A traveling medical technician who spread hepatitis C to dozens of patients getting treatment in hospitals in Maryland and around the country was sentenced Monday to 39 years in federal prison.
David Kwiatkowski, 34, who did contract work at four hospitals in Maryland between 2008 and 2010, had pleaded guilty to placing dirty, saline-filled syringes into circulation at multiple hospitals after using them to inject himself with painkillers.
U.S. District Judge Joseph Laplante in New Hampshire handed down the sentence after hearing from several victims and from Kwiatkowski. About 45 people have been confirmed infected, prosecutors said.
"The whole reason I got into health care was to help people, and my addiction took that away," Kwiatkowski told the court. "I cannot begin to tell you how much it hurts me. ... I don't blame the families for hating me. I hate myself."
The case prompted hospitals to test hundreds of patients as potential victims and led to efforts to tighten regulation of contract hospital workers. Kwiatkowski knew he was infected with hepatitis C at the time and misled officials in various states about past alcohol and drug problems.
Kwiatkowski and his attorneys had asked for a sentence of 30 years in prison. The prosecution asked for a 40-year sentence. He pleaded guilty to obtaining controlled substances by fraud and tampering with a consumer product.
Laplante said the defendant's conduct went beyond recklessness, verging on "cruelty" or "hostility."
Kwiatkowski's actions were first investigated by the FBI after an outbreak of hepatitis C among patients at a New Hampshire hospital where he worked. Soon after, hospitals from Arizona to New York scrambled to identify patients who might have been placed in danger.
Several patients in Maryland, including at Johns Hopkins Hospital and the Baltimore VA Medical Center, were eventually identified as having likely contracted the disease from Kwiatkowski, officials said.
One of them, Linwood Nelson, was at Kwiatkowski's sentencing in Concord, N.H., on Monday with his son, to tell the court what contracting hepatitis C at the Baltimore VA Medical Center meant for his life.
"I always thought that when I saw medical scrubs and medical ID, a hospital ID, that they were there to comfort me when I was sick, but [Kwiatkowski] fooled me," the 66-year-old Vietnam War veteran and Baltimore native said in an interview shortly after walking out of the courtroom.
"I served in Vietnam, served my country, gave back ... only to be injured by friendly fire, and he was the friendly fire," Nelson said.
Rod J. Rosenstein, the U.S. attorney for Maryland, had said Kwiatkowski's actions in Maryland would be considered in his sentencing in New Hampshire, where he was accused of stealing syringes full of the painkiller fentanyl at Exeter Hospital in 2012, according to court documents.
On Monday, Rosenstein said the 39-year sentence likely brings Kwiatkowski's court appearances to an end.
"In theory, he could still be prosecuted on state charges, but it's unlikely because this is going to guarantee that he's going to spend nearly the rest of his life, if not the rest of his life, in federal prison," Rosenstein said.
Rosenstein said he hopes Kwiatkowski's victims see the sentence as an assurance that Kwiatkowski won't harm any more patients.
"The harm that he did to the victims can't be compensated, no matter what sentence he receives, but I think it did offer them some reassurances," he said.
After revelations of Kwiatkowski's actions, Maryland officials launched an investigation, which determined a systemwide breakdown led to Kwiatkowski's ability to inject himself with stolen narcotics in this state. Hospitals here offered free hepatitis C testing to more than 1,750 patients.
Nationally, the U.S. Centers for Disease Control and Prevention recommended about 12,000 people be tested for the potentially deadly virus, according to court documents.
Kwiatkowski, a Michigan native, worked at the 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.
Dr. Lucy Wilson, chief of the state health department's epidemiology center who helped investigate Kwiatkowski's actions in Maryland, said there were "missed opportunities that could have stopped" him from diverting the drugs.
The investigation found problems with how staffing agencies screen applicants and a culture that makes staff wary of reporting peers.
At one Maryland hospital, staff suspected Kwiatkowski of stealing fentanyl from a cardiac catheter lab, but a manager later gave Kwiatkowski a satisfactory review to a staffing agency inquiring about his time there.
Government regulators also relied on applicants to self-report criminal history instead of verifying worker backgrounds, the study found. Kwiatkowski had failed to disclose a DWI arrest and other disciplinary actions, according to the report.
At the time he was working in Maryland, he had been caught with fentanyl syringes at work at the University of Pittsburgh Medical Center. But he didn't tell Maryland officials about that or a 2005 DUI arrest, and a background check wasn't completed.
"We found there wasn't one single overarching issue, but really it was instead multiple systemwide vulnerabilities in multiple arenas," Wilson said at the time.
According to Linwood Nelson Jr., who traveled with his father to Concord and provided an impact statement of his own, Kwiatkowski's sentencing "doesn't repair anything."
"Hopefully, it's a hindrance and is something that rings out to all the other people who are doing it, if there are any," he said.
His father is now afraid of close contact with loved ones, including his 19-month-old granddaughter.
"He's hesitant to show affection to family members because he's worried that it may end up affecting a family member inadvertently," the younger Nelson said.
Hepatitis C, which attacks the liver, is transmitted by blood, most commonly through transfusions or intravenous drug use.
The older Nelson, who underwent a kidney stone removal and lung scan at Baltimore VA Medical Center in 2008, told the court that his doctors have said his hepatitis C will eventually prevent his body from producing the enzymes that clot blood.
Two weeks ago, he said, he had to have a tooth removed and instead decided to have all of his teeth taken out at once, to pre-empt future complications because hepatitis C could reduce his ability to heal quickly from minor surgeries.
"Today gave some closure, to know that he cannot infect another victim, whether it be a veteran or otherwise. He will never have that opportunity with 39 years incarcerated," Nelson said.
"Like I told him, if I'm the veteran that he got to, and he isn't able to infect another one, then I'll carry it."
Reuters contributed to this article.