Arrest made in Exeter hepatitis C outbreakBy DOUG ALDEN
New Hampshire Union Leader
July 19. 2012 2:51PM
David Matthew Kwiatkowski, 32, is charged with obtaining controlled substances by fraud and tampering with a consumer product, U.S. Attorney John Kacavas said Thursday, adding the investigation is far from over.
'There's no way to put an end point or horizon on it,' Kacavas said during a news conference at the Concord Federal Building.
Kacavas said investigators believe Kwiatkowski, who has had the virus since at least June 2010, diverted powerful anesthetics intended for patients and injected himself with the drugs. According to federal court documents filed Thursday, Kwiatkowski exposed patients to the virus through tainted syringes.
State health officials have identified 31 people infected with the same strain of the virus linked to Exeter Hospital's cardiac catheterization laboratory, where Kwiatkowski worked as a technician from April 2011 until this May.
Hepatitis C is a potentially deadly virus that causes damage to the liver.
'There are certainly other cases around the country where diversion has occurred and that diversion resulted in epidemiological outbreaks such as this, but this one has potential for very far-reaching implications,' Kacavas said.
Investigators are looking into places Kwiatkowski worked before Exeter, where he started as a contract employee working for a company that supplied temporary health care workers to facilities across the country, a common practice in the industry.
Kacavas declined to name the company during the news conference. Later Thursday, he refused to confirm whether the company was Triage Staffing Inc.
Boston malpractice attorney Domenic Paolini said he plans to file a lawsuit alleging negligence involving Kwiatkowski's employment for the company.
In a July 9 letter to Triage Staffing executive Brad McClatchey, Paolini wrote: '...it appears these patients are victims of a drug diversion scheme perpetrated by David Kwiatkowski, a traveling technician placed at Exeter Hospital by Triage Staffing.'
A message left by the New Hampshire Union Leader at Triage headquarters in Omaha, Neb., was not returned Thursday.
Manchester attorney Ralph Suozzo acknowledged to the Union Leader that he had been hired by Triage, but declined to comment further.
Paolini, who is representing a group of patients, said Thursday night that he planned to file a lawsuit either Friday or early next week in federal court in Omaha.
Paolini has been working with Elenore Casey Crane of Nashua, a former state representative who recently formed a nonprofit advocacy group called 'The Patients Speak.' Crane said the group has been receiving calls about the Exeter case and is pushing for legislation to prevent a similar outbreak in the future.
Kacavas said Kwiatkowski is currently in a Massachusetts hospital and will be taken into federal custody when he is released.
Contacting other states
Dr. Jose Montero, the state's public health director, held a news conference later Thursday and called the arrest 'an important development,' but said he could not comment on the criminal investigation. He said his own division's public health investigation will continue.
'We are not done,' Montero said.
Since 2007, Kwiatkowski worked as a traveling technician at catheterization labs in at least six states, according to an affidavit filed in U.S. District Court in Concord. Montero said New Hampshire health officials have been in touch with their counterparts in other states where Kwiatkowski worked in health care facilities, and with the Centers for Disease Control and Prevention.
'We are relating to them our experience and our approach, and they are using it as a starting point to make a determination of how they will proceed,' he said.
In a news release, Exeter Hospital officials revealed that Kwiatkowski began working at the hospital in April 2011 as a temporary employee, also known as a 'traveler.'
He was hired as a full-time cardiovascular technician in the cardiac catheterization lab that October and worked there until he was placed on leave at the onset of the investigation in May. He was later terminated, the statement said.
The release called the indictment 'a critical milestone in this incredibly difficult and painful situation.' And it noted the hospital provided investigators with 'specific information about Kwiatkowski's suspicious actions.'
Kevin Callahan, president and CEO of Exeter Hospital, said: 'It is deeply disturbing that the alleged callous acts of one individual can have such an impact on so many innocent lives.'
36 still sought
The state public health lab and Exeter Hospital have identified 1,292 people who were treated at the cardiac catheterization lab since Oct. 1, 2011, who needed to be tested for hepatitis C, according to Montero. To date, the state has received 1,119 blood specimens from those patients; investigators are still trying to contact 36 individuals who need to be tested, he said.
Montero said 121 of those identified as undergoing procedures at the cardiac cath lab in the targeted time frame have died. Investigators have looked into those cases to see if hepatitis C or a related liver disease 'was a contributing factor to their demise, and so far we have not been able to prove that,' he said.
The ongoing testing also identified 14 other individuals infected with hepatitis C, Montero said, but those patients have a different strain of the virus than Kwiatkowski's. The CDC has been doing additional testing on blood samples from New Hampshire patients, but that has not turned up any additional cases connected to the Exeter outbreak, Montero said.
'There is no secondary cluster of Hepatitis C that we are aware of,' he said.
On his Facebook page, Kwiatkowski said little about his job at Exeter Hospital, only updating his page in February stating that the hospital was his employer.
In other postings, he expressed concerns about the health of his dog, diagnosed with diabetes and renal disease last August. At one point he posted about taking antibiotics for his 'crohns flare.'
In September 2011, Kwiatkowski talked about having a tumor removed from his leg and wrote that 'it's been two weeks of hell.'
On one night in February, he posted that he couldn't sleep because his 'body hurts.'
In early April - about a month and a half before the outbreak was revealed publicly - Kwiatkowski hinted on his Facebook page that he might be looking for work elsewhere. He said a hospital in Michigan - his home state - wanted to talk to him.
His last post was on April 4 when he wrote, 'Going to the D. I'm out of this B.' In a follow-up comment, he wrote, 'It's on!! We doing the casino?? Need to roll the dice.'
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Doug Alden may be reached at firstname.lastname@example.org. Union Leader Correspondent Jason Schreiber contributed to this report.