Husel Trial -- NOT GUILTY

[neurodoc]

Strangely enough, the jury asked what "reasonable doubt" was. After deliberating today, they called it quits for the day. It's looking more and more like a hung jury.

I'm going to guess they asked about that because they were wondering if any doubts they might have had whether or not Husel "intended" to kill patients constitute "reasonable doubt." If that's why they asked the question it shows how poorly the prosecution presented their case to the jury for murder, especially since Husel (wisely now it seems) refused to take the stand. It also shows how the prosecution screwed up by not including the charge for manslaughter (e.g. reckless homicide), which would not have prompted the jury to ask such a question.

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[WilcoWorld]

if there is a hung jury- can they go back and charge with a lower charge? Or does the judge's ruling carry through for all future trials?

I don't think it would carry over to future trials, though a not guilty verdict would.

 

[neurodoc]

With the definition of manslaughter being "the crime of killing a human being without malice aforethought, or otherwise in circumstances not amounting to murder" I wonder if the judge was trying to avoid setting a precedent of doctors getting convicted for their patient's death in the absence of "malice aforethought". Might have been the right call.

It would apply to physicians who kill their patients due to gross negligence. Normally medical malpractice leads to civil trials, but in egregious cases such as this a criminal charge like manslaughter would seem appropriate. The argument being that if Husel didn't intend his patients to die from narcotic overdoses he sure as heck was negligent in his dosing.

Not the right call IMHO, but a gift to the defense. Not sure who makes the decisions regarding "lesser included charges."

 

[Tigers540]

this could certainly be one last hold out for not guilty, but after 50+ state witnesses and one defense witness....a deliberation this long bodes well for defense i would think.

also, after being given the legal definition of reasonable doubt, if you're having to ask for more information on that definition - i think reasonable doubt has been met.

 

[Birdstrike]

I’m not a lawyer. But I believe being “deadlocked” doesn’t necessarily mean the jury is deadlocked on all the the charges. They might be. Or they may be unanimous on one or more, and deadlocked on one or more. They have to vote separately on each charge. It’s not a package deal.

You could have a mistrial in all the charges but one or two, which could be unanimous not guilty, or unanimous guilty, verdicts. Those don’t get retried. They are final (barring appeals, of course).

There are significant differences between each of these cases. So, it doesn’t surprise me they’re having trouble getting unanimous agreement on at least one of them.

I would have been surprised if they quickly came out unanimous on all of the cases, either for guilty or not guilty.

 

[Tigers540]

While I understand your point, these charges are 13 1000mcg boluses and 1 2000mcg bolus right? The 13 cases are identical, I dont see how any could have different results than the others. The entire case depended on the dose, since nothing else even hinted at murderous intent. In my opinion all 13 of those charges have to be murder/attempted or not guilty.
The 2,000mcg is somewhat of an outlier and could cause some confusion i suppose

 

[PTPoeny]

While I understand your point, these charges are 13 1000mcg boluses and 1 2000mcg bolus right? The 13 cases are identical, I dont see how any could have different results than the others. The entire case depended on the dose, since nothing else even hinted at murderous intent. In my opinion all 13 of those charges have to be murder/attempted or not guilty.
The 2,000mcg is somewhat of an outlier and could cause some confusion i suppose

I disagree. If the patients were on different amounts of opioid infusion pre-extubation or died at different intervals after the dose of fentanyl then I could see the jury treating different cases differently.

Isn't there one case where there was testimony quoted that the patient was sitting up and the family was asking for more pain medication after the initial bolus?

 

[Tigers540]

I disagree. If the patients were on different amounts of opioid infusion pre-extubation or died at different intervals after the dose of fentanyl then I could see the jury treating different cases differently.

Isn't there one case where there was testimony quoted that the patient was sitting up and the family was asking for more pain medication after the initial bolus?

so you're saying sometimes 1,000mcg could be murder/attempted and sometimes not? All of their expert testimony was that "1,000mcg would only be given with one intent". Literally no other piece of evidence points to intent. The dose is everything

 

[WilcoWorld]

so you're saying sometimes 1,000mcg could be murder/attempted and sometimes not? All of their expert testimony was that "1,000mcg would only be given with one intent". Literally no other piece of evidence points to intent. The dose is everything

You are oversimplifying things. I suspect that you are doing so intentionally. I'm not sure what your motivation is, but you appear to have joined this forum simply to comment in defense of Husel - often in ways that cloud rather than clarify the discussion.

