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A former hospital employee has been arrested in connection with an outbreak of Hepatitis C in New Hampshire. The suspect is accused of stealing syringes containing drugs, and after injecting himself, reusing the syringes on patients. For his part, he has told authorities he did not steal or use drugs. But officials in a massive investigation are trying to find out if patients in at least seven other states might also have been exposed. As New Hampshire Public Radio's Todd Bookman reports, thousands could need to be tested for the blood-borne virus.

TODD BOOKMAN, BYLINE: After five years of crisscrossing the country as a traveling medical technician, David Kwiatkowski landed at New Hampshire's Exeter Hospital. It was the spring of 2011. By October of that year, he was offered a full time job in the hospital's cardiac unit. It was there that federal prosecutors say the 33-year-old diverted syringes of the drug fentanyl. He would inject himself with the painkiller, and then refill syringes with a saline solution. Kwiatkowski is Hepatitis C positive, meaning those tainted needles may have spread the virus, which can damage the liver.

JOHN KACAVAS: It has resulted in where we are today, with at least 30 patients sharing that same strain of Hepatitis C.

BOOKMAN: U.S. Attorney John Kacavas is leading the investigation into the outbreak. He alleges that during the five years prior to arriving at Exeter, Kwiatkowski may have exposed patients in at least seven other states.

KACAVAS: We believe that he worked in four hospitals in Maryland. He worked in several hospitals in the state of Michigan, perhaps more than one or two hospitals in Arizona. So this has tentacles throughout the country.

BOOKMAN: Public health officials in New York, Pennsylvania, Kansas and Georgia have also confirmed his employment. In a written statement, Exeter Hospital said that Kwiatkowski was drug tested and given a background check upon arriving in New Hampshire. Medical staffing firms also do a background investigation on their temps. But those checks appear to have missed at least one major red flag.

In April, 2010, Kwiatkowski was fired from the Arizona Heart Hospital, 11 days after arriving for a temporary assignment. Monica Bowerman is their CEO.

MONICA BOWERMAN: This individual was actually found in the facilities' men's locker room, unresponsive, and he had in his possession some syringes and needles.

BOOKMAN: A drug test turned up cocaine and marijuana in his system. Bowerman, who wasn't with the hospital at the time, says management alerted the Phoenix Police Department. Kwiatkowski was fired and lost his technician's license in Arizona. But later that same month, April 2010, he was placed, by a new staffing firm, at a hospital in Philadelphia.

Doctor Leslie Aiken is a professor at University of Pennsylvania's School of Nursing. She's an expert in the field of medical staffing, and says one problem is that there's no national governing body for technicians.

LESLIE AIKEN: We don't have overall standards for med techs that are anywhere near our national standards for doctors and nurses.

BOOKMAN: Aiken says that hospitals across the country rely on temporary doctors, nurses and technicians to fill in employment gaps. Most contracts last just a few months. For their part, the hospitals like using travelers because they don't have to pay them benefits or provide much in terms of training. But this outbreak could change how hospitals screen their temps. It's already led to lawsuits against both the staffing firm and Exeter Hospital.

Kwiatkowski has been charged with tampering and fraud, and is facing 24 years in prison. According to an FBI affidavit, Kwiatkowski told authorities he had no idea he had Hepatitis C until recently. He also denied diverting any drugs. His court appointed attorney declined to comment. U.S. Attorney John Kacavas says there could be more charges brought as details from other states emerge.

KACAVAS: We are closer to the beginning of this investigation than we are to the end of it.

BOOKMAN: While the massive investigation continues, thousands of patients in New Hampshire, and around the country, continue to get tested.

For NPR News, I'm Todd Bookman in Concord, New Hampshire.

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