CONCORD, N.H. — David M. Kwiatkowski’s hospital colleagues often thought of him as an upbeat, athletic co-worker. But for more than a decade, he hid a dangerous drug-stealing tactic that spanned eight states and infected dozens with Hepatitis C, court documents say.
According to a plea agreement filed Tuesday, Kwiatkowski hopped from job to job as a traveling technician, often working in cardiac catheterization labs where he routinely stole syringes loaded with narcotics. He replaced them with syringes he had already used and refilled with saline solution — and that he had contaminated with the potentially lethal virus he acquired during years of drug abuse.
The agreement reveals the breadth of Kwiatkowski’s elaborate scheme and how hospitals failed to communicate with one another to stop him from infecting patients elsewhere; when caught or suspected of drug abuse, he simply found employment at a new hospital, the plea agreement said.
Kwiatkowski, 34, is expected to appear in federal court Wednesday to plead guilty to diverting hospital drugs — typically the narcotic Fentanyl — for his personal use. Prosecutors say that the Michigan native, who ultimately worked in 19 hospitals in eight states, caused at least 45 patients, mostly in New Hampshire, to be infected with his strain of Hepatitis C. He will go to prison for 30 to 40 years, according to the plea agreement.
A spokeswoman for the US attorney’s office declined to comment, saying the office would speak after Kwiatkowski’s court hearing. Lawyers for Kwiatkowski did not respond to a request for comment.
According to the plea agreement, one of the patients infected by Kwiatkowski, at Hays Medical Center in Kansas, has since died and a coroner concluded that Hepatitis C played a role in the death. The plea agreement also identifies seven of the 32 patients from Exeter Hospital, though not by name, who were infected by Kwiatkowski and have since suffered medical complications, as well as mental distress for fear of infecting others.
Kwiatkowski admitted to swapping out syringes an estimated 50 times while working in Exeter, at least 20 times in Kansas and approximately 30 times in Georgia, according to the plea agreement.
The revelation of Kwiatkowski’s drug diversion prompted massive public health investigations, with public health authorities ultimately recommending that more than 11,000 people be tested for Hepatitis C.
Among the details to emerge was the revelation that Kwiatkowski’s scheme started in 2002 while he was doing his training in Michigan, and how many 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 did not warn other nearby hospitals where he sought work.
For instance, St. Joseph Mercy Health System terminated Kwiatkowski in 2004 after he tested positive for controlled substances. That same year, William Beaumont Hospital terminated him for “gross misconduct.” Two years later the University of Michigan Hospital hired him, and months later, he resigned while campus police questioned him about drug larcenies. He then found work at Oakwood Annapolis Hospital and resigned while suspended for potential drug use.
Kwiatkowski fled Michigan and began working as a temporary “traveler” employee through various health care agencies across the country. He ultimately maneuvered through 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, he was caught in possession of empty syringes bearing fentanyl labels after a co-worker saw him stealing the drugs.
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 came to Exeter Hospital in spring 2011, first as a temporary employee. It was there his drug diversion was halted 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.
According to the plea agreement, Kwiatkowski told investigators, “I’m going to kill a lot of people out of this.” The agent responded, “I’m sorry?” To which Kwiatkowski repeated, “I’m killing a lot of people.”
The number of patients he infected nationwide may 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 an infected victim there.
The plea deal effectively consolidates all the federal charges that Kwiatkowski faces. The agreement is also signed by prosecutors in Maryland, Kansas, and Georgia.