Suspect in hepatitis C outbreak portrayed as traveling addict

Case has implications in Maryland, where technician worked at four hospitals

  • Linwood Nelson, a Vietnam War veteran, was infected with hepatitis C by David Kwiatkowski during a procedure at Baltimore VA Medical Center. Kwiatkowski has been arrested for spreading the disease by using and replacing needles at a hospital where he worked in New Hampshire.
Linwood Nelson, a Vietnam War veteran, was infected with hepatitis… (Algernia Perna, The Baltimore…)
November 03, 2012|By Kevin Rector, The Baltimore Sun

When David Kwiatkowski was found slurring his words and smelling of alcohol in a Boston-area hotel room littered with prescription pills late one July night, his life as a traveling medical technician had largely unraveled already.

In his early 30s, he was living out of hotels, hopping among hospital jobs — including four in Maryland — and addicted to the powerful narcotic fentanyl, according to court and police documents. Federal investigators, meanwhile, were hot on his trail as they probed an outbreak of hepatitis C at a hospital where he had worked.

When a police officer entered the room in the Holiday Inn Hotel & Suites after responding to a call about a man "feeling dizzy," he found Kwiatkowski "unsteady on his feet," police records say. He also found a handwritten note amid the pill bottles asking the finder to call someone named Kerry to "let her know I passed away."

"Tell her I couldn't handle this stress anymore," the note read, according to the police report. "She'll know what to do."

Kwiatkowski soon landed in a federal detention center — and in the center of a national spotlight. The Michigan man, who is charged with federal drug crimes, allegedly used contaminated needles in a New Hampshire hospital — and possibly in others around the nation — triggering a hepatitis C outbreak involving dozens of patients. In Maryland, hospitals and patients such as Linwood Nelson, a man treated at a medical center where Kwiatkowski worked, are scrambling to trace infections.

The blood-borne viral infection can cause liver damage or failure, and lead to chronic health problems.

According to an affidavit written by an FBI agent and filed in federal court, Kwiatkowski routinely injected himself with drugs meant for patients during surgeries by swapping prepared syringes with similar ones he'd used before. The affidavit, from Special Agent Marcie DiFede, portrays Kwiatkowski as a drug addict and compulsive liar.

"I know that some of [his] behaviors that witnesses described observing (bloodshot eyes, excessive sweating, and foaming at the mouth) are associated with narcotics use and/or withdrawal," DiFede wrote.

Since then, the FBI investigation of Kwiatkowski's alleged role in a hepatitis C outbreak among more than 30 patients at Exeter Hospital in New Hampshire — all diagnosed with a specific strain of the disease that matches his — has ballooned into a nationwide probe.

From New York to Arizona, patient records have been examined at hospitals where Kwiatkowski worked as a contracted technician, a type of employee often hired to provide short-term assistance when regular staffers go on leave or other temporary fluctuations occur.

Four hospitals in Maryland where Kwiatkowski worked have launched their own investigations, offering free testing to patients who came in contact with him.

Kwiatkowski worked at Baltimore VA Medical Center from May to November 2008, Southern Maryland Hospital between December 2008 and February 2009, Johns Hopkins Hospital between July 2009 and January 2010, and Maryland General Hospital from January to March 2010.

About 1,800 patients at those hospitals had possible contact with Kwiatkowski, the hospitals have said. Many patients have already been tested, but the hospitals have not released any preliminary results or commented on their findings to date.

Nelson, a 65-year-old Vietnam War veteran who lives in Baltimore and is being treated for hepatitis C, believes he was infected while receiving medical treatment at the Baltimore VA Medical Center during the time Kwiatkowski worked there.

Christopher H. Mitchell, one of Nelson's attorneys, said he filed notice of his client's claim that he was infected with the U.S. Department of Veterans Affairs last week. The department has six months to respond, after which time Nelson can file a federal tort claim, the attorney said.

Hospital officials have declined to discuss the cases of any specific patients but say they are investigating links between Kwiatkowski's work there and possible hepatitis infections. An initial review found that 168 patients had contact with the technician, and medical screenings found that 117 did not require further testing. The remaining 51 patients were urged to get tested for hepatitis C.

Nelson, who has emphysema and uses an oxygen machine 16 hours a day, was the first Marylander to come forward in the investigation. He said he underwent procedures for a kidney stone removal and a lung scan in May and September 2008.

"Mentally I'm still trying to come to grips with this," Nelson said in a recent interview. "Physically I feel OK, but I guess the mental [stress] will make the physical feel kind of rough."

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