Case: 2:20-cv-00258-EAS-KAJ Doc #: 8 Filed: 01/21/20 Page: 1 of 165 PAGEID #: 387
`Case: 2:20-CV-00258—EAS-KAJ DOC #: 8 Filed: 01/21/20 Page: 1 Of 165 PAGEID #: 387
`Franklin Count Ohio Clerk of Courts ot the Common Pleas- 2019 D
`19 7:47 AM-190V010094
`03973 — 913
`y
`6°
`
`CASE NO. _
`
`COMPLAINT
`
`Jury Demand
`Endorsed Hereon
`
`COURT OF COMMON PLEAS OF THE STATE OF OHIO
`FRANKLIN COUNTY — GENERAL DIVISION
`______________»-Huufl__-_-—u__»________________—__________________-———————n»x
`
`REBECCA MCNEIL (cfo Graff & McGovern, LPA, 604
`E. Rich St, Columbus, OH 43215),
`BETH MACIOCE~QUINN (cfo Graff & McGovern, LPA,
`604 E. Rich St., Columbus, OH 43215),
`EARLENE ROMINE (cfo Graff & McGovern, LPA, 604
`E. Rich St., Columbus, OH 43215),
`EDWARD WRIGHT (Clo Graff & McGovern, LPA, 604
`E. Rich St, Columbus, OH 43215),
`BRANDI WELLS (c/o Graff & McGovern, LPA, 604 E.
`Rich St., Columbus, OH 43215),
`AKEELA BOWENS (Clo Graff & McGovern, LPA, 604
`E. Rich St., Columbus, OH 43215),
`AMELIA POWERS (cfo Graff & McGovern, LPA, 604 E.
`Rich St., Columbus, OH 43215),
`CHAD READOUT (cfo Graff & McGovern, LPA, 604 E.
`Rich St., Columbus, OH 43215),
`JESSICA SHEETS (cfo Graff & McGovern, LPA, 604 E.
`Rich St., Columbus, OH 43215), and
`DERON LUNDY (cfo Graff & McGovern, LPA, 604 E.
`Rich St, Columbus, OH 43215)
`
`.
`:
`'
`
`:
`:
`’
`.
`:
`:
`'
`
`Plaintiff's,
`
`— against —
`
`MOUNT CARMEL HEALTH SYSTEM (do CT
`Corporation System, 4400 Easton Commons Way, Suite
`125, Columbus, OH 43219),
`TRINITY HEALTH CORPORATION (Clo CT
`Corporation System, 4400 Easton Commons Way, Suite
`125, Columbus, OH 43219),
`and EDWARD LAB/[B (c/O Mount Carmel Health System
`Corporate Service Center, 6150 E Broad St #1574,
`Columbus, OH 43213),
`
`Defendants.
`_________________-____________________udqHDCDHHH"__--_-____-—___w_n________x
`
`Plaintiffs Rebecca McNeil, RN, Beth Macioce-Quinn, RN, Earlene Romine, RN, Edward
`
`Wright, RN, Brandi Wells, RN, Akeela Bowens, RN, Amelia Powers, RN, Chad Readout, RN
`
`EXHIBIT
`
`A.
`
`

`

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`and Jessica Sheets, RN and pharmacist Deron Lundy, PharmD (collectively “Plaintiffs”) by their
`
`undersigned counsel, allege as follows against defendants Mount Carmel Health System (“Mount
`
`Carmel"), Mount Carmel’s parent organization Trinity Health Corporation (“Trinity"), and
`
`Edward Lamb:
`
`NATURE OF THE ACTION
`
`1,
`
`This action is brought by IO former employees of Mount Carmel (six night-shift
`
`ICU nurses, their supervisor, their clinical educator and one pharmacist who was assigned to
`
`assist the ICU and an additional ICU nurse that worked in a separate ICU within the Mount
`
`Carmel system), all of whom followed their personal callings and dedicated their professional
`
`lives to helping the sickest members of the Columbus community, and all of whom worked with
`
`and around the now-publicly-vilifled Dr. William S. Husel, night after night, treating and saving
`
`the lives of thousands of critically-ill patients over the course of five years. These ten
`
`individuals had a singular goal: to save as many lives as possible every day.
`
`2,
`
`From time to time during those years, the Mount Carmel ICUs would admit a
`
`patient who was simply too sick to survive, and in some cases, the families of those patients
`
`would request that life support be withdrawn so that the patient and their loved ones could avoid
`
`needless suffering.
`
`3,
`
`This was by no means a daily event, but it was common enough, and it was
`
`something the ICU staff trained for, and had clear policies for. Those policies were designed to
`
`ensure that each patient received the best possible care in the last minutes of their lives. Senior
`
`management at Mount Carmel, of course, approved of the ICU’s standard operating procedures,
`
`as they had been largely unchanged from 2014 until December 2018, notwithstanding periodic
`
`reviews and updates.
`
`

