Plea deal of lab tech linked to hepatitis C outbreak reveals more past details

CONCORD, N.H.A traveling hospital technician accused of infecting dozens of patients with hepatitis C through needles tainted with his own blood reached an agreement with prosecutors that would give him a sentence of as little as 30 years instead of the nearly 100 he could have faced if convicted in a trial.

The agreement, filed Monday, also contained new revelations that he was fired from two Michigan hospitals and resigned from two others before beginning his traveling temp career.

David Kwiatkowski, who has been jailed since his arrest in July 2012, is accused of stealing painkiller syringes from Exeter Hospital's cardiac catheterization lab in New Hampshire and replacing them with blood-tainted saline. He told investigators he had been stealing drugs for more than a decade and was "killing a lot of people," according to the plea agreement filed Monday.

If convicted at trial, he could have been sentenced to up to 98 years behind bars. He agreed to plead guilty to 14 federal drug theft and tampering charges he faced in exchange for a lighter sentence of 30 to 40 years in prison.

Kwiatkowski's attorneys did not immediately respond to emails or a phone message left at their office Monday night. A hearing on the plea agreement is set for Wednesday.

Linda Ficken, of Andover, Kan., is among those Kwiatkowski is accused of infecting. Ficken, 71, said Monday she's glad he pleaded guilty but wishes the sentence were longer.

"It should've been life, since he gave us potentially a death sentence," she said.

More than a year after Kwiatkowski's arrest, Ficken said, she is still angry at Kwiatkowski and at the system that let him move from job to job after he was fired over allegations of drug use and theft.

Thirty-two patients in New Hampshire have been diagnosed with the strain of hepatitis C carried by Kwiatkowski, who worked at 18 hospitals in seven states before being hired in New Hampshire in 2011. There have been seven cases in Maryland, six in Kansas and one in Pennsylvania.

One of the Kansas patients has died, and hepatitis C, a blood-borne viral infection that can cause liver disease and chronic health issues, played a "contributing role," the plea agreement said.

The plea agreement includes details of an interview Kwiatkowski gave investigators in New Hampshire after his arrest in which he said he knew he'd been diagnosed in 2010 but continued to "swap out" syringes of the painkiller fentanyl.

He said he had been stealing drugs since 2002 and estimated that he had swapped syringes at least 50 times in New Hampshire, at least 30 times in Georgia and more than 20 times in Kansas. Under the plea deal, Kwiatkowski would avoid criminal charges in the latter two states.

After Kwiatkowski's arrest, two of his previous employers confirmed that he had been fired over drug allegations. But several new incidents emerged in Monday's court filing.

AP: Lab tech's arrest in hepatitis C outbreak shows flaws in system Lab tech accused in hep C outbreak fired by Ariz. hospital in 2010 over drugs 95 patients infected with hepatitis C linked to Chinese clinic According to the plea agreement, Kwiatkowski was fired from a Michigan hospital in 2004 after failing a drug test and was fired from another that year for gross misconduct. He resigned from two more Michigan hospitals while under investigation for drug use.

Kwiatkowski, who grew up in Michigan, later began work as a traveler sent by staffing agencies to hospitals around the country, usually for temporary jobs. In announcing federal drug charges last year, U.S. Attorney John Kacavas called him a "serial infector."

Hospital technician to plead guilty in hepatitis C outbreak

CONCORD, N.H. A hospital technician accused of causing a multi-state outbreak of hepatitis C will plead guilty in exchange for a prison term of 30 to 40 years, according to a plea agreement filed Monday in New Hampshire federal court.

The plea says it would allow David Kwiatkowski to avoid criminal charges in Kansas, Maryland and Georgia — states where authorities say the traveling cardiac technologist injected himself with painkillers then put saline back in the tainted needles.