 

[Tigers540]

You are oversimplifying things. I suspect that you are doing so intentionally. I'm not sure what your motivation is, but you appear to have joined this forum simply to comment in defense of Husel - often in ways that cloud rather than clarify the discussion.

Not at all. But you can ignore my comments if you wish.

I watched almost the entire trial. The prosecutions case was entirely predicated on the dose given. The only attempt at proving his intent was in the dosages given. They essentially called it a lethal dose. Their most damning witness was the expert who said it was enough to take down an elephant and that it can only be given with intent to kill.

If you want to discuss the case then cool but otherwise ignore me and move on.

 

[WilcoWorld]

Not at all. But you can ignore my comments if you wish.

I watched almost the entire trial. The prosecutions case was entirely predicated on the dose given. The only attempt at proving his intent was in the dosages given. They essentially called it a lethal dose. Their most damning witness was the expert who said it was enough to take down an elephant and that it can only be given with intent to kill.

If you want to discuss the case then cool but otherwise ignore me and move on.

Well if I knew more about your background then it would help me contextualize your comments. Are you a lawyer? A curious spectator?

Personally - I practice end of life care, that's why I'm interested. I'm more interested in the actual medicine and ethics than I am in the prosecution's argument.

I do not think the dose is the only thing to consider. I need to know how he arrived at that dose. Sure, the dose is highly suspicious, but it is not enough to demonstrate criminal intent in a vacuum. I'm currently caring for a patient who is on high dose methadone, high dose dilaudid, IV ketamine and a number of other adjunctive pain treatments. You can tell that I'm not trying to kill him by looking at how we got here - not by looking at my PCA settings today.

So, to me, a single case of 1000mcg fentanyl is not enough to prove intent: I'm open to explanation. However a pattern of over a dozen patients getting such an abnormal dose is strongly suggestive of something amiss.

 

[Tigers540]

Well if I knew more about your background then it would help me contextualize your comments. Are you a lawyer? A curious spectator?

Personally - I practice end of life care, that's why I'm interested. I'm more interested in the actual medicine and ethics than I am in the prosecution's argument.

I do not think the dose is the only thing to consider. I need to know how he arrived at that dose. Sure, the dose is highly suspicious, but it is not enough to demonstrate criminal intent in a vacuum. I'm currently caring for a patient who is on high dose methadone, high dose dilaudid, IV ketamine and a number of other adjunctive pain treatments. You can tell that I'm not trying to kill him by looking at how we got here - not by looking at my PCA settings today.

So, to me, a single case of 1000mcg fentanyl is not enough to prove intent: I'm open to explanation. However a pattern of over a dozen patients getting such an abnormal dose is strongly suggestive of something amiss.

I agree with everything you said. My point is that the prosecution team presented their case as 1,000mcg = intent to murder. So, in my opinion, it is impossible to land on not guilty for some 1,000mcg boluses and murder/attempted on others legally speaking. I don’t know how that can be rationalized at this point given the case that the prosecution presented.
I wasn’t criticizing/commenting anyone else’s personal opinion of this case, I was responding to someone’s speculation on jury deliberations and how each charge could possibly be handled.

 

[To Infinity and Beyond]

Verdict in. Not guilty on all counts. Long trial.

 

[Dred Pirate]

Verdict in. Not guilty on all counts. Long trial.

not overly suprised - I figured there must have been going down the hung jury route- must have been one hold out that finally gave in

 

[Birdstrike]

... I honestly can't say without having sat in the jury box and heard 100% of the evidence.

He's innocent of any and all crimes in my opinion, until and unless convicted in a court of law.

I presume Husel innocent, until proven otherwise by a court of law. Let's let the facts of the case and the jury determine the outcome, not our own personal fears or interests.

...The jury will have the final word.

And there we have it. The jury has spoken. Dr. Husel has been found not guilty on all counts of murder and attempted murder. They have the final word. I accept their decision as should we all.

 

[Birdstrike]

Husel reacts to verdict at 28:25 into video

 

[emergentmd]

From what I have read, I would NEVER NEVER NEVER convict him of any charges.

 

[Dr Mantis Toboggan]

Baez is a hell of a lawyer.

 

[Tigers540]

The correct call given the prosecution’s case.