`

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`4.
`
`The ICU nurses were not only responsible for the patients’ acute needs but also
`
`for assisting physicians. They wore many hats, including the need to provide emotional support
`
`to patients and families as they dealt with uncertainty, fear, loss and pain. They helped cheer up
`
`recovering patients, attended to chaotic life-or-death emergencies, and in these rare
`
`circumstances when patients reached a state where death was near and unavoidable, the ICU
`
`nurses held the hands of patients and families, cried with them, prayed with them, and
`
`sometimes, when patients had no families, simply stayed with them so that the patient would not
`
`die alone.
`
`5.
`
`Until late November 2018, the ICU at Mount Carmel West hospital (“MC West”)
`
`was an outstanding unit that served several underprivileged communities in western Columbus.
`
`The plaintiffs here were all proud to be a part of it (and its sister unit at Mount Carmel St, Ann’s,
`
`where one of the plaintiffs here worked). They did not take their jobs for the money. Before
`
`January 2019, any ICU nurse with Mount Carmel on their resume could write their own tickets,
`
`and get hired anywhere they wanted. More experienced nurses, such as Beth Macioce—Quinn,
`
`would regularly receive unsolicited offers of employment with signing bonuses from the nation’s
`
`top hospitals, which she declined because being an ICU nurse at MC West was her calling.
`
`6.
`
`But in December 2018, everything began to change rapidly, for the worse. Acting
`
`on orders from Trinity, its Michigan-based corporate parent organization, Mount Carmel fired
`
`Dr. Husel, placed 13 nurses and 7 others on leave, and drastically changed its ICU policies from
`
`patient-centered policies that left appropriate discretion to its trusted physicians, to new hard-
`
`rules that endangered patients, and delayed urgent care.
`
`7.
`
`With respect to comfort care provided to the few terminally-ill and actively dying
`
`patients whose families made the gut-wrenching decision to withdraw aggressive life support,
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`

`

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`the new policies went contrary to accepted medical standards and created a situation where
`
`patients could, and unfortunately have, died in avoidable agony while their families watched.
`
`8,
`
`In these situations, the nurses and physicians have, just as before, stayed with the
`
`families and tried to comfort them; but under the new regimens they did so with the terrible
`
`knowledge that under the earlier procedures, they could always do something to ease the pain for
`
`all involved. No longer.
`
`9,
`
`At the time, nobody but senior Mount Carmel and Trinity management
`
`understood why these new policies were being implemented, and why theses capable, talented
`
`and loved colleagues had been removed from their positions. Many on the ICU staff, including
`
`all seven of the Plaintiffs who remained at Mount Carmel at the time, questioned these decisions
`
`— vocally and strenuously — defending their colleagues against obviously false allegations of
`
`wrongdoing and voicing strong opposition to the new policies that they knew were improper,
`
`detrimental to patient care, and were harming patients, and would continue to harm them.
`
`10.
`
`All who spoke up against Trinity and Mount Carmel were made to suffer as a
`
`consequence for doing so by being wrongfully terminated and defamed, in an effort to preclude
`
`them from ever working again in their chosen fields.
`
`| 1.
`
`The new policies, along with many other destructive actions that Trinity and
`
`Mount Carmel took, were all designed to create a single false appearance: that in the preceding
`
`five years, Dr. Husel and dozens of ICU staff, had not been following established policies and
`
`had not. been providing compassionate and proper care to patients who had been removed from
`
`life support on their and their families’ wishes. Rather, the “remedial” policies (and public
`
`statements about them) were designed to create the false appearance that the ICU staff had,
`
`

