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Editorial: Preventing another hospital tragedy

One of the most chilling episodes in the whole awful saga of the traveling hospital worker who pleaded guilty this week to a horrific drug-stealing scheme came outside the federal courthouse in Concord. There, one of David Kwiatkowski’s victims told reporters that he remembered the technician from his stay at Exeter Hospital – and remembered that something was distinctly wrong with him.

The man described Kwiatkowski as sweaty and his eyes red and glassy. He figured he was either drunk or high on marijuana. That alone would have been cause for alarm – from patients and coworkers alike. Incredibly the truth was far worse.

Kwiatkowski moved regularly from job to job, often working in cardiac catheterization labs. As he has now admitted, he regularly stole syringes full of narcotics and replaced them with syringes he had already used – refilled with saline solution. That, too, would have been cause enough for alarm, for Kwiatkowski’s patients were denied the painkillers they needed. But that wasn’t the end of the story either.

Those old syringes were contaminated with hepatitis C, which Kwiatkowski had acquired during years of drug abuse. As a result, nearly four dozen patients in New Hampshire, Kansas and Maryland were infected with a potentially fatal virus.

Kwiatkowski will spend between 30 and 40 years behind bars, a sentence federal prosecutor John Kacavas described as the best deal available under the law. “I can’t give (the victims) their health back. I can’t give them compensation. . . . What we can give them is some measure of justice within the criminal justice system. And that is a term of years of incarceration. I understand their frustration and I understand victims who want nothing less than a life sentence or the death penalty. I get that. But our system does not allow for that.”

There may be one measure of hope – not for these patients, alas, but for the safety of future patients.

Pending at the State House is legislation intended to prevent similar drug-addicted workers from carrying such schemes from one unwitting hospital to another. The bill would create a state board to oversee the licenses of medical technicians and a registry of the status of those licenses. If a hospital technician’s license was rescinded here, it would be public knowledge, checkable by any future employer. The information would be available on a national database of health-care worker licenses.

The rules for medical technicians vary from state to state. Some require certain subsets to require licenses; New Hampshire is one of many states that don’t require any licensing.

Clearly, licensing and registration here is an important first step. Despite the fashionable political talk about burdensome government regulation, this is an area where less is not better. Of course, a New Hampshire registry would raise red flags about only those medical technicians who had gotten into trouble in New Hampshire. Advocates here hope that it might eventually lead to a national registry, so that abusers like Kwiatkowski couldn’t easily slip from one state to another.

A national registry for health care workers is a worthy cause for members of New Hampshire’s congressional delegation. New Hampshire brought this tragic problem to the nation’s attention. The state should now lead the way in helping to prevent it in the future.

Good final sentence in TCB's comment: Lastly there was a system in place at the facility involved. I am told the problem was reported, more than once, and it was not acted upon. I believe if responsible people had acted upon their own rules the scope of this tragedy would not be as large.

Nobody wants to see patients hurt or uncared for any reason but especially because of some drug addicts. I can tell you after many decades in healthcare that there are already state laws rules and regulations prohibiting substance diversion. Hospitals have books of rules and regulations on the same topic healthcare workers are even encouraged to spy on one another looking for the possibility of substance abuse. In this deal to do good there is there is and has been real collateral damage. In some care healthcare institutions it has fostered a “guilty until proven innocent atmosphere” most healthcare workers have no real objection to routine random drug testing-if it’s done right. By that I mean with too many of these programs special groups get accepted for example administration and way too commonly-physicians. I am okay with routine random drug testing for healthcare-but it needs to be everybody underneath the roof. It’s not common but there have also been false positive drug tests. Because of the guilty until proven innocent atmosphere the mere allegation can be more than just can inconvenience it can effectively be a career ender. I support routine random drug testing for protection of patients and all concerned but there also needs to be a safety net for the rare but real false positives that impact an innocent career. I have also seen the legal papers involved in the case where hospital administration actually squirted narcotic into a drug specimen to get rid of somebody. Detailed testing revealed that it was the raw drug it had never been in the human body and thus that particular employee will never have to work again their set for life. But it illustrates the point that this is in perfect system and in an effort to protect patients we need to be mindful of the potential for collateral damage. So I am okay with routine random drug testing of healthcare staff if:1) it’s done right, 2) includes everybody under the roof including administrative and upper-level staff and 3) safeguards are put in place for the potential of innocent careers impacted by false positives.. If a facility says we don’t need to do this because the system is foolproof-their reluctance to put these minor safety measures in place is proof positive it’s NOT foolproof. Lastly there was a system in place at the facility involved. I am told the problem was reported, more than once, and it was not acted upon. I believe if responsible people had acted upon their own rules the scope of this tragedy would not be as large.

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