medical records for Husel’s patients, saying that in 13 of the 14 cases he looked at, he believes the administration of medications given to them and prescribed by Husel hastened or caused their deaths.

Prosecuting attorney Janet Grubb asked Schweiger about the medical records of Danny Mollette, 74, who died under Husel’s care after receiving 1,000 micrograms of fentanyl in December 2017.

Schweiger said that Mount Carmel staff did not give Mollette, who suffered from diabetes and abnormally high blood pressure, enough time to determine whether the 74-year-old’s underlying symptoms would have been terminal.

He testified that there was no need for Husel to prescribe additional anxiety-reducing pain medications like Versed and Dilaudid, as Mollette was comatosed at the time he received the doses and thus could not feel pain.

“In my professional opinion, the intention was to rapidly terminate Mollette’s ability to breathe on his own and consequently hasten death,” Schweiger said.

Schweiger continued to testify Tuesday afternoon on the medical records and deaths of several other alleged Husel victims, including James Allen.

“Within a reasonable degree of medical certainty, the administration of the 1,000 mics of fentanyl in combination with the 6 milligrams of Versed at the time the endotracheal tube was removed did in fact hasten Mr. Allen’s death and thus prevent a natural death that would have otherwise occurred had these medications not been administered at these doses,” Schweiger said on the stand."

-Source: NBC4i News

On Wednesday, it turns out that he apparently didn't read the medical records. Defense roughed him up a bit.

 

[Birdstrike]

On Wednesday, it turns out that he apparently didn't read the medical records. Defense roughed him up a bit.

Link source, please.

 

[dpmd]

On Wednesday, it turns out that he apparently didn't read the medical records. Defense roughed him up a bit.

An expert witness said stuff without having actually done a deep dive in the records? I'm shocked I tell you, shocked.

 

[TJRock]

Link source, please.

Edited to remove the video. The one I linked has, for some reason, changed to a completely different video.

The video can be found at Law&Crime Network Channel B. The cross examination of this doctor is on day 19 of the trial. The cross starts at about 38:00.

 

[Birdstrike]

Yo...That video is 8 hours long. Where's the part where he supposedly admitted to not reading the medical records? Did he admit to reading none of them. Most, but not all? Hardly any? Just missed a page or two?

I'm not being argumentative or saying he didn't say it. I'm just curious to see the transcript or hear what exactly he said.

I'm not sure why he wouldn't read the records. In the expert witness work I've done, the best part of it is reading the records. It's like getting suddenly getting paid bookoo bucks for doing homework you did for 20 years, for free.

 

[AlmostAnMD]

I'm behind

I started watching last expert testimony but turned it off after he said elevated lactic acid levels do not cause pain

clearly he has never run a marathon

I'll probably just skip to cross at some point

 

[TJRock]

Dude...That video is 8 hours long. Where's the part where he supposedly admitted to not reading the medical records? Did he admit to reading none of them. Most, but not all? Hardly any? Just missed a page or two?

I'm not sure why he wouldn't read the records. In the expert witness work I've done, the best part of it is reading the records. It's like getting suddenly getting paid bookoo bucks for doing homework you did for 20 years, for free.

Just scan through to where the cross-examination is taking place. Pick any spot. He is not looking good. He didn't know about meds that were administered, he didn't seem to pay attention to the fact that, in all 14 cases, other doctors agreed that the patient was actively dying before the extubation, etc...

And, of course, he read the medical records but apparently didn't spend much time on them and therefore made many mistakes. According to his testimony, he spent an average of one hour per record before he issued his report.

 

[Birdstrike]

I'm behind

I started watching last expert testimony but turned it off after he said elevated lactic acid levels do not cause pain

clearly he has never run a marathon

I'll probably just skip to cross at some point

I'm not sure what the context was, but sure, lactic acid hurts, if you're running a marathon. But does it always cause pain? Even if you're unconscious, comatose or 'brain dead'?