`

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`without any rational explanation whatsoever, been deliberately overmedicating dying patients in
`
`their final moments on Dr. Husel’s orders to cause (or “hasten") their deaths.
`
`12.
`
`This preposterous (but headline-grabbing) false narrative of an evil rogue doctor
`
`and his complicit staff ultimately destroyed the lives and livelihoods of dozens of dedicated
`
`nurses and pharmacists, and convinced the public, the Franklin County prosecutor, and the State
`
`Attorney General, that something terrible had been going on. But nothing could be further from
`
`the truth.
`
`13.
`
`Because of Mount Carmel and Trinity’s public statements, many in the Columbus
`
`community have wondered why a doctor and dozens of nurses and pharmacists would
`
`intentionally murder patients after being removed from life support. The answer is simple: They
`
`did not.
`
`14.
`
`Why then did Mount Carmel, Trinity, and their respective senior executives make
`
`the public statements that they did? This answer is also simple: A toxic brew of enormous
`
`amounts of money, combined with personal self-interest, ignorance and fear.
`
`15.
`
`By November of 2018, Trinity had established itself as a leading institution on
`
`running a tightly-controlled operation (from a Medicarefbilling perspective) that was also a
`
`leading voice in combating the national opioid crisis. As a result, Trinity had obtained, for the
`
`past several years, a lucrative designation as a Medicare Accountable Care Organization and then
`
`a Next Generation Medicare Accountable Care Organization (an “NGACO”),
`
`16.
`
`At the same time, the senior leaders of Mount Carmel and Trinity were acutely
`
`aware that in the spring/summer of 201 8, a joint task force of federal and state law enforcement
`
`agencies had brought hundreds of prosecutions and administrative actions for opioid overuse and
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`

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`associated fraudulent billing practices against not only competing institutions and their clinical
`
`staffs, but against their non-clinical executives too.
`
`17.
`
`In November 2018, Trinity and Mount Carmel executives became focused on the
`
`flexible and discretion-permitting policies that had been in place for years in the Mount Carmel
`
`ICUs that had permitted a doctor and the staff to administer seemingly high, but appropriate,
`
`doses of fentanyl and similar medications to patients being removed from life support in order to
`
`prevent the pain and physical struggle associated with the process of dying.
`
`18.
`
`For years, the executives had access to any information they wanted regarding
`
`fentanyl use in the ICUs, but had never cared to focus on it earlier. When they finally looked at
`
`the information in November 2018, they did not understand why such seemingly high doses
`
`would be used. This was because they did not understand how care is given in the last minutes
`
`of life after life-support is withdrawn, nor did they have any appreciation of the difference
`
`between very-end-of-life care and pain management for patients expected to survive, or even
`
`longer-term palliative patients (those who are terminally ill, but have days, weeks or months to
`
`live as opposed to minutes). These differences are drastic.
`
`19.
`
`The doses given when a patient is being removed from life support can be far
`
`higher than would be used to treat ordinary (eg. post-operation) pain in the average patient, and
`
`also higher than those used in longer-term palliative care. For example, whereas fentanyl is
`
`ordinarily prescribed in the 100-300 microgram (“mcg”) dose range for pain relief in an
`
`otherwise healthy patient, doses of 500, 1000, and even 2000 mcg and even substantially higher
`
`can be appropriate in end-of-life care to combat pain, dyspnea and agonal breathing (visible and
`
`painful reactions that a dying body has due to the loss of oxygen when a ventilator is removed).
`
`

