This month’s case made national headlines and sparked a great deal of conversation about the topic of ‘comfort care’ for seriously ill and dying patients.

Dr H was a rising star physician in his late 30’s when he took a position as the night-shift physician in the Intensive Care Unit (ICU) of an Ohio hospital in 2013 after completing a residency at the Cleveland Clinic. Dr H’s patients in the ICU were in extremely critical condition and part of his care involved prescribing pain relief or ‘comfort care’ for dying or severely ill patients, including those who were being removed from ventilators.

In October 2018, a formal report was filed with the hospital by an employee who alleged that Dr H was ordering excessive doses of pain killers for his patients. The complaint was not seriously investigated until a second complaint was filed the following month, November 2018.

At this point the hospital broadened its investigation, after noting the death of a patient following administration of an abnormally high dosage of fentanyl by the physician. A day later another of Dr H’s patients was declared dead after a high dose of fentanyl. At this point, Dr H was immediately removed from patient care duties. He was fired from his position with the hospital in early December of that year.

After the hospital fired Dr H, it contacted the state medical board and the county prosecutor’s office. The hospital also contacted the state boards of pharmacy and nursing. By this point, the hospital had identified 24 patients who were believed to have received excessive painkiller doses ordered by Dr H. The first case allegedly occurred in February 2015 when one of Dr H’s patients died after being administered 400mcg of fentanyl. The hospital eventually identified over 2 dozen cases that took place from 2015 to 2018 where patients were given large doses of painkillers and died soon after.

In January 2019, Dr H’s medical license was suspended. In the meantime, a criminal investigation had been launched by police and investigators from the prosecutor’s office. In June 2019, Dr H was officially charged with 25 counts of murder, and he turned himself in to police. Eventually 11 of the murder counts were dismissed, but the remaining 14 counts of murder went to trial. The 14 remaining counts were some of the highest doses of fentanyl given to patients, one patient received 1000mcg of fentanyl and one received 2000mcg.