CONCORD, N.H. -- Prosecutors say a traveling hospital technician who infected patients with hepatitis C through tainted syringes created a "national public health crisis" and should spend 40 years in prison, but defense attorneys argue he should get 30 years, in part because his addiction clouded his judgment.
David Kwiatkowski, 34, who pleaded guilty in August to 16 federal drug charges, has admitted stealing painkiller syringes from hospitals where he worked and replacing them with saline-filled syringes tainted with his blood.
He has a sentencing hearing on Monday.
Since his arrest last year, 45 people in three states have been diagnosed with the same strain of hepatitis C he carries, including a Kansas man who has since died. Authorities say hepatitis C, a blood-borne virus that can cause liver disease and chronic health problems, contributed to the death.
A total of 32 patients were infected in New Hampshire, seven in Maryland and six in Kansas. Mr. Kwiatkowski also worked in Michigan, New York, Arizona, Georgia and Pennsylvania.
One of the places Mr. Kwiatkowski worked was UPMC Presbyterian, but the hospital system has said he did not infect anyone there. In August, a spokeswoman for UPMC said, "Based on testing of patients [at Presbyterian] who had positive results followed by genotyping, none had the same strain of hep C as Kwiatkowski, which means that any patient who tested positive did not get it from any exposure to Kwiatkowski."
Ahead of Mr. Kwiatkowski's sentencing hearing Monday, lawyers on both sides filed documents this week outlining their recommendations. U.S. Attorney John Kacavas said a 40-year sentence is appropriate because Mr. Kwiatkowski put a significant number of people at risk -- testing was recommended for more than 12,000 people -- and caused substantial physical and emotional damage to a large number of victims.
"The defendant was behaving in a heinous and cruel fashion merely by depriving ill patients of pain relief," Mr. Kacavas wrote. "However, his decision to refill syringes that he had used, knowing that he was infected with hepatitis C, and 'swapping' them so that tainted saline would be injected into patients' bloodstreams is unusually heinous and cruel behavior."
The prosecutor noted that Mr. Kwiatkowski's victims already were vulnerable and medically compromised, and most are expected to suffer lifelong medical problems. Mr. Kwiatkowski's lawyers also acknowledged that suffering in making their recommendation, summarizing several letters victims have sent to the court.
One woman said she had received a small cut and was afraid to console her toddler grandson when he fell. Another woman who was being treated for her third heart attack when she was infected said she is in danger of losing her job because she has missed work due to fatigue and nausea, and because of liver damage, can't take medication that would protect her from additional heart problems.
"Kwiatkowski's reckless conduct has forced vulnerable, unsuspecting and innocent people to endure immeasurable suffering and anguish," wrote his attorneys Jonathan Saxe and Bjorne Lange.
Mr. Kwiatkowski recognizes that the "life shattering nature" of the injuries should drive the judge's decision, but they said a 30-year sentence was more appropriate. Among their arguments: Mr. Kwiatkowski confessed before his first court appearance, didn't blame anyone else and decided relatively early to plead guilty, sparing the victims and the state from a potentially lengthy and costly trial.
Defense lawyers also argued that the shorter sentence would balance the seriousness of the crimes against Mr. Kwiatkowski's mental and emotional problems and his "addictive disease which clouded his awareness of the risk to which he was exposing his patients, as well as himself."
They said Mr. Kwiatkowski began abusing alcohol as a teenager and by last year was drinking a sizable amount of vodka daily to feel "normal," injecting himself with 100 milligrams of fentanyl several times per week and taking 80 milligrams of OxyContin on days when he couldn't get fentanyl.
Mr. Kwiatkowski grew up in Michigan and started his career there before becoming a traveling hospital technician who was assigned by staffing agencies to fill temporary openings around the country. According to the plea agreement, Mr. Kwiatkowski told investigators he had been stealing drugs since 2002 -- the year before he finished his medical training -- and that his actions were "killing a lot of people."
Before he was hired by New Hampshire's Exeter Hospital in 2011, Kwiatkowski worked as a cardiac technologist in 18 hospitals in seven states, moving from job to job despite being fired at least four times over allegations of drug use and theft. Thirty-two patients were infected in New Hampshire, seven in Maryland, six in Kansas and one in Pennsylvania. Mr. Kwiatkowski also worked in Michigan, New York, Arizona and Georgia.