`

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`In one medical study, discussed below, an end-of—life patient received 4250 mcg of fentanyl
`
`every hour for three days. The proper dose always depends on the patient and the circumstance.
`
`20.
`
`In November and December 2018, Trinity and Mount Carmel executives made
`
`rash and highly-consequential decisions without understanding these fundamental issues
`
`regarding the unique considerations in treatment of patients with minutes to live,
`
`21.
`
`The executives panicked, as they believed that federal and state regulators and the
`
`public might learn that high doses of fentanyl were being administered in the ICUs, and that
`
`these constituents would conflate (as the executives had) proper last-minutes—of-life care with the
`
`truly wrongful conduct of over-prescription of opioids that was creating an addiction and human
`
`health crisis currently sweeping the nation.
`
`22.
`
`Because of their ignorance of the applicable standards of care for the withdrawal
`
`of life support, the executives though! Trinity’s reputation as a leader in the fight against the
`
`opioid crisis would be harmed. They thought Trinity’s lucrative status as an NGACO and even
`
`its ability to accept Medicare and Medicaid patients could be revoked if their long-standing
`
`flexible and discretion-focused policies were examined in light of the more stringent
`
`documentation and oversight standards Trinity had committed to. And some even feared finding
`
`themselves on the wrong side of the next wave of criminal prosecution for contributing to opioid
`
`overuse.
`
`23.
`
`Mount Carmel’s written policies from at least 2014 until December 10, 2018 were
`
`appropriately vague in order to provide substantial (and appropriate) discretion to doctors. Its
`
`standard operating procedures allowed discretion to be put into effect in a way that was most
`
`beneficial for patients being cared for. The system worked for patients, but it may not have been
`
`up to snuff by Medicare/Medicaid and NGACO standards, which required more formalized
`
`

`

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`written policies detailing standards of care and operating procedures. But this was hardly the
`
`fault of the physicians and nurses that abided by the policies in place at Mount Carmel, and who
`
`provided good and ethical patient care in doing so.
`
`24.
`
`Much literature and learning regarding opioids relating to their use (and overuse)
`
`to treat pain in non-terminal patients refers to doses below 500 mcg, which is appropriate for
`
`those circumstances. But medical literature and studies on the use of opioid pain medication to
`
`lessen the pain experienced in the process of active dying in terminally-ill patients in connection
`
`with the withdrawal of life support all say the same thing: There is no maximum dose, either
`
`legally or ethically.
`
`25.
`
`Moreover, peer-reviewed medical studies have shown that high doses of fentanyl
`
`and other opioids under these circumstances either have no meaningful impact on the time
`
`between withdrawal of life support and death, or show that the high doses can extend post-
`
`withdrawal survival by several minutes. (Indeed, with the 35 patients at issue here who received
`
`between 200 mcg and 2000 mcg, there is also no correlation between the dose given and the time
`
`to death following withdrawal.)
`
`26. While the reason for this phenomenon is not known, the studies speculate that the
`
`sedative properties of fentanyl prevent the body from struggling when the lungs and heart fail
`
`after life-support is withdrawn, which not only prevents pain and facilitates an easier death, but
`
`which conserves energy, thus sometimes modestly elongating survival.
`
`27.
`
`None of this mattered to Mount Carmel, Trinity, and their senior management.
`
`The narrative they crafted of a physician intentionally using “fatal” doses of fentanyl with the
`
`assistance of the ICU staff, they knew, would destroy the doctor’s life and the lives of the nurses
`
`and pharmacists involved and of their families. The executives also knew their public statements
`
`

`

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`would not just destroy the lives and livelihoods of many caring and talented clinical
`
`professionals, but the ICU in its entirety, and perhaps even MC West as a whole.
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`It did not
`
`matter to them.
`
`28.
`
`That is because they also knew that their rogue-doctor story would allow Mount
`
`Carmel and Trinity to explain the use of what the executives feared would be seen — by
`
`Medicare, the Department of Justice or others — as high opioid doses as an aberration and
`
`violation of policies. If the doctor and the ICU staff could be said to have acted outside of their
`
`scope of duties and Mount Carmel policies, then any potential fallout could be contained to the
`
`Mount Carmel ICUs and kept away from Trinity (and the executives themselves).
`
`29.
`
`And so, the sacrifice began.
`
`In December 2013, Mount Carmel fired Dr. Husel,
`
`put 20 staff on leave, contacted a homicide detective, and called the families of 26 patients to tell
`
`each of them that their loved ones had been given a “fatal” dose of fentanyl (even though no such
`
`thing had occurred).
`
`30.
`
`That month, Mount Carmel also revised serval of its policies in a way that
`
`delayed patient care and removed discretion from physicians in critical circumstances where
`
`discretion, and fast responses, were necessary. While these revisions were devastating from a
`
`patient care perspective, they were clearly drawn with a single audience in mind —
`
`MedicarefMedicaid — and with a single absolute rule — making the care provided in the 26 (and
`
`later 35) cases at issue appear improper by comparison, regardless of any practical repercussions
`
`the policies would have for future patients.
`
`31.
`
`On January 14, 2019, Mount Carmel called the families of 26 patients again (as
`
`well as one more), to reiterate that their loved ones had been given a “fatal" dose of medication
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`