 

[WilcoWorld]

Also didn't take the time to watch, so I'm simply responding to what's reported here. But if the prosecution is going to try to argue that these patients didn't need opioids, that's going to fail. You definitely need opioids to do a compassionate extubation compassionately. What you don't need is 1000mcg fentanyl boluses with a midazolam chaser.

 

[Birdstrike]

What you don't need is 1000mcg fentanyl boluses with a midazolam chaser.

"Penix was given 2,000 micrograms of fentanyl and paralytics, a point family and civil attorneys argue could have impacted how she appeared.

"Did Dr. Husel ever instruct you to check the patient for the effect of the paralytics before she was extubated?"

"No," he said."

 

[Southpaw]

"Penix was given 2,000 micrograms of fentanyl and paralytics, a point family and civil attorneys argue could have impacted how she appeared.

"Did Dr. Husel ever instruct you to check the patient for the effect of the paralytics before she was extubated?"

"No," he said."

I haven’t seen any of the testimony mention paralytics. And honestly, if he ordered them that should be the focus of the case because that’s open and shut. But I also haven’t paid super close attention to the testimony.

All of your posts are anti-Husel. Why?

 

[Southpaw]

Also, there’s some really weird stuff going on in that hospital if, for years, everyone knowingly tolerated a physician ordering paralytics for planned terminal extubation.

 

[Robotic Wis-Hipple]

"Penix was given 2,000 micrograms of fentanyl and paralytics, a point family and civil attorneys argue could have impacted how she appeared.

"Did Dr. Husel ever instruct you to check the patient for the effect of the paralytics before she was extubated?"

"No," he said."

I just really find that hard to believe. If there was ever a paralytic ordered anywhere near orders for terminal extubation/comfort care it’s immediate guilty. Why would you even go to court?

The only possible reason paralytics could come up in this case or by miscellaneous witnesses is in patients that were prescribed a NMBD for severe lung injury/vent management in a patient hours prior to final goals of care decision for withdrawal. And then perhaps he didn’t reverse prior to terminal extubation. And honestly I’m not sure how intensivists typically do that other than by confirming spontaneous ventilatory effort on the vent.

 

[Birdstrike]

I haven’t seen any of the testimony mention paralytics.

Interesting response to my post documenting people witnessing Husel giving paralytics.

 

[dpmd]

I just really find that hard to believe. If there was ever a paralytic ordered anywhere near orders for terminal extubation/comfort care it’s immediate guilty. Why would you even go to court?

The only possible reason paralytics could come up in this case or by miscellaneous witnesses is in patients that were prescribed a NMBD for severe lung injury/vent management in a patient hours prior to final goals of care decision for withdrawal. And then perhaps he didn’t reverse prior to terminal extubation. And honestly I’m not sure how intensivists typically do that other than by confirming spontaneous ventilatory effort on the vent.

Also possible they are referring to the paralytic given for induction. But yeah it has clearly been a side reference rather than the main issue so makes it pretty clear to me the administration was not peri extubation.

 

[Birdstrike]

Also possible they are referring to the paralytic given for induction. But yeah it has clearly been a side reference rather than the main issue so makes it pretty clear to me the administration was not peri extubation.

Hypothetical:

Patient codes. They’re paralyzed and intubated, and resuscitated. They’re quickly declared ‘brain dead’ without any protocol to actually declare brain death, and without adequate time to ensure paralytics are no longer on board. Family is quickly told, “There’s no hope. They’re ‘brain dead.’ Withdrawal support. Not doing so is cruel.”

Without ensuring paralytics are out of the system, 2000 mcg of fentanyl and 6 mg of versed are given, rapidly and decisively hastening death. The patient is exutubated and dies within 5 minutes.

You don’t see a problem?

 

[dpmd]

Hypothetical:

Patient codes. They’re paralyzed and intubated, and resuscitated. They’re quickly declared ‘brain dead’ without any protocol to actually declare brain death, and without adequate time to ensure paralytics are no longer on board. Family is quickly told, “There’s no hope. They’re ‘brain dead.’ Withdrawal support. Not doing so is cruel.”