Exeter Hospital lab tech indicted in New Hampshire hepatitis C outbreak AP: Lab tech's arrest in hepatitis C outbreak shows flaws in system Lab tech David Kwiatkowski, indicted in N.H. hospital hepatitis C outbreak, denies drug use

Dozens of patients in three states were infected as a result of Kwiatkowski's actions, according to the plea agreement. One patient in Kansas who was infected with hepatitis C genetically linked to Kwiatkowski's strain died and the infection played a "contributing role" in the patient's death, the plea agreement said.

The agreement includes details of an interview Kwiatkowski gave investigators in New Hampshire after his arrest, saying he knew he'd been diagnosed in 2010 but continued to "swap out" syringes of the painkiller fentanyl.

According to the agreement, Kwiatkowski said he was the only person involved in the diverting of drugs at Exeter Hospital in New Hampshire then added, "and I'm going to kill a lot of people out of this."

Kwiatkowski also infected patients at Johns Hopkins University Hospital in Baltimore, the VA Medical Center in Baltimore and Hays Medical Center in Kansas, according to the plea agreement signed by Kwiatkowski and his attorneys on July 18.

Under the terms of the deal, Kwiatkowski will plead guilty to seven counts each of tampering with a consumer product and obtaining controlled substances by fraud. A change of plea hearing was scheduled for Wednesday.

Kwiatkowski, who grew up in Michigan, worked as a "traveler" sent by staffing agencies to hospitals around the country, usually for temporary jobs. In announcing federal drug charges last year, U.S. Attorney John Kacavas called him a "serial infector."

Kwiatkowski's attorney did not immediately a phone message left at his office Monday night.

Born prematurely? You risk heart failure as adult, study suggests

Babies born prematurely carry more health risks than those born after a full pregnancy, including raised risk for intellectual disability, cerebral palsy, breathing problems, digestive woes, and hearing and vision loss.

New research adds heart problems during adulthood to the list.

Adults in their 20s who were born before the 37th week of pregnancy were found to have more problems with the heart's right ventricle, which could reduce the heart's capacity to pump blood.

A typical pregnancy lasts 40 weeks, though recent research suggests pregnancy time may vary up to five weeks from a woman's expected due date.

The researchers behind the new study, published Aug. 12 in Circulation, point out that that up to 10 percent of young adults today are born premature.

"We wanted to understand why this occurs so that we can identify the small group of patients born premature who may need advice from their health care provider about this cardiovascular risk," said study author Paul Leeson, a professor of cardiology at the University of Oxford's Cardiovascular Clinical Research Facility in the U.K., in a press release. "The changes we have found in the right ventricle are quite distinct and intriguing."

The study was funded by the British Heart Foundation.

The human heart contains four chambers: the right and left atria -- which receive and collect blood -- and right and left ventricles, which pump blood from the heart into the circulatory system and rest of the body.

The ventricle on the right side of the heart, specifically, pumps blood from the heart to the lungs, according to the National Heart Lung and Blood Institute.

When breathing air in, a cycle kicks off in which oxygen is passed from the lungs through blood vessels and into the blood. Then, carbon dioxide (waste) is passed from the blood through the lungs where it's removed when you breathe out. The left atrium is what receives this oxygen-rich blood from the lungs, which is then pumped out by the left ventricle into the main artery of the body, the aorta. Then it is delivered to the rest of the body.

The researchers followed a group of premature babies born in the 1980s until they were about 25. They were given standard heart tests checking for blood pressure and cholesterol, in addition to MRI machines to measure patients' blood vessels and heart structures. They then created a computer model to determine how much blood is being pumped in their hearts.

"Their hearts appear to be slightly smaller, they had slightly thicker walls and had a slight reduction of the blood they are pumping," Leeson told CBS News' Alphonso Van Marsh of those born prematurely, when compared to those born at full term.

People with these types of changes in the right ventricle's structure are more likely to have mild to moderate cases of high blood pressure (hypertension), and are at an increased risk for heart failure or cardiovascular-related death, according the researchers.

Previous studies have found similar changes in the left ventricle in adults who had been born prematurely.