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`for the purpose of hastening or causing their death, and to tell them the incident was not isolated,
`
`but rather that a doctor and more than a dozen individuals had caused the deaths of 27 patients.
`
`32.
`
`That same day, Mount Carmel CEO Edward Lamb released a written public
`
`statement and two videos, telling the world that 23’ patients had received “excessive and
`
`potentially fatal” doses of fentanyl, in violation of Mount Carmel policies. Lamb stated that
`
`these actions had been committed by a single physician, but with the involvement of nurses and
`
`pharmacists who “made bad decisions” and were “i gnor[ing] policies and putting our patients’
`
`safety at risk." While Lamb’s statement used the phrase “potentially fatal," the clear thrust of the
`
`statement was that the doses were, in fact, fatal.
`
`Indeed, that is what the hospital had told the
`
`families ofthe patients, as explicitly alleged in each of the civil law suits that would soon follow.
`
`33.
`
`Trinity put out a similar press release repeating the salient false and defamatory
`
`statements.
`
`34.
`
`The press had a field day.
`
`In the following weeks, the families of patients who
`
`had been falsely lead to believe their loved ones had been murdered after being removed from
`
`life support began to sue.
`
`35.
`
`Anyone at Mount Carmel who resisted management or openly defended the care
`
`that the doctor, nurses and pharmacists had provided was threatened, suspended andz'or
`
`eventually fired, as were those who called out the new Mount Carmel policies for what they
`
`were: dangerous and harmful.
`
`36.
`
`It got worse.
`
`37.
`
`Every few weeks, Mount Carmel would announce more patients that, they
`
`alleged, received “fatal" or “excessive” doses until the number reached 35.
`
`10
`
`

`

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`38.
`
`In February, Mount Carmel announced that 5 of the patients might have .mmfved
`
`but for the medication. This statement was the worst of them all.
`
`It was absolutely false, and
`
`anyone with a medical or nursing degree who was involved with the patients, or had access to
`
`medical records, would immediately know this. The cause of death for each of these patients
`
`was their numerous illnesses, co—morbidities, and multiple organ failures.
`
`39.
`
`But once again, no one publicly questioned Mount Carmel’s statements and the
`
`press frenzy increased. By this point, those nurses, pharmacists, physicians and others at Mount
`
`Carmel who knew better were absolutely terrified to speak up.
`
`40.
`
`In March 2019, Edward Lamb upped the ante again, telling the public that 48
`
`nurses, pharmacists and others were under investigation, and those 30 that were still employed
`
`by Mount Carmel were all placed on paid leave. While the press continued to focus on patients
`
`receiving “up to 2000 micrograms," many of the individuals placed on suspension were involved
`
`in cases where vastly less was given. But Trinity and Mount Carmel did not base their
`
`suspension (and later termination) decisions on the dosages. They based it on whether the staff
`
`member was willing to go along with management’s rogue-doctor story, and whether they
`
`accepted the new policies without speaking up about the harm they could cause.
`
`41.
`
`In June, after an onslaught of one-sided media that juxtaposed a series of damning
`
`(though false) admissions from Mount Carmel with images and interviews of distraught family
`
`members whose mourning processes had been radically (and intentionally) interrupted by Mount
`
`Carmel‘s unbelievable statements, the Franklin County district attorney indicted Dr. Husel on 25
`
`counts of intentional murder (one of the largest murder indictments in Ohio, and our country’s
`
`history). The Ohio attorney general called Dr. Husel a “serial killer," and announced that his
`
`11
`
`

