Still, she saw some distressing signs. She found needles in his laundry, but believed him when he said they were for cancer treatments. Federal authorities have said there was no evidence he had cancer.
It was his Crohn’s disease that he talked most about. While in New Hampshire, he got a tatoo on his arm, featuring multiple squiggly lines, which he told friends was a well-established symbol for those fighting Crohn’s.
Kwiatkowski now and then seemed physically unsteady. Some staff members alerted supervisors that he sometimes showed up at work with bloodshot eyes, or skin drenched in sweat. Sometimes he raced to the bathroom, saying he felt ill.
This past spring, Kwiatkowski talked of making changes in his life, including possibly returning to his home state of Michigan to work. On April 2, he posted a message to his Facebook page referring to attending the Detroit Tigers’ opening day, and how he “might not come back” to New Hampshire.
“Beaumont hospital Friday am wants to talk with me. I didn’t bring any dress cloths though,” he wrote.
But he would not move back to his home state. A month later, several patients in the cardiac catheterization lab at Exeter inexplicably tested positive for a specific strain of hepatitis C. After rounds of testing, public health authorities traced the source of that strain to Kwiatkowski.
Scouring his medical records, federal authorities learned he had first tested positive in June 2010, though they are not saying why he was tested then, citing the privacy of medical records.
Public health officials reviewed his work history and sent letters to thousands of patients about the need to get screened for hepatitis C.
Meanwhile, law enforcement was building its case against Kwiatkowski. In late June, a few days after police had interviewed his parents, Kwiatkowski abruptly fled his apartment in New Hampshire. For many days, friends and family could not locate him.
In mid-July, a family member called Exeter police to say they worried that Kwiatkowski was suicidal and had a gun. Officers in Marlborough, Mass., located him at a Holiday Inn close to midnight. They found no weapons but an array of prescription bottles.
After he was taken to a hospital, police uncovered an apparent suicide note, with a message to be conveyed to his close friend in New Hampshire. It read in part, “. . . let her know I passed away. Tell her I couldn’t handle this stress anymore.”
Kwiatkowski faces up to 20 years in prison after being arraigned on two charges: obtaining a controlled substance through fraud and tampering with a consumer product. He is expected to be indicted soon on a far broader range of charges based on new evidence — and patient infections — that have emerged since the summer. His lawyer, Bjorn Lange, has declined comment other than to say “the case is tragic.”
Though Kwiatkowski’s alleged crimes are remarkable for their national reach, he was not the first addicted technician carrying the hepatitis C virus to think of this syringe-swapping scheme. Three years ago, Kristen Parker, 26, was arrested for doing just that at the Rose Medical Center in Denver, infecting 18 patients. In May 2011, Steven Beumel, 48, was arrested in a similar scheme that infected at least two patients while he was at Mayo Clinic in Jacksonville, Fla.
Some lawmakers have called for tighter hospital security over narcotics, as well as a new national data bank, similar to one now available for troubled doctors and nurses, that would help hospitals identify health care professionals who have disciplinary actions against them in other states. Also, some legal specialists say that new laws have to be passed to protect hospitals from litigation if they give candid — and negative — references. The institutions with personnel policies designed to avoid legal exposure are now swamped with lawsuits from furious patients and their families.
With each passing month, more hepatitis C cases are linked to Kwiatkowski. Though all patients have yet to be fully screened, 32 have tested positive in New Hampshire, six in Kansas, and one in Maryland, all infected with his strain of the virus. Some additional patients have tested positive, but are awaiting results indicating whether their strain matches Kwiatkowski’s.
A 65-year-old former Army sergeant who fought in Vietnam is believed to be among the first infected by Kwiatkowski. Linwood Nelson said he was stunned and angered to learn that he acquired a liver-damaging virus after going to the Baltimore Veterans Affairs Medical Center in 2008 for two procedures, one involving a kidney stone, another an imaging test for his lungs.Continued...