But, Leeson insists there's no reason for such adults to panic if they were once a preemie.

"The vast majority will be absolutely fine," says Leeson. But, people born prematurely may represent a group at higher risk that doctors can keep a closer eye on.

The new study "is a great example of how computer models can help identify and analyze an individual's risk," Don Morris, vice president of scientific product technology development at Archimedes Inc., a subsidiary of Kaiser Permanente, said to HealthDay. "This information can be used today to help with better identification of people at risk so they can be treated proactively, for example, by more careful monitoring and control of blood pressure and cholesterol." Morris was not involved in the research.

Bed rest may not prevent premature birth after all Lullabies and infant-synchronized music may help premature babies' development Premature birth rates could fall with five proven steps, report finds For mothers trying to reduce their risk of having a premature baby, the Centers for Disease Control and Prevention notes risks include cigarette smoking, alcohol use, chronic health problems in the mother such as diabetes and high blood pressure and having certain infections during pregnancy.

Induced labor may increase risk of autism in offspring

Having labor that is induced or augmented may lead to a greater chance of having a child with autism, new research reveals.

The U.S. government estimates that one in 50 school-aged kids has an autism spectrum disorder, which is the designation for a group of developmental brain disorders. All the conditions include some level of impairment when it comes to social skills, communication and behavioral issues.

Researchers looked at data from the North Carolina Detailed Birth Record and Education Research databases, which included 625,042 live births linked with school records. Of the group, 5,500 children had been diagnosed with autism.

Induced labor occurs when a medical professional intervenes in order to jump start the labor process. This usually happens when the woman is past her due date and has yet to go into labor or if there are problems with the baby or the mother's health. The doctor or midwife can use hormone medication (Pitocin) or other methods to open the mother's cervix, begin contractions and help her body prepare for vaginal birth.

According to the U.S. Census Bureau, about 23.1 percent of all births in 2008 were induced.

Doctors may also augment labor to help along the birth if the process stops or slows down for some reason. This method is less commonly used than inducing labor and often requires medication.

Overall, the researchers estimated two out of every 1,000 autism cases in boys could potentially be prevented by not inducing or augmenting labor. Though the numbers seemed small, they were statistically significant, meaning not due to random chance.

Mothers who had induced labor were 13 percent more likely to have a child with autism. Mothers with augmented labor were 16 percent more likely to have a kid with the disorder. If a mother had both methods used on her, the child was 27 percent more likely to be diagnosed with autism during childhood.

For comparison, the authors noted that a mom who had other pregnancy problems, like diabetes, increased the risk of autism in her children by 23 percent, and if the fetus was ever in distress, the chance went up 25 percent.

C-sections did not affect the rate of autism.

Other conditions during pregnancy have recently been linked to increased autism risk. An August 2012 study showed that mothers who were obese were 67 percent more likely to have children with the disorder compared to those who maintained a normal weight during pregnancy.

Taking the anti-epilepsy drug valproate has been linked to a five-fold higher risk of having a child with an autism spectrum disorder in an April 2013 study published in JAMA. Exposure to air pollution while with child was also significantly connected to higher rates of autism, a June 2013 Environmental Health Perspectives study revealed.

Though the risk in the new study may seem alarming to some, Dr. Jeffrey L. Ecker, an obstetrician at Massachusetts General Hospital, told HealthDay that mothers shouldn't be concerned if they need to have their labor assisted -- nor should they go against their doctor's recommendation.

"Women should not conclude that if they need induction or augmentation their child will have or be at high risk for autism. Nor should they seek to avoid induction (or) augmentation," Ecker, who was not involved in the study, said. "The latter reaction would ... almost certainly (increase rates of) cesarean delivery, an intervention that we know has important (negative) effects on both maternal and neonatal health."

The study published in JAMA Pediatrics on Aug. 12.

The dark side of the love hormone

New research finds that oxytocin could deepen emotional wounds

First comes love, then comes the crippling social anxiety?

