White Coat Notes

Plea deal: Hospitals failed to stop addicted worker, who infected 45 patients with hepatitis C

A plea deal with a former New Hampshire hospital employee accused of infecting patients with hepatitis C shows for the first time the extent of his drug-stealing scheme, and how little hospitals communicated with each other to stop this troubled employee from harming patients elsewhere.

David Kwiatkowski, 34, is expected to appear in federal court in Concord, N.H., Wednesday and plead guilty to diverting hospital drugs for his personal use as early as a decade ago, in return for a prison term between 30 and 40 years. Prosecutors say that the Michigan native, who ultimately worked in 19 hospitals in eight states, caused at least 45 patients—32 who were treated at Exeter Hospital in New Hampshire—to be infected with his strain of hepatitis C.

Kwiatkowski, who came off to many colleagues as an upbeat athletic guy, hid for years a particularly dangerous drug-stealing tactic: Often working in cardiac catheterization labs, he took new syringes loaded with narcotics, typically Fentanyl, and replaced them with syringes he had previously used and re-filled with dummy fluid. The replacement syringes were contaminated with traces of the potentially lethal virus that he acquired during his years of drug abuse, and these syringes were ultimately used during patient procedures.

Advertisement—Continue Reading Below

According to the plea deal, one of the patients infected by Kwiatkowski, who was at Hays Medical Center in Kansas, has since died, and a coroner concluded that hepatitis C played a role in the death. The written plea deal involves only seven of the patients from Exeter Hospital, who were allegedly infected by Kwiatkowski and have since suffered medical complications, as well as extreme mental distress for fear of infecting others. The patients were not named.

Among the new details to emerge is the revelation that Kwiatkowski’s scheme started as early as 2002 while he was being trained in Michigan, and that at least four hospitals in the Detroit and Ann Arbor area, where he grew up and received his earliest jobs, knew of his drug problems and terminated him, but clearly did not warn other nearby hospitals where he went off to work.

For instance, St. Joseph Mercy Health System terminated Kwiatkowski in 2004 after he tested positive for controlled substances, and that same year he was terminated by William Beaumont Hospital for “gross misconduct.” Two years later he got hired at the University of Michigan Hospital, and months later, he resigned while campus police questioned him about drug larcenies. He then went to work at Oakwood Annapolis Hospital, and resigned while suspended for potential drug use.

Kwiatkowski then left Michigan and began working as a temporary employee, called a traveler, through various health-care employment agencies across the country. He was hired to work at nearly 20 hospitals, despite leaving graphic evidence while on the job in Pennsylvania and Arizona that he was heavily addicted to narcotics. At UPMC Presbyterian, affiliated with the University of Pittsburgh in Pennsylvania, he was caught in possession of empty syringes bearing fentanyl labels.

Still, Kwiatkowski got jobs elsewhere and often told friends and colleagues that he had Crohn’s disease, a chronic intestinal inflammatory disorder, and sometimes needed painkillers for the disease.

Kwiatkowski ultimately came to Exeter Hospital in the spring of 2011, first as a temporary employee, then as a permanent employee. It was there he was ultimately stopped when several patients in the cardiac catheterization lab inexplicably tested positive for a specific strain of hepatitis C. After rounds of testing, including of employees, public health officials traced the source to Kwiatkowski.

The number of patients he infected nationwide may still increase as testing continues, and Kwiatkowski makes new disclosures about his illicit behavior. For instance, prosecutors say Kwiatkowski has in the past year admitted to diverting drugs at Houston Medical Center in Georgia, using the syringe-swapping method at least 30 times in that hospital. However, officials have yet to conclusively identify any infected patients there.

The plea deal effectively consolidates all the federal charges that Kwiatkowski faces. The agreement is also signed by federal prosecutors in Maryland, Kansas and Georgia.

Share