From what I have read, I would NEVER NEVER NEVER convict him of any charges.

Agree, and the media reports usually slanted it to look bad for Husel. When you watched the trial it became even more of a farce.

 

[emergentmd]

Although, this case is an extreme, it just shows me that if a hot shot DA wants to make a name for himself, they could go through my medical records and ruin my career. This goes with almost every doc who works in critical care.

 

[Dr. Rude]

He will still likely face multiple civil suits. Unlikely he will ever work again.

 

[CCM-MD]

From what I have read and know about the case, I am glad to hear the not-guilty verdict. The fentanyl doses were extremely high in comparison to my own practice and any intensivist I know of, but a guilty verdict in this case would have set a very dangerous precedent.

 

[dadaddadaBATMAN]

He will still likely face multiple civil suits. Unlikely he will ever work again.

Probably also true in the reverse. It seems like a lot was made of his actions being criminal, both in his termination and in the revocation of his license. I would not be surprised if he sued his former employer, and to a lesser extent would be unsurprised if he filed a suit against the sbom. Not sure if either will carry, but the appearance of conspiracy may play poorly for mt caramel.

 

[CCM-MD]

He will still likely face multiple civil suits. Unlikely he will ever work again.

Maybe. Looks like Mount Carmel had already settled with the patient families for 17 million and part of the settlement was that the families couldn’t testify in favor of Husel in the trial.

I actually fully expect Husel to sue Mount Carmel and get a nice payday.

 

[Dr. Rude]

Maybe. Looks like Mount Carmel had already settled with the patient families for 17 million and part of the settlement was that the families couldn’t testify in favor of Husel in the trial.

I actually fully expect Husel to sue Mount Carmel and get a nice payday.

Gotta link?

That doesn't mean they couldn't sue Husel for "killing" their family member.
This was criminal trial. They could be subpoenaed to testify for either the prosecution or the defense. I would think that would supersede any settlement NDA.

 

[bravotwozero]

He will still likely face multiple civil suits. Unlikely he will ever work again.

He’s already been sued and cases settled, at least that’s what someone pointed out earlier in the thread.

The flip side is he might turn around and sue the hospital, with good cause.

 

[Kryptocoin]

Not surprise by the verdict. I've stated all along that they needed to prove intent to convict him. Medicine is an art and a science. So many gray areas in this field. Nothing is absolute. Let the medical boards and medical societies dictate what the practice is medicine is; not criminal courts.

 

[Birdstrike]

Husel has already been suing the hospital for over 2 years.

Husel Sues Mt. Carmel For Defamation, Breach of Contract

 

[Birdstrike]

I sense that many on this forum are glad a blow was dealt to those who wish to criminalize the practice of Medicine, while still disagreeing with Husel's actions.

 

[Tigers540]

I think he’s going to be very very rich. There’s a decent amount of evidence that a witch hunt took place. Plus he has the support/testimony of every single ICU nurse except for the one who made a deal with prosecution

 

[coffeebythelake]

Maybe. Looks like Mount Carmel had already settled with the patient families for 17 million and part of the settlement was that the families couldn’t testify in favor of Husel in the trial.

I actually fully expect Husel to sue Mount Carmel and get a nice payday.

Agree. Husel will sue Mt Carmel for millions in defamation, after the inflammatory accusations made where they basically called him a murderer. And now the jury has acquited him. This is the reason why smart employers say "no comment on pending litigation".

 

[AlmostAnMD]

As someone who watched most of the trial I'm unsurprised but relieved to see the verdict.

This man was portrayed as a mass murderer in the media and underwent a serious hit job by Mount Carmel. Yet, he still came out not guilty because the facts clearly demonstrated that to be the case.

Good luck Husel! Sue everyone that tried to throw you in front of the bus and enjoy your FIRE from the windfall. Well deserved for being demonized for practicing good aggressive palliative care.

 

[southerndoc]

There may be opportunity to sue the expert witness as well.

 

[coffeebythelake]

There may be opportunity to sue the expert witness as well.

Don't know if that is possible. If they wanted to call the Bible thumper out for fake facts, they should have done it on cross examination.

 

[Kryptocoin]

The expert witness industry is like the wild wild west. Very unregulated. I guess it's hard to sue someone for giving a good fate medical opinion. It's up to their medical boards to censure them.