Without ensuring paralytics are out of the system, 2000 mcg of fentanyl and 6 mg of versed are given, rapidly and decisively hastening death. The patient is exutubated and dies within 5 minutes.

You don’t see a problem?

We aren't dealing with your hypothetical so I don't have to discuss whether or not that would be a problem. You keep insisting you don't have an opinion on this case while consistently posting things against Dr Husel while leaving out thing that support his actions. Wonder why that is?

 

[Robotic Wis-Hipple]

Hypothetical:

Patient codes. They’re paralyzed and intubated, and resuscitated. They’re quickly declared ‘brain dead’ without any protocol to actually declare brain death, and without adequate time to ensure paralytics are no longer on board. Family is quickly told, “There’s no hope. They’re ‘brain dead.’ Withdrawal support. Not doing so is cruel.”

Without ensuring paralytics are out of the system, 2000 mcg of fentanyl and 6 mg of versed are given, rapidly and decisively hastening death. The patient is exutubated and dies within 5 minutes.

You don’t see a problem?

In the order of operations of things wrong with that hypothetical not confirming paralysis has worn off is like #3 behind declaring brain death without a brain death exam/protocol being followed and declaring brain death with/without a protocol while actively under neuromuscular blockade.

I mean certainly if brain death was declared with zero actual testing or a false positive brain death exam resulted while the patient was paralyzed he goes directly to prison and everyone here thinks he’s a criminal of the highest order.

It’s possible, but oh so unlikely. I mean even if his goal was straight euthanasia to decrease his rounding list and number of notes due, the 1000mcg fentanyl and 6mg versed was plenty and at least he could try to argue it was for comfort/anxiolysis. 50mg of Roc and pulling the tube 45min later (let alone 10min later) is so obviously criminal intent he’d have never gone to trial.

 

[WilcoWorld]

I’m not sure how intensivists typically do that other than by confirming spontaneous ventilatory effort on the vent.

that or a train of four or you delay till a few half-lives have cycled

 

[thegenius]

On Wednesday, it turns out that he apparently didn't read the medical records. Defense roughed him up a bit.

Oh god. What a f**king circus.

 

[thegenius]

That video violates HIPPA left and right.

 

[thegenius]

So I'm home listening to this nonsense. it's late, I can't sleep. I'm up at 3:00 AM listening to this. I'm writing some java code for no particular reason and have this on the other monitor.

This witness is so damn annoying. he repeats EVERY SINGLE question given to him, and he just can't answer "yes" or "no".

"Is your name Dufus McDingus?"
"Yes, my name is Dufus McDingus."

Just say "Yes" homie.

 

[dadaddadaBATMAN]

That video violates HIPPA left and right.

hipaa 🙂

Thought it didn’t apply after death, turns out it lasts 50 years after.

However , I don’t think you can use a privacy law to prevent evidence from being presented in a murder trial, though I wonder if the families had to sign releases to allow so much of this to become public.

 

[TJRock]

So I'm home listening to this nonsense. it's late, I can't sleep. I'm up at 3:00 AM listening to this. I'm writing some java code for no particular reason and have this on the other monitor.

This witness is so damn annoying. he repeats EVERY SINGLE question given to him, and he just can't answer "yes" or "no".

"Is your name Dufus McDingus?"
"Yes, my name is Dufus McDingus."

Just say "Yes" homie.

Just remember that he is a professional expert witness and is being paid $600/hr for his testimony.

 

[Birdstrike]

We aren't dealing with your hypothetical so I don't have to discuss whether or not that would be a problem. You keep insisting you don't have an opinion on this case while consistently posting things against Dr Husel while leaving out thing that support his actions. Wonder why that is?

What did I leave out, that supports his actions?

 

[Birdstrike]

We aren't dealing with your hypothetical so I don't have to discuss whether or not that would be a problem.

