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The Ohio hospital system where excessive painkiller doses were given to dozens of patients who died fired 23 nurses, pharmacists and managers Thursday and said it is changing leadership, a sign that professional fallout from the scandal has expanded far beyond the intensive care doctor accused of ordering the drugs. The announcement by the Columbus-area Mount Carmel Health System comes five weeks after that doctor, William Husel, pleaded not guilty to murder charges in 25 of the deaths, marking one of the biggest cases of its kind against an American health care professional. (Franko, 7/11)

The chief executive of an Ohio health care system announced his resignation and the termination of 23 employees on Thursday, one month after a doctor who worked for the hospital was charged in one of the largest murder cases in the state’s history. Ed Lamb, the chief executive of Mount Carmel Health System, said in a statement that his resignation would take effect on July 25. He added that the hospital’s executive vice president, Richard Streck, would be retiring at the end of September. The employees’ terminations were effective immediately. (Padilla, 7/12)

The patient deaths have exposed a stunning case of medical oversight and alleged medical malpractice, and called into question how repeated failures potentially involving 30 or more employees could have gone unchecked for so long. Husel pleaded not guilty and was released on bond following his arrest June 5. He faces 15 years to life in prison per count if convicted. Husel's attorney has denied that the doctor was trying to kill any of his patients, most of whom were older and already in poor health, and said he never attempted to euthanize them. (Ortiz, 7/11)

Facing pressure from federal agencies, Mount Carmel has undertaken a series of reforms since firing Husel. The federal Centers for Medicare and Medicaid, with the Ohio Department of Health, launched a separate investigation into Mount Carmel in January. Both Mount Carmel West and Mount Carmel St. Ann's were found in violation of federal regulations surrounding pharmaceutical practices and building safety. (Rosenberg and Pfleger, 7/11)