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`office would step in to prosecute all contested administrative actions that the Ohio Boards of
`
`Nursing or Pharmacy might take.
`
`42.
`
`The press began openly discussing whether Dr. Husel should receive the death
`
`penalty.
`
`43.
`
`Then, in July, Mount Carmel publicly announced that it had terminated all but 11
`
`of its suspended employees (and did not mention that several suspended employees had simply
`
`resigned due to the pressure). The public announcement erased any of the empty innocent-until-
`
`proven-guilty platitudes in which Mount Carmel had couched its prior statements about the
`
`suspended staff. All of those who had spoken up internally against Mount Carmel’s and
`
`Trinity’s decision, either in support of their colleagues or in opposition to the dangerous new
`
`policies put in place in December 2018, were terminated Only those that Mount Carmel was
`
`convinced would never speak up were permitted to return.
`
`44.
`
`The terminations released each of these dedicated, talented, and caring individuals
`
`into a thoroughly poisoned environment. On account of the defamatory and other false
`
`statements Mount Carmel and Trinity made, almost none of them have been able to find
`
`employment in their chosen fields (including those former Mount Carmel employees who
`
`worked at other facilities and lost their jobs once their employers realized that they previously
`
`worked with Dr. Husel). Some have found that nobody is willing to hire them in any field due to
`
`the association, and being a publicly-presumed accomplice to murder.
`
`45.
`
`Nurses have had their morals questioned by friends and family, been accosted at
`
`their children’s sports games, and even been refused service by mental health providers when
`
`they sought assistance to deal with the psychological impact of what Mount Carmel and Trinity
`
`had done to them.
`
`12
`
`