 

[CliveStaples]

I do not practice like Husel does with terminal patients who are being extubated. I do not believe that those doses of medications are necessary to treat pain/air hunger with terminal extubation. I may be the one who is wrong, but my practice aligns with the practice of virtually everybody else in the nation and until there comes some evidence that we are actually criminally underdosing terminal extubations, my practice will not change.

That said, I agree with the jury's ultimate decision that it could not be said beyond a reasonable doubt that the fentanyl administered was the cause of death in any of these patients, who all had plenty of alternative reasons to die after extubation. There was also no evidence for a motive, which I think played a significant part in the verdict. No evidence that he ever expressed an opinion that these patients needed to die faster to open up beds, etc.

I think most people here feel good about the verdict because we all recognize the "grey area" that palliative care of the terminally ill can be. We genuinely believe that the physicians involved want to ease suffering and once people are prosecuted for it, we know it is the patients that could eventually suffer.

 

[southerndoc]

The expert witness industry is like the wild wild west. Very unregulated. I guess it's hard to sue someone for giving a good fate medical opinion. It's up to their medical boards to censure them.

Medical Justice | Medical Malpractice Insurance Is Not Enough

We stand vigilantly by our member physicians with guidance and grit, relentlessly clearing out frivolous lawsuits before they start.

medicaljustice.com

 

[ACSurgeon]

Even if Husel can sue for a large sum, the damage that’s been done is not trivial. They always say that having a medical malpractice suit is a huge heart ache even if acquitted. Husel’s ordeal is magnitudes worse. Lesson learned: stay within the big red lines.

 

[dpmd]

I do not practice like Husel does with terminal patients who are being extubated. I do not believe that those doses of medications are necessary to treat pain/air hunger with terminal extubation. I may be the one who is wrong, but my practice aligns with the practice of virtually everybody else in the nation and until there comes some evidence that we are actually criminally underdosing terminal extubations, my practice will not change.

That said, I agree with the jury's ultimate decision that it could not be said beyond a reasonable doubt that the fentanyl administered was the cause of death in any of these patients, who all had plenty of alternative reasons to die after extubation. There was also no evidence for a motive, which I think played a significant part in the verdict. No evidence that he ever expressed an opinion that these patients needed to die faster to open up beds, etc.

I think most people here feel good about the verdict because we all recognize the "grey area" that palliative care of the terminally ill can be. We genuinely believe that the physicians involved want to ease suffering and once people are prosecuted for it, we know it is the patients that could eventually suffer.

I don't believe any level of suffering you allow your patients to feel around the end of their life will ever be considered criminal. Nor should it be if we are talking about unknowable levels of suffering rather than the agonized cries of awake patients being underdosed because people are afraid to escalate beyond some narrow parameters.

 

[narcusprince]

I know Dr Husel and sent support to him the entire time through the case. I am beyond happy the jury returned a not guilty verdict. I cannot imagine the personal growth he has gone through to clear his name. He is a good person who has been vindicated. I cannot wait to see the person he becomes on the other side of this when he gets what is deserved.

 

[AlmostAnMD]

Gerry Leesberg, an attorney representing the patients, said that his staff issued notices and subpoenas to Dr. Husel to appear for deposition.

He hopes that the deposition can reveal the reasoning behind Dr. Husel's decision to order doses of fentanyl.
"Dr. Husel is going to have to defend what he did and not just sit back at the table and allow his lawyer to speak on his behalf," Leesberg said.

Damn, they didn't even give Husel a day. Leeches be leechin.

Even if civil burdens are less than criminal I think a not guilty verdict goes a long way towards civil stuff, but that's my non-lawyer opinion.

 

[Proudfather94]

Nurses in TikTok are already bashing him for being found not guilty. Aprn-beauty called him a sociopath. Couldn't someone in a position to diagnose mental disorders (NP) That throws out accusations of someone having a disorder without being their patient be at risk for being sued and disciplined by their board of nursing?

 

[WheezyBaby]

I agree that the opioid requirement to treat air hunger is much lower than that needed to treat ETT discomfort, but, the opioid requirement to prevent withdrawal isn't necessarily dramatically lower than whatever they were on before.

I feel like there is very basic information that didn't come out in this thread or other articles that I have read. The dosages and duration of the opioid infusions that these patients were on prior to extubation is hugely important to one side or the other and somehow it just didn't come up? Or at least I haven't seen any quotes about this...

