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The Ohio Board of Nursing sent notices on Thursday telling 25 Mount Carmel Health System nurses that they could lose their licenses for their roles in the care of critically ill patients who died after receiving inappropriate doses of pain medications.

Also Thursday, a 25th wrongful-death lawsuit naming Mount Carmel and Dr. William Husel was filed in Franklin County Common Pleas Court. It says that 37-year-old Brandy McDonald of London, Ohio, died at Mount Carmel West on Jan. 14, 2018, after receiving a lethal dose of fentanyl ordered by Husel.

The state nursing board said the nurses receiving notices were involved in administering drugs ordered by Husel, who has been accused by the health system of overdosing 35 intensive-care patients, with dosages high enough to be potentially fatal for 29.

Letters released by the board say the nurses violated state law and reference 31 patients who received care at Mount Carmel West hospital in Franklinton and one at Mount Carmel St. Ann’s hospital in Westerville from September 2014 to November of last year. Nurses, the letters say, knew or should have known that the drugs would be harmful and that there is no documentation that they questioned orders or consulted with others involved in patient care.