CONCORD, N.H. (AP/ABC7) - A federal prosecutor said Tuesday he expects to bring more charges against a traveling medical technician accused of infecting 30 patients with hepatitis C in New Hampshire, and health officials said they are casting a wider net as they look for more victims.
Kwiatkoski worked at four Maryland hospitals from 2008 to 2010: including Baltimore Veterans Affairs Medical Center, Johns Hopkins and Maryland General, as well as Southern Maryland Hopital, where he was assigned to the cardiac unit.
In his first court appearance on two drug charges, David Kwiatkowski briefly answered a judge's questions, agreeing that there is enough evidence to keep him incarcerated while the case goes to a grand jury.
Afterward, U.S. Attorney John Kacavas said more charges are likely, possibly one for each infected patient.
Southern Maryland Hospital is scrambling to get in touch with patients who might have had contact with Kwiatkowski.
"He only worked in our cath lab and our vascular lab and we have looked at every patient who went there during that time period," says Dr. Andy Sumner, chief medical officer at Southern Maryland Hospital.
He only worked there for three months, but the hospital is sending letters to 116 former patients who potentially came into contact with Kwiatkowski.
"We want to err on the side of caution to go ahead and test all of the people who may have been exposed here," Sumner says.
Kwiatkowski, who was charged last week with fraudulently obtaining drugs and tampering with a consumer product, is accused of stealing anesthetic drugs from the cardiac catheterization lab at Exeter Hospital where he worked, injecting himself and contaminating syringes that were later used on patients.
Thirty have been diagnosed with the same strain of hepatitis C that Kwiatkowski carries, and more cases are possible as the state expands it testing.
Previously, only patients who had been treated in the cardiac lab were asked to get tested, but testing is now recommended for anyone who had surgery at Exeter Hospital or was admitted to its intensive care unit from April 1, 2011, to May 25, 2012, the timeframe of Kwiatkowski's employment.
According to the hospital, Kwiatkowski occasionally moved patients to operating rooms or the ICU, but he wasn't involved with procedures or patient care.
"As health care providers, our focus is first and foremost on our patients' care and safety," said Nancy Baese, president of the hospital's medical staff. "We would rather that thousands of our patients be tested by the state even if they all turn up negative than to miss one patient who might have been infected by this alleged criminal."
The new recommendation covers about 6,000 people, some of whom might have been covered in the previous testing targeting just under 1,300 people, said state public health director Dr. Jose Montero. The testing recommendation doesn't include patients of the hospital's ambulatory surgical center.
Kwiatkowski, who grew up in Michigan, worked as a traveler sent by staffing agencies to hospitals around the country, usually for temporary jobs. Federal prosecutors initially said he had worked in at least six states since 2007; Kacavas increased that number to eight on Tuesday.
Although authorities haven't publicly identified the other states, health officials in Michigan, Maryland, Kansas and New York have confirmed his employment.
Former co-workers in other states told investigators that Kwiatkowski was known for telling false stories, including saying that he had cancer.
According to court documents, he was fired for falsifying his time sheets at one hospital, accused of stealing an anesthetic drug from a hospital operating room in 2008 and aroused significant suspicion in Exeter, where co-workers said he sometimes looked like he was "on something."
Kwiatkowski told investigators he did not steal drugs, is "not a shooter" and is scared of needles, according to court documents. His court-appointed lawyer declined to comment Tuesday.
In a statement Tuesday, Exeter Hospital said it was sad that those who reportedly noticed cases of drug diversion apparently failed to report them to law enforcement.
"This inaction allegedly resulted in Kwiatkowski being able to secure employment in other hospitals around the country, including Exeter Hospital, resulting in this hepatitis C outbreak that has touched thousands of individuals across the New Hampshire seacoast and beyond."
Montero said the state will be sending letters to affected patients this week inviting them to a public forum Thursday night at Exeter High School.
Testing clinics will be held Saturday, Sunday, Monday and Tuesday at the school where officials will be using a rapid-response blood test that will give results in 20 minutes rather than the customary several days or weeks.
Those who test positive will need additional testing, however, Montero said.