When we normally think about oxytocin — the so-called love hormone — we think of warmth, tenderness, and trust, the kinds of fuzzy feelings one might associate with walking on sunshine. In fact, oxytocin's considerable cuddle powers are why researchers are trying to bottle the stuff as a commercially viable nasal spray.

But it turns out that the hormone may also play a key role in triggering deep anxieties and emotional conflict, leaving scars that can last for years, if not decades. A new study by Jelena Radulovic of Northwestern University's Feinberg School of Medicine discovered that oxytocin actually strengthens the social anxieties we get from intense emotional pain, whether that's being bullied in school as a kid, or getting caught in the hopeless spin-cycle of an abusive relationship.

Radulovic and her team discovered that oxytocin helps to unleash a signaling molecule called extracellular signal regulated kinase (ERK), which is usually activated 6 hours after a negative social experience. As Science News reports:

"ERK causes enhanced fear by stimulating the brain's fear pathways, many of which pass through the lateral septum. The region is involved in emotional and stress responses," Prof Radulovic explained.

"By understanding the oxytocin system's dual role in triggering or reducing anxiety, depending on the social context, we can optimize oxytocin treatments that improve well-being instead of triggering negative reactions." [Science News]

Oxytocin is often heralded as a magical hormone, the kind of cure-all that makes us nicer, gentler people. Previous studies have suggested that oxytocin can help diminish social fear, relieve stress, and make us more generous. The kinds of things, as George Dvorsky at io9 writes, that make humans human.

On the other hand, the latest findings seem to indicate that oxytocin has a dark side that we've only just begun to explore. Which, of course, is part of being human, too.

Should we allow prisoners to smoke weed?

Research suggests pot makes for more peaceful prisons

This guy needs to mellow out.

When compared to the other illicit activities that occur behind bars, smoking pot ranks pretty low on the list of dangerous behavior. In fact, a recent survey conducted by the International Journal of Drug Policy (IJDP) suggests marijuana consumption could lead to more peaceful prison conditions.

The study, which focused on Swiss prisons, reveals that about 80 percent of prisoners and 50 percent of guards smoke pot. The Journal concluded:

Participants showed similar opinions on effects of cannabis use that were described both at individual and institutional levels: analgesic, calming, self-help to go through the prison experience, relieve stress, facilitate sleep, prevent violence, and social pacifier. [IJDP]

Although marijuana is illegal in Switzerland, prison officials turn a blind eye because smoking keeps prisoners calm and reduces violence, according to the study. Participants acknowledged the potential negative effects of marijuana use, including lethargy and antisocial behavior, but most agreed the consequences of a crackdown would be worse. Guards worried that ramping up regulation of cannabis use would lead to "violence, increased trafficking, and a shift to other drug use" among prisoners.

A study of Danish prisons released in 2012 yielded similar results. Seventy-eight percent of the prison guards interviewed by researchers at the Aarhus University's Centre for Alcohol and Drug Research said they use their own discretion when they encounter marijuana, rather than following the official drug regulations.

"The guards bend the rules to maintain order," Torsten Kolind, one of the anthropologists who conducted the study, told Science Nordic. "Many inmates have smoked cannabis for several years before they were imprisoned. They often smoke as a way of dealing with personal problems. If the guards take away their weed, they become restless and it could result in trouble."

Denmark technically has a zero-tolerance policy on drug possession, meaning cannabis has the same legal status as heroine and methamphetamine. But the corrections officers said they were more likely to crack down on substances like cocaine or alcohol, because they can lead to erratic, violent behavior, whereas marijuana often renders prisoners more docile.

"The guards know the inmates," Kolind said. "If they see inmates who suffer from personal problems such as loneliness sitting there in their cell smoking weed, they understand why they need it. They may then just tell them to shut the door because it smells of weed."

New York City is eyeing a ban on electronic cigarettes

Smoke 'em while you got 'em

Sorry, Stephen Dorff, but your blue e