Do adults really survive palliative extubation on a "regular basis"? As peds ICU I had one fellowship attending approaching retirement who had seen a single child survive palliative extubation once and no one else there or where I work now has seen it happen.

I had an adult liver failure / septic shock / ARDS / renal failure who lived for about 2 days. I've had a child autoresuscitate following termination of CPR and go on to live for about a day without an ETT or even NIPPV for that matter. Wildest I've had is a child who was palliatively decannulated from ECMO (remained been vent supported) who is now home without respiratory support. I agree with Wilco that my general pre-extubation counseling has been that the patient decides how long it takes and sometimes that it is surprisingly long.

 

[Dr. Rude]

Medical Justice | Medical Malpractice Insurance Is Not Enough

We stand vigilantly by our member physicians with guidance and grit, relentlessly clearing out frivolous lawsuits before they start.

medicaljustice.com

Expert "Opinion" testimony enjoys very broad protections from civil litigation.
However, specialty societies and their board certification arm can discipline them (if they are members). State boards of Medicine can also censure members. Doesn't happen all that often.

 

[coffeebythelake]

Nurses in TikTok are already bashing him for being found not guilty. Aprn-beauty called him a sociopath. Couldn't someone in a position to diagnose mental disorders (NP) That throws out accusations of someone having a disorder without being their patient be at risk for being sued and disciplined by their board of nursing?

These nurses probably also rallied around Nurse Vaught when she was convicted. Stuff like this is politics. Nurses love that ****.

 

[Apollyon]

Nurses in TikTok are already bashing him for being found not guilty. Aprn-beauty called him a sociopath. Couldn't someone in a position to diagnose mental disorders (NP) That throws out accusations of someone having a disorder without being their patient be at risk for being sued and disciplined by their board of nursing?

That's for ABPN certified psychiatrists - the "Goldwater Rule". Noctors don't have such scruples.

 

[ToliBro]

These nurses probably also rallied around Nurse Vaught when she was convicted. Stuff like this is politics. Nurses love that ****.

Having to live in the nursing sphere myself (can't wait to be done soon) you'd be absolutely correct, more is the pity. Lots of false equivalency thrown about. I am somewhat happy to see this myself, I was concerned that a guilty verdict might result in homeopathic comfort care dosing protocols at hospitals in general, written by a bunch political committee nurses, with physician judgment removed entirely from the loop.

 

[Tigers540]

While I understand your point, these charges are 13 1000mcg boluses and 1 2000mcg bolus right? The 13 cases are identical, I dont see how any could have different results than the others. The entire case depended on the dose, since nothing else even hinted at murderous intent. In my opinion all 13 of those charges have to be murder/attempted or not guilty.
The 2,000mcg is somewhat of an outlier and could cause some confusion i suppose

it appears I was correct.
Baez confirmed in an interview that the jury was deadlocked 11-1 for the 13 counts of 1,000mcg and deadlocked 10-2 on the remaining count.

Also, he said that their motion to recuse the judge will be made public as well. I will be interested to see their accusations, as the judge certainly appeared biased when watching the trial. At one point the judge was told by a neutral party that he was "making faces during defense examination", and had to instruct the jury to disregard it. He was definitely odd.

 

[Proudfather94]

These nurses probably also rallied around Nurse Vaught when she was convicted. Stuff like this is politics. Nurses love that ****.

It's pretty childish they look like a toddler going "Wah something unfair happened to us so it needs to happen to you too!"

 

[thegenius]

I am surprised but I guess the prosecution couldn't prove motive. Not sure what the facts were. To me it's previous obvious what he was intending to do by giving 2000 mcg fentanyl pushes. He was attempting to hasten death. That was his intent. I'm not particularly impressed by anything this Husel guy has done, he doesn't seem trustworthy and I question his judgement. Why would an ICU somewhere else want to employ this guy now?

I'm more embarrassed and saddened by all the of legal shenanigans about buying out nurses, settling large sums of money to keep quiet, and all sorts of other devious legal maneuverings to cover up the truth. Only in 'Merica.


Let's say you are admin at a hospital, and you learn one of your ICU docs is giving 2000 mcg fentanyl for a palliative extubation. Would you not stop that practice? It's f'ing embarrassing and not needed, and dangerous. Unless those patients are tachyphylaxic to opioids, there is just no reason to do so.