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Three health care staffing firms face reviews after hepatitis outbreak

Three health care staffing agencies are facing scrutiny by the nation’s largest health care accreditation organization, because they employed a medical technician who was accused last month of infecting at least 30 New Hampshire hospital patients with hepatitis C through tainted needles.

“We’re in the process of reviewing them,” said Dr. Ana McKee, chief medical officer of The Joint Commission, a nonprofit group best known for accrediting hospitals.

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She would not go into details, but confirmed the commission’s examination of the three staffing companies ­began after it learned they employed David Kwiatkowski, a 33-year-old medical technician at the center of one of the most disturbing cases of hospital misconduct. The three agencies are certified by the commission, which began setting standards for health-related employ­ment agencies eight years ago.

These personnel firms help hospitals, nursing homes, and other health providers fill gaps in staffing, for everything from technicians to nurses to doctors, and their numbers have grown rapidly, according to industry executives. The commission now certifies more than 700, said Michele Sacco, ­executive director of its health care staffing programs.

Kwiatkowski is accused of feeding his drug addiction by stealing injectable painkillers at Exeter Hospital and leaving ­infected syringes — refilled with saline solution to avoid ­detection — to be reused on ­patients. Some 30 patients who underwent heart procedures are believed to have been infected by Kwiatkowski, and thousands more people are scheduled to be tested this month. He is in federal custody in New Hampshire.

Because Kwiatkowski worked in at least eight states over the past five years as a “traveler” for staffing agencies, patients nationwide are also ­being tested for hepatitis C. The agencies identified so far by government and hospital officials as having hired Kwiatkowski — and placed him in their client hospitals — are Maxim Staffing Solutions of ­Columbia, Md., SpringBoard Healthcare Staffing of Phoenix, and Triage Staffing of Omaha, Neb.

Sixteen hospitals, stretching from New England to Georgia to Arizona to Michigan, have been identified so far as possibly having used Kwiatkowski as a temporary worker.

Kwiatkowski’s ability to move from hospital to hospital over the past five years, even when two hospitals where he worked, in Pittsburgh and Phoenix, detected irregular behavior, has triggered calls for a national registry to alert hospitals of problematic health care workers.

Barbara Yeninas, spokeswoman for SpringBoard, said Kwiatkowski had two short stints with her agency at two different hospitals in Arizona in 2009 and 2010, and the last one ended with him being fired for “exhibiting inappropriate” ­behavior.

She declined to elaborate on why he was let go, citing confidentiality, though government investigators, based on interviews with Kwiatkowski’s past employers, have said he had been associated with illicit drug use.

Yeninas said her agency ­notified the proper regulatory authorities in Arizona about his behavior, but that information, she said, appears never to have left the state.

Maxim and Triage declined to provide detailed information about Kwiatkowski’s work history with them, other than ­acknowledging that they had hired him for hospital assignments.

McKee of The Joint Commission said its endorsements of staffing agencies are generally good for two years, provided they maintain proper standards.

Those standards, she said, include verifying workers’ credentials and training, as well as making sure that personal references and resume information are independently verified. McKee said the commission does not have explicit requirements around drug testing, but requires that its certified agencies make sure its workers comply with drug-testing rules mandated by the hospital where they are placed.

She added that when the commission accredits hospitals, these institutions are required to conduct their own independent review of any worker who enters their hospital and not ­rely on the vetting process of an employment agency.

Commission officials said that staffing agencies seek certification as a sign of their legitimacy and that the cost is about $6,000. The officials said they began certifying personnel agencies largely at the request of firms in the field who “wanted to raise the bar” to establish standards in this growing ­industry.

Meanwhile, the New Hampshire Department of Health and Human Services, which had postponed its expanded hepatitis C testing originally slated for late last month, ­announced Friday that it will begin this month screening some 3,000 patients who were treated in Exeter Hospital’s main operating rooms and the intensive care unit from April 1, 2011, to May 25, 2012.

Patricia Wen can be reached at wen@globe.com.
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