Former hospital worker sent up the river for spreading hepatitis

[MillCreek]

http://articles.baltimoresun.com/2013-12-02/health/bs-hs-kwiatkowski-sentenced-20131202_1_david-kwiatkowski-exeter-hospital-linwood-nelson

I have seen a couple of these cases over the years.  Usually they involve someone in anesthesia or emergency medical services who are tapping the narcotics vials and refilling them with sterile saline.  In this case, I wonder if any of the infected patients will end up dying of the disease.

[RevDisk]

You'd think the person would have at least cleaned the needles.

[Hawkmoon]

You'd think the person would have at least cleaned the needles.

What would make you think a doper might care about anyone else?

[BlueStarLizzard]

I'm not sure I understand. Is fentynal stocked in syringes rather then viels or something?

I also am not getting why the dirty needles other then to intentionally spread the diesease.

The only way I could see what he was doing as even being easier is if the fentynal comes prepackaged in syringes with attached needles. And even that doesn't make sense, because wouldn't there be a safety seal from the manufacture on each one?

[Sergeant Bob]

I'd love to sit on the jury of one of his victims "accused of murder" in this scumbag's death.

Prison time is way to good for him.

[MillCreek]

I'm not sure I understand. Is fentynal stocked in syringes rather then viels or something?

I also am not getting why the dirty needles other then to intentionally spread the diesease.

The only way I could see what he was doing as even being easier is if the fentynal comes prepackaged in syringes with attached needles. And even that doesn't make sense, because wouldn't there be a safety seal from the manufacture on each one?

Fentanyl comes both in pre-loaded single-dose syringes with fixed needles and in multi-dose vials.  The syringes generally come sealed in a wrapper and are opened from the wrapper and put on a tray to be used during a procedure.  What I bet he was doing was stealing the filled syringes, using them to inject himself, and then putting the used syringe, filled with saline, back on the procedure tray.  Once the pre-filled syringes are out of the wrapper, there is no other safety seal.  Once the syringe is refilled with saline, a clear liquid, it looks just like an unused Fentanyl syringe ready to be used, and you cannot remove and replace the needle from the syringe.  So once it is used and is put back, it goes back dirty.  He likely also contaminated the saline vials that he used to refill the syringes.  I would not be surprised if he also tapped the multi-dose vials and refilled those with saline.

I see that the perpetrator worked in cardiac cath labs, and Fentanyl is commonly used there to anesthetize patients undergoing a cardiac cath procedure. 

[Pharmacology]

I'm not sure I understand. Is fentynal stocked in syringes rather then viels or something?

I also am not getting why the dirty needles other then to intentionally spread the diesease.

The only way I could see what he was doing as even being easier is if the fentynal comes prepackaged in syringes with attached needles. And even that doesn't make sense, because wouldn't there be a safety seal from the manufacture on each one?

In my limited experience, the nurse would need access to the pharmacy, then access to the vault/locked area within the pharmacy to reach the vials.

What goes up to the floor/pyxis where nurses can get their mitts on them is the pre-filled syringes / PCA pumps.

[geronimotwo]

unless the exchange took place on the way to the patient?

when i broke my wrist last summer, they had me on a regular schedule for pain meds.  until it came to the night nurse.  it would take me a number of calls to get her to administer meds.  she would give me excuses like "we have to call the doctor", then "they're filling the script at the pharmacy", then "it's on it's way here" and would string me along for hours.  every other nurse was there before i could complain, giving me the doctor ordered shot.    i was unhappy enough about it that i made a complaint with the hospital.  now i wonder if she was using, and taking the meds herself.  at least she didn't give me hepatitis.

[Pharmacology]

unless the exchange took place on the way to the patient?

when i broke my wrist last summer, they had me on a regular schedule for pain meds.  until it came to the night nurse.  it would take me a number of calls to get her to administer meds.  she would give me excuses like "we have to call the doctor", then "they're filling the script at the pharmacy", then "it's on it's way here" and would string me along for hours.  every other nurse was there before i could complain, giving me the doctor ordered shot.    i was unhappy enough about it that i made a complaint with the hospital.  now i wonder if she was using, and taking the meds herself.  at least she didn't give me hepatitis.

Yeah, that's probably where it happened.

Pharmacy makes the med,  and then pharm techs  deliver it to the floor / med locker by the patients room.

After it's delivered to the floor there's a million ways for a nurse to yank it.

[geronimotwo]

likely had a used one in the pocket with saline loaded and just switched it out with the real syringe.

[vaskidmark]

Yeah, that's probably where it happened.

Pharmacy makes the med,  and then pharm techs  deliver it to the floor / med locker by the patients room.

After it's delivered to the floor there's a million ways for a nurse to yank it.

All the good drugs come to the patient's room in the VA Hurtspital via automated robot that needs the UPC wristband scanned to unlock the drawer.  Little chance of diversion after it leaves the pharmacy in Robby Robot's rolling safe.  Get a decent nurse that will contact a decent doctor for pain meds ahead of the protocol schedule and the robot will show up in about 30 minutes.  Denials are communicated to you in about the same time frame.

stay safe.

[Ned Hamford]

Wow. As if there needed to be more worries for someone going into a hospital. 

[BobR]

What goes up to the floor/pyxis where nurses can get their mitts on them is the pre-filled syringes / PCA pumps.

Not necessarily. I have about 10 vials in my medication dispensing system. We used to have glass ampules, but the vials are now cheaper.

bob

[brimic]

unless the exchange took place on the way to the patient?

when i broke my wrist last summer, they had me on a regular schedule for pain meds.  until it came to the night nurse.  it would take me a number of calls to get her to administer meds.  she would give me excuses like "we have to call the doctor", then "they're filling the script at the pharmacy", then "it's on it's way here" and would string me along for hours.  every other nurse was there before i could complain, giving me the doctor ordered shot.    i was unhappy enough about it that i made a complaint with the hospital.  now i wonder if she was using, and taking the meds herself.  at least she didn't give me hepatitis.

Jeez, she should have at least given you a happy ending for supplying her with drugs.