Dr. William Husel walked into the lobby of Columbus police headquarters in a tailored dark suit Wednesday and shook the hand of a cold-case homicide detective who had spent the past six months investigating him.

Surrounded by uniformed police officers, Husel walked to the back of the elevator and lowered his head as the doors closed.

At the Franklin County Jail, he was handcuffed, asked to take off his shoes and socks and patted down in the booking room. Two hours later, the 43-year-old wore the earth tones of a jail inmate as a Franklin County Common Pleas Court magistrate read his 25-count indictment for murder and set bond at $1 million.

>>VIDEO: Dr William Husel intake at Franklin County Sheriff's Office

If convicted, the former intensive-care doctor for the Mount Carmel Health System faces 15 years to life for each of the 25 counts of murder against him in what is one of the largest murder cases in the state's history.

“It is certainly the biggest and most complex cases I have ever been involved with,” said Franklin County Prosecutor Ron O’Brien.

When asked by The Dispatch if he knows why Husel would have ordered the lethal doses of medication, O’Brien said, “No, I do not know.”

Husel is charged in the deaths of Emma Bogan, 75; Jan Marlene Thomas, 65; Norma J. Welch, 85; Joanne S. Bellisari, 69; Ryan Hayes, 39; Timothy Fitzpatrick, 55; Beverlee Ann Schirtzinger, 63; Michael Walters, 57; Robert P. Lee, 70 (the one patient who died at Mount Carmel St. Ann’s hospital); Thomas Mathews, 61; Danny Mollette, 74; Larry Brigner, 70; Janet Kavanaugh, 79; Brandy McDonald, 37; Francis Burke, 73; Charles Longstreth, 67; Jeremia Hodge, 57; James Allen, 80; Troy Allison, 44; Corrinnia Blake, 55; Bonnie Austin, 64; James Nickolas Timmons, 39; Sandra Castle, 80; Rebecca Walls, 75; and Melissa Penix, 82.

>>Read more: Here are the victims in the Mount Carmel criminal case

Mount Carmel Health System officials have said Husel ordered excessive doses of painkillers for 35 patients over a four-year period, though they said they do not believe six of those patients died because of the drugs. All but one of those patients were at the former Mount Carmel West hospital; one died at Mount Carmel St. Ann’s hospital in Westerville.

Some patients received 1,000 micrograms, and two patients received 2,000 micrograms, according to wrongful-death lawsuits filed in Franklin County Common Pleas Court and details in Ohio Department of Health inspection reports.

"This breach of a doctor's oath is vile," acting Columbus police Chief Thomas Quinlan said. "It is our sincere hope that the families of these victims will find solace by the state of Ohio holding Dr. Husel accountable for his devious conduct."

Authorities said all 25 victims in the criminal cases were given at least 500 micrograms of the opiod fentanyl, a level which O’Brien said was medically unnecessary.

“At the 500-microgram level there would be no legitimate medical purpose,” O’Brien said. “The only purpose would be to hasten their deaths.”

Husel’s attorney Richard Blake, of Cleveland, said his client shouldn’t have been charged with any crimes and has been cooperating with law enforcement.

Asked why Husel, who lives in Liberty Township near Dublin, would have prescribed such large doses of the painkiller, Blake said: “I can’t speak about that.”

He said Husel was providing “comfort care” to end-of-life patients.

“I can assure you there was never an attempt to euthanize anyone by Dr. Husel,” Blake said. “At no time did he ever have intend to euthanize anyone.

"He wants to clear his name at trial."

Blake also disagreed with the bond set for Husel because he said the doctor is not a flight risk and is not a threat to the community because he was stripped of his ability to practice medicine when his medical license was suspended.

Mount Carmel fired Husel on Dec. 5 and alerted authorities. Hospital officials said they received the first complaint about Husel on Oct. 25. There were two more reports of questionable care by Husel after Oct. 25, and three more patients died after the first complaint in October.

>>Read more: Former Mount Carmel doctor William Husel has complicated past

The health system initially said all of the patients who died were near death, but they later discovered that five patients might have lived if given proper treatment.

O'Brien said none of the 35 or so nurses, pharmacists and administrators placed on administrative leave as part of an internal investigation by Mount Carmel will be criminally charged. His office treated them as witnesses.

State boards that oversee pharmacists, nurses and doctors are still investigating actions of the other Mount Carmel employees.

O'Brien said he expects several employees put on paid leave by the hospital will face repercussions that likely will include having their licenses suspended or revoked.

"Mount Carmel has made and will continue to implement meaningful changes throughout our system to ensure events like these never happen again," said Ed Lamb, president and CEO of the Mount Carmel Health System. "There is nothing more important to Mount Carmel than the safety of our patients and their trust in us."

Lamb said Wednesday that O'Brien has requested the hospital make no further comments about Husel's actions or the investigation.

O’Brien said Mount Carmel and the state medical, nursing and pharmacy boards were all cooperative throughout the investigation, which was led by Columbus police detectives Anne Pennington and William Gillette.

Husel will not face the death penalty because he wasn’t charged with aggravated murder, which would have alleged the doctor planned the killings.

He still faces 19 pending wrongful-death lawsuits filed by families of patients who died. At least eight lawsuits have been settled.

>>Read more: Timeline of the William Husel case

It took police and prosecutors months to comb through medical records to try to determine what levels of fentanyl could be medically unnecessary, O’Brien said. They considered medical condition, weight and tolerance for opiates.

Investigators consulted with two primary medical experts, one from Ohio and one from out of state, but O’Brien declined to identify them.

Authorities found the appropriate dose to initially administer to patients to be 50 micrograms, O’Brien said.

In several instances, Husel would prescribe excessive doses of fentanyl shortly after telling family members that their loved one was brain-dead, according to attorneys and families who have previously spoken to The Dispatch.

The health inspection reports indicated that many of the high doses of the painkiller were accessed through the use of emergency overrides that sidestepped warnings and the pre-approval from pharmacists that is normally required.

Husel used his authority, charm and medical pedigree as a former doctor at the Cleveland Clinic to deceive or convince nurses that his decisions were sound, some current and former hospital staff members have told The Dispatch.

Families of his patients said Wednesday that they still can't comprehend why Husel practiced medicine this way. But some of them said the indictments confirm their grief.

"It gives some validity to show that what he was doing wasn't right," said Christopher Thomas, son of patient Jan Marlene Thomas. "There should've been measures in place a long time ago to prevent this from happening."

His 65-year-old mom was found unresponsive at her Far West Side home by her home health aides in 2015 and was sent to Mount Carmel West, where she died less than 24 hours later.

Jeremia Hodge, 57, known to most by her middle name Sue, was transported to Mount Carmel West with cardiopulmonary arrest on Easter Sunday 2018. The Hilltop resident was dead before the end of the night.

>>Read more: Families of Mount Carmel victims relieved after Husel arrest

Four of Hodge's five sons spoke Wednesday. The struggle of losing their mother was in their voices.

"I'm happy this is finally going on," Robert Hodge said. "I hope that justice is served."

Jeremiah Hodge, another of Sue's children, wore a shirt with a picture of his mother and father on it with the words "Who will fill their shoes" around the picture.

"It's an unanswerable question," Jeremiah said of the words on his shirt. "No one can."

Dispatch Reporters Henry Palattella and John Futty contributed to this story.

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