Mount Carmel Health System's investigation into a former intensive-care doctor has revealed that seven additional near-death hospital patients received excessive doses of painkillers, administrators told The Dispatch on Thursday.

That brings the total number of patients to 34, and Mount Carmel’s top executive said in a statement that the system anticipates more might be discovered.

Three of the patients were overdosed after the system received its first formal complaint about Dr. William Husel on Oct. 25, said Ed Lamb, president and CEO.

The fact that three patients received potentially fatal doses after the health system was alerted to a possible problem was "heartbreaking," said Dr. Dan Roth, executive vice president and chief clinical officer at Trinity Health, parent to Mount Carmel.

“We should have begun a more expedited process to investigate and consider immediate removal of Dr. Husel from patient care,” Lamb’s statement said. “We are sorry for this tragedy, and we will continue to investigate how we responded to this report and whether there is any other information that should have led us to investigate sooner into Dr. Husel’s practices.”

Roth said Husel's intentions are unclear but it doesn't appear that error led to the high doses.

>>Complete coverage: Find out more on this on-going investigation at Mt. Carmel

Husel was removed from providing patient care on Nov. 21 after the health system received two more complaints about the doctor.

All 34 patients died, and Lamb said the doses given were potentially fatal in 28 of the deaths.

Husel, 43, of Liberty Township, who is accused of ordering the doses, was fired Dec. 5, and six pharmacists and 14 nurses have been placed on leave. 

Columbus-based Mount Carmel announced the investigation and Husel's termination last week, saying the overdoses began in 2015.

Lamb said the investigation reviewed the care of specific patients based on medication records. It is now being expanded to include all patients who died under the care of Husel, who began working for the health system in 2013. It was not clear how many patients that would include.

The system also is investigating whether families who discontinued lifesaving measures were properly informed about patient conditions, and if excessive doses were ordered when there may have been other options to consider for possible improvement.

In each of the 34 patients, families had requested that lifesaving measures be stopped, but the amount of painkiller prescribed was beyond what was needed to provide comfort, executives said.

Families of the initial 27 patients have been notified, and the health system was notifying families of additional families Thursday morning.

The Franklin County prosecutor's office and Columbus police are investigating, and the Ohio Department of Health has been investigating on behalf of the federal Centers for Medicare and Medicaid Services.

Mount Carmel also has notified the state boards that regulate medical, pharmacy and nursing licenses.

Thirty-three of the patients received care at Mount Carmel West hospital in Franklinton, and one was a patient at Mount Carmel St. Ann's in Westerville.

At least seven of the initial patients have been identified by attorneys who have filed or plan to file lawsuits in their deaths.

Those named range in age from 39 to 83. Their deaths occurred at Mount Carmel West beginning March 1, 2015. The latest was on Oct. 24, 2018.

Lawyers have said fentanyl was involved in at least six of the identified cases. Roth said the Mount Carmel investigation showed fentanyl was not the only painkiller used.

The Trinity Health network, based in Livonia, Michigan, is affiliated with the Roman Catholic Church and includes 94 hospitals.

Here's a timeline of events, according to Mount Carmel.

jviviano@dispatch.com

@JoAnneViviano