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`46.
`
`These nurses and pharmacists have been demeaned, defamed and — as was Mount
`
`Carmel and Trinity’s plan — silenced. Until now.
`
`47.
`
`The ten Plaintiffs here have overcome the fear instilled in them by the senior
`
`executives of a corporation and a hospital system determined to silence them, and now speak up
`
`for what is right and just, to reclaim their own names, their livelihoods and passions to care for
`
`the sickest members of their communities, to support a doctor that they know to have been
`
`falsely accused and whom they considered one of the best they had worked with. And more
`
`importantly, they speak up to restore Columbus“ faith in those individuals who chose to serve
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`their communities in their sacred and trusted professions,
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`48.
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`The Defendants’ intentional misconduct makes them liable to the Plaintiffs under
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`three distinct legal doctrines:
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`a. All ten Plaintiffs have been defam ed, per se and per quad, and have suffered
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`damages as a mm”,
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`b. The seven Plaintiffs who remained at Mount Carmel and were terminated after
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`voicing their objections to Mount Carmel’s new policies as dangerous to patients,
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`and speaking up on behalf of their colleagues, were each wrongfully terminated as
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`an act of retaliation and in Violation of clearly-stated Ohio public policy; and
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`c. The coordinated press strategy that Mount Carmel and Trinity jointly designed
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`and executed to convince the world that a rogue-doctor and dozens of complicit
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`staff had intentionally caused death was a false advertising campaign designed to
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`protect Trinity and Mount Carmel at the ICU staff’ 5 expense, constituting a
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`violation of federal law (15 U.S.C. § I 125(a)) and the Ohio Deceptive Trade
`
`13
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`Practices Act and causing professional/reputational damage to all ten Plaintiffs
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`who work in the same competitive industry as the Defendants — healthcare.
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`Plaintiffs
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`PARTIES
`
`49.
`
`Rebecca McNeil, RN, is a registered nurse who was employed as an ICU nurse at
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`MC West from 2000 to 200? and as a Clinical Educator responsible for the ICU (among other
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`units) from 2007 until January, 2019.
`
`50.
`
`Beth Macioce-Quinn, RN, is a registered nurse who was employed as an ICU
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`nurse at MC West from May 1998 to July 11, 2019.
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`51.
`
`Earlene Romine, RN, is a registered nurse who was employed as an ICU nurse at
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`MC West from 2004 to 2012, and as the ICU Nursing Unit Director from 2012 to July 11, 2019.
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`52.
`
`Edward Wright, RN, has been a registered nurse since 1991 who was employed as
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`an ICU nurse at MC West from September 201? to November 2018.
`
`53.
`
`Brandi Wells, RN, is a registered nurse who was employed as a nurse at MC West
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`in the medical, surgical and bariatric units from 2003-2007 and as a nurse in the ICU from 2007
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`toJuly 11,2019.
`
`S4.
`
`Akeela Bowens, RN, is a registered nurse who was employed as an ICU nurse at
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`MC West from 2012 to July 11, 2019.
`
`55.
`
`Amelia Powers, RN, is a registered nurse who was employed as an ICU nurse at
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`MC West from 2014-2016.
`
`56.
`
`Chad Readout, RN, is a registered nurse who was employed as an ICU nurse at
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`Mount Carmel St. Ann’s (another Mount Carmel hospital) from 2015 to October 2018.
`
`14
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`57.
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`Jessica Sheets, RN, is a registered nurse who was employed as a nurse in the
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`palliative, oncology and medical surgery units at MC West from August 2015 to February 2017
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`and in the ICU from February 2017 to July ll, 20l9.
`
`58.
`
`Deron Lundy, PharmD, is a Doctor of Pharmacy who was employed as a
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`pharmacist at MC West from July 9, 2012 to July 1 l, 2019 and who had responsibilities that
`
`included covering the ICUs.
`
`Defendants
`
`59.
`
`Mount Carmel Health System, according to its website, is “one of the largest
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`integrated health systems in the community, Mount Carmel provides people-centered care at four
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`hospitals — Mount Carmel East, Mount Carmel Grove City, Mount Carmel St. Ann’s and Mount
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`Carmel New Albany — an inpatient rehabilitation hospital, free-standing emergency centers,
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`outpatient facilities, surgery centers, urgent care centers, primary care and specialty care
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`physician offices, community outreach sites and homes across the region.” At all relevant times,
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`Mount Carmel also operated MC West, which has since been closed and relocated to a new
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`facility: Mount Carmel Grove City.
`
`60.
`
`Trinity Health Corporation, Mount Carmel’s parent organization, is a national
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`Catholic health system based in Michigan with 92 hospitals and 109 continuing care facilities,
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`home care agencies, and outpatient centers in 22 states. Spokespeople for Trinity Health
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`Corporation go to great lengths to highlight and rely upon its Catholic association in defense of
`
`all of its decisions and conduct. Trinity is an Indiana for-profit corporation, headquartered in
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`Livonia, Michigan and licensed to do business in the State of Ohio.
`
`61.
`
`At all relevant times, Edward Lamb was an employee of Mount Carmel and held
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`the title of Chief Executive Officer of MC West.
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`15
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`JURISDICTION AND VENUE
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`62.
`
`This Court has personal jurisdiction over Mount Carmel because it is located in
`
`the county.
`
`63.
`
`This Court has personal jurisdiction over Trinity because it owns and manages a
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`hospital system in the county, and because it was directly involved in the acts and decisions that
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`led to plaintiffs’ injuries.
`
`64.
`
`This Court has personal jurisdiction over defendant Lamb because, at all relevant
`
`times, he was employed in the county and his actions at issue here were made in connection with
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`his employment and taken within the county.
`
`65.
`
`Venue is appropriate in this county because a substantial part of the events or
`
`omissions giving rise to the claim occurred herein.
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`STATEMENT OF FACTS — BACKGROUND AND HISTORY
`
`The Use of Fentanyt'for Prevention (.{fPain in Withdrawal ofLife Support
`
`66.
`
`In numerous public statements, Mount Carmel and Trinity have asserted that
`
`forty-eight nurses, pharmacists and other hospital workers participated, either directly or
`
`indirectly, in terminal ventilator wi thdrawalr’extubati on procedures in which anywhere from 200
`
`mcg to 2000 mcg of fentanyl was administered.
`
`In those same public statements, Mount Carmel
`
`and Trinity have asserted that those doses were objectively excessive for terminal ventilator
`
`withdrawalr’extubation procedures, in fact lethal, and caused the death of 29 patients. (These
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`procedures are often referred to in Mount Carmel’s policies as “palliative ventilator withdrawal",
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`but as discussed herein, involved more than the removal of a patient from the ventilator).
`
`6?.
`
`That theory is unsupportable, and any physician experienced in end-of—life care in
`
`an intensive care unit would have known that for two reasons:
`
`( 1) determining the appropriate
`
`dose of pain medication for a patient in connection with the terminal withdrawal of all life
`
`16
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`support, including withdrawal of ventilatory support (“palliative extubation”) is both imprecise
`
`and highly patient specific, where diagnoses, body mass and opioid tolerance are critical; and (2)
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`medical research and best practice publications universally state that in the administration of pain
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`medication in connection with palliative extubation, there is no upper limit to dosing because the
`
`so