What if it's not a hypothetical?

"...Dr. William Husel also prescribed two paralytic drugs (Nimbex and Vecuronium) for Penix shortly before having a conversation with family members about the prognosis of Penix...It appears this may have been done to create the appearance that the patient was comatose and unresponsive, in order to support recommendations that the family withdraw life support. Shortly after the paralytics were given, and the family was informed Ms.Penix was “brain dead,” the family agreed to withdraw life support. At that point, Dr. Husel administered 2000 mcg of Fentanyl and 10 mg of Versed through an IV push, causing the patient’s death within 5 minutes." -NBC4i

You keep insisting you don't have an opinion on this case while consistently posting things against Dr Husel while leaving out thing that support his actions.

Please educate me on the 'things that support his actions' that I'm supposedly leaving out. Seriously, I really want that. I'd love nothing more than to see his defense team, once they get to present their side, show that the prosecution's accusations are all BS, made up, they're rogue and need to be disbarred and that Husel did nothing wrong. I'd love nothing more, than to see that in the next few weeks as he presents his side. We'll have to wait and see. As they present their case, I plan to keep following it and post any and all testimony that rebuts the testimony I've shared above. I have no dog in this fight other than, 1) I don't want any doctor falsely accused of anything, and 2) I don't want doctors purposely killing people. Which applies to Husel, #1 or #2, the jury will decide.

 

[Birdstrike]

I mean certainly if brain death was declared with zero actual testing or a false positive brain death exam resulted while the patient was paralyzed he goes directly to prison and everyone here thinks he’s a criminal of the highest order.

The allegation regarding brain death protocols is that "virtually none of these guidelines were completed or documented by Husel." -NBC4i

 

[Birdstrike]

Just remember that he is a professional expert witness and is being paid $600/hr for his testimony.

Likely the same or similar fee as paid to the defense expert witnesses.

 

[TJRock]

Likely the same or similar fee as paid to the defense expert witnesses.

No doubt, but, as @thegenius noted, this guy likes to talk. Perhaps he needs/wants the extra hours.

 

[Southpaw]

Interesting response to my post documenting people witnessing Husel giving paralytics.

I thought you were quoting from an article. If you’re quoting from actual testimony then link it because I’d love to listen.

Again, if he’s giving paralytics on terminal extubation then the case is open and shut. I thought this case was about excessive narcotic dosing. If I’m wrong I’m wrong.

 

[coffeebythelake]

Hypothetical:

Patient codes. They’re paralyzed and intubated, and resuscitated. They’re quickly declared ‘brain dead’ without any protocol to actually declare brain death, and without adequate time to ensure paralytics are no longer on board. Family is quickly told, “There’s no hope. They’re ‘brain dead.’ Withdrawal support. Not doing so is cruel.”

Without ensuring paralytics are out of the system, 2000 mcg of fentanyl and 6 mg of versed are given, rapidly and decisively hastening death. The patient is exutubated and dies within 5 minutes.

You don’t see a problem?

You don't make a brain death determination on a patient who is muscle relaxed,

 

[coffeebythelake]

The allegation regarding brain death protocols is that "virtually none of these guidelines were completed or documented by Husel." -NBC4i

Doesn't brain death determination require 2 physicians?

 

[neurodoc]

That video violates HIPPA left and right.

Normally the HIPAA rules protect the privacy of a decedent's healthcare records until 50 years after death, which is at least partly intended to protect the decedent's relatives, but there are exceptions to this rule. You can check this for yourself.

 

[dpmd]

What did I leave out, that supports his actions?

I would have to scroll back through the thread to list all the times you posted stuff and I posted the more complete information in response, but stuff like how ill the patients were, reasons to suspect opioid tolerance in them, and nursing staff testifying the first high dose didn't control suffering such that additional doses were needed.

 

[dpmd]

I thought you were quoting from an article. If you’re quoting from actual testimony then link it because I’d love to listen.

