The Hospital Tech Who Stole Needles
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Last year, the health care world was rocked by the arrest of David Kwiatkowski, a Michigan native and itinerant cardiac technologist who traveled the country plying his trade. He was also a fentanyl addict. To feed his addiction, he stole IV drugs from operating rooms in 19 hospitals across the country, possibly infecting hundreds of patients with Hepatitis C. As experts rewrite the rules to try and prevent a repeat of this devastating outbreak, they may wind up turning for guidance to the demographic that arguably knows the topic best: recovering drug addicts.
Thirty-three years old, with close-cropped hair and a tidy goatee, Kwiatkowski pleaded not guilty last month in a federal indictment on seven counts of stealing drugs, and seven more of tampering with a consumer product—namely fentanyl. His case is complicated, crossing state lines, involving potentially hundreds of victims, witnesses and hospital administrators. From 2008 to 2012, Kwiatkowski worked for hospitals in seven states across the country (in Arizona he was reportedly discovered passed out in the men's room with a needle mark in his elbow and a fentanyl syringe in the toilet next to him).
Kwiatkowski was due to face trial next month, but a judge postponed it until October 2013 to give prosecutors time to comb through the wreckage. John P. Kacavas, U.S. Attorney for the New Hampshire district, has said Kwiatkowski is facing up to 98 years in prison and $3.5 million in fines. Kwiatkowski is suspected of infecting at least 32 patients with Hepatitis C at the Exeter, N.H. hospital where he worked from April 2011 to May 2012.
This case is not just a case of one dope fiend’s egregious drug theft and the blind eye agency workers turned to it. It’s a stunning example of the unanticipated ways addiction can threaten public health.
And that’s just the New Hampshire patients. Eighteen other hospitals have sent letters to thousands of patients advising them to get tested for Hepatitis C, a major risk in injection drug-use and an illness the Centers for Disease Control (CDC) says kills more Americans each year than HIV. Now the civil suits are starting to roll in against the hospitals and the staffing agency who hired Kwiatkowski to them, citing their failure to protect patients from Kwiatkowski’s addiction.
“He was observed at UPMC stealing drugs,” says Brendan Lupetin, a Pittsburgh attorney who filed the first class-action lawsuit against the University of Pittsburgh Medical Center and Kwiatkowski’s staffing agency. AS FAR BACK AS 2008, Kwiatkowski worked as a radiological technician at UPMC-Presbyterian, in the heart of the UPMC complex. The suit states that in May of that year another employee saw Kwiatkowski lift his shirt in an operating room and shove a syringe of fentanyl down his pants. Later it was found that Kwiatkowski had swapped out the fentanyl syringe for a syringe filled with saline—a syringe he’d previously used on himself. The suit says UPMC supervisors found three empty fentanyl syringes in his clothes and an empty morphine syringe in his locker.
UPMC fired Kwiatkowski, Lupetin said, but they didn’t file the required Form 106 to alert the DEA of Kwiatkowski’s conduct, which Lupetin says would have alerted drug enforcement officials of Kwiatkowski's conduct and possibly have prevented him from moving on to other jobs with such ease. UPMC has said they thought the staffing agency would file the form, since he was officially being paid by them. UPMC spokespeople did not respond to The Fix’s request for comment.
The Pittsburgh class-action suits seek damages for the more than 2,000 patients who have been advised to get Hep C testing, citing possible medical costs, lost work-time and pain and suffering. Lupetin says attorneys in the states where Kwiatkowski worked—after UPMC fired him, he got jobs at facilities including Baltimore Veterans Affairs Medical Center, Johns Hopkins Hospital, Maryland General Hospital, Arizona Heart Hospital in Phoenix, Temple University Hospital in Philadelphia, and Hays Medical Center in Hays, Kansas, where six patients have tested positive with his strain of hep C—will doubtless be filing similar suits.
The Kwiatkowski case is not just a case of one dope fiend’s egregious drug theft and the blind eye facilities and agency workers turned to it. It’s a stunning example of the unanticipated ways addiction can threaten public health, and healthcare facilities and policymakers need to begin thinking of new ways to protect society from the consequences of addiction.
“This case highlights how public-health agencies have to respond to the cracks in the system,” says David Smith, M.D., founder of the legendary Haight-Ashbury Free Clinic in San Francisco. Smith, a godfather of American addiction medicine, has been working for 50 years in an epicenter of injection-drug use and has spent a great deal of his career trying to protect people with addiction and the general public from infection resulting from IV drug use. Smith has seen a lot of hep C. Yes, 70 to 80 percent of cases can be curable, “but it’s not simple,” he says. “It’s not like having an infection in your throat, you give them pills and it goes away. These people are going to have problems for the rest of their lives.”
Unfortunately, Smith noted, “usually what it takes to change the system is a crisis.”