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Medical tech’s arrest shows flaws in system

Loopholes » Technicians aren’t as closely regulated as doctors or nurses, and there is no nationwide database.

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People involved in a 2010 incident at Arizona Heart Hospital tell a different story. Kwiatkowski was 10 days into a job assignment when a co-worker found him passed out in a bathroom stall. A stolen syringe, bearing a label for fentanyl, floated in the toilet. In the emergency room, he tested positive for both cocaine and marijuana.

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"I’m going to jail," he moaned when he regained consciousness, according to an account given to state regulators by the colleague who found him.

This time police were summoned, but the officers decided not to file charges or even write up a report after being told that Kwiatkowski had flushed the syringe. "We had no evidence. We had nothing except what they told us," said Phoenix Officer James Holmes, a police spokesman.

Hospital officials alerted Springboard, which had gotten Kwiatkowski the assignment in Arizona, and also informed the Arizona Medical Radiologic Board of Examiners, which took steps to revoke Kwiatkowski’s license. Springboard also sent a report to the American Registry of Radiologic Technologists, the organization that 37 states rely on to verify that technicians have proper credentials.

But after learning police hadn’t filed charges, the national accreditation group dropped its inquiry without ever speaking to anyone at the hospital or the state licensing board, said a spokesman, Christopher Cook.

Just days after Kwiatkowski’s firing, he landed a new job filling in for striking technicians at Temple University Hospital in Philadelphia. He faxed a handwritten note to Arizona licensing officials from a Philadelphia airport hotel saying he would surrender his license rather than fight the accusations.

If Kwiatkowski had been a doctor, that loss of his Arizona license would have jeopardized his ability to work anywhere in the U.S. But in this case, he had nothing to worry about. Like many other states, Pennsylvania doesn’t require most radiological technicians to be registered and doesn’t maintain records of disciplinary actions against them.

He soon moved on to other hospitals, including Hays Medical Center in Hays, Kan., where he worked in the heart catheterization lab and was involved in the care of 460 patients who are now undergoing testing for hepatitis C.

Linda Ficken, 70, who went to Hays to get a pacemaker two years ago, was informed last week that she has been diagnosed with hepatitis C. The Kansas health department said two other patients have been diagnosed with a strain of the virus closely related to the one Kwiatkowski carries. Further analysis is planned.

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"I was pissed," Ficken said. "And I still am. And also with the people that employed him, because he put me and my family in jeopardy, he put a lot of people in jeopardy and this is just going to continue to mushroom. Somebody fell down on the job someplace. He didn’t slip through the cracks on his own."

Hospitals and the staffing agencies that routinely help them fill jobs are supposed to share responsibility for verifying that workers have proper licensing and good reputations. But four of the states where Kwiatkowski worked over the full course of his career — New Hampshire, Georgia, Pennsylvania and Michigan — don’t even license radiology workers.

The institutions that allowed Kwiatkowski to keep working offered a variety of excuses and explanations as to how he slipped by various background checks and managed to get licensed in other states.

University of Pittsburgh Medical Center spokeswoman Gloria Kreps said that when he was accused of stealing fentanyl, officials did not contact police because they did not believe they had enough evidence. "We noticed unusual behavior, caught him with a syringe, but did not witness him in the act of committing a crime," she said.

They didn’t alert the national credentialing organization, she said, because they felt that was the responsibility of Maxim Staffing Solutions, the agency that had placed him. Officials at the staffing agency’s parent company did not return calls for comment.

Matt Price, chief executive of Advantage RN, the staffing agency that got Kwiatkowski the position in Philadelphia, said his stint in Phoenix was so short that it was easy for him to hide that he ever worked there.

And because of the need to find strike-replacement workers fast, Temple asked the company to verify only the last two jobs held by each applicant. So even though Kwiatkowski listed his Pittsburgh job on his resume, no one called the hospital for a reference.

In Kansas, which in 2010 became the last state to license Kwiatkowski, the Board of Healing Arts verified his education, national certification and other state licenses, but not his work history, said the agency’s lawyer, Kelli Stevens.

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