Again, if he’s giving paralytics on terminal extubation then the case is open and shut. I thought this case was about excessive narcotic dosing. If I’m wrong I’m wrong.

The case has been about the narcotics all along until now. So which is more believable, the hospital staff knew he was paralyzing people to kill them off and did nothing, or these people got paralytics for the purpose of intubation or ventilation and the prosecution is using this out of context to make him look bad to the jury even though the timing is one that raised zero eyebrows at the time or during review after?

 

[Birdstrike]

Doesn't brain death determination require 2 physicians?

Some brain death protocols vary, state to state. It think the two physician rule tends to apply more for organ donation. But required or not, having two attending physicians certified in determining brain death, makes a heck of a lot of sense.

 

[Robotic Wis-Hipple]

You don't make a brain death determination on a patient who is muscle relaxed,

If they have any proof he ordered/gave paralytics for the purpose of convincing a family the patient is “brain dead” he not only will go to prison indefinitely but he’s very much the serial killer he’s made out to be.

I mean, paralyze, tell family pt is brain dead to coerce withdrawal decision, no actual brain death declaration, then terminally extubate a paralyzed or partially paralyzed patient AND give grams of fentanyl to them? This would be so clearly psychologic illness derived murder he may not actually do jail time…. Really really hard to believe an Intensivist could ever do that more than once without being dragged out of a hospital in cuffs.

 

[NITRAS]

If they have any proof he ordered/gave paralytics for the purpose of convincing a family the patient is “brain dead” he not only will go to prison indefinitely but he’s very much the serial killer he’s made out to be.

I mean, paralyze, tell family pt is brain dead to coerce withdrawal decision, no actual brain death declaration, then terminally extubate a paralyzed or partially paralyzed patient AND give grams of fentanyl to them? This would be so clearly psychologic illness derived murder he may not actually do jail time…. Really really hard to believe an Intensivist could ever do that more than once without being dragged out of a hospital in cuffs.

Or that nursing staff would do that. It really doesn’t take that long for Nimbex to wear off.

 

[dpmd]

If they have any proof he ordered/gave paralytics for the purpose of convincing a family the patient is “brain dead” he not only will go to prison indefinitely but he’s very much the serial killer he’s made out to be.

I mean, paralyze, tell family pt is brain dead to coerce withdrawal decision, no actual brain death declaration, then terminally extubate a paralyzed or partially paralyzed patient AND give grams of fentanyl to them? This would be so clearly psychologic illness derived murder he may not actually do jail time…. Really really hard to believe an Intensivist could ever do that more than once without being dragged out of a hospital in cuffs.

We would have the believe the nurse was in on it too because there is no indication he ever personally administered the meds.

 

[Birdstrike]

We would have the believe the nurse was in on it too because there is no indication he ever personally administered the meds.

I'm not sure what your background is, or how much experience you have in death and dying. But I've observed that many others in healthcare who's attitudes about euthanasia, while not necessarily being openly in favor, are perhaps....passively acquiescent. I'm just speculating, but someone might be more willing to look the other way on something they view as "compassionate" as opposed to something they view as "cold blooded," even if both are illegal. This thread, is actually a great example. There's an entire branch of psychology around the concept of why good people often tolerate (or even agree to do) unethical things they see happening around them.

 

[Robotic Wis-Hipple]

that or a train of four or you delay till a few half-lives have cycled

This is what I was looking for. I’ve never seen an ICU use a TOF/twitch monitor so I just assumed the vast majority just waited 3-5 half lives or just verified spontaneous effort. Though these days sugammadex makes reversal too easy if using roc.

But in this alleged/hypothetical context I’d assume nimbex infusion with q whatever hour re-order of the nimbex infusion and then clinically Intensivist just waits 30min prior to withdrawal without formal reversal or TOF assessment.

But there’s so many crazy claims and/or witness testimony who knows what was going on. There’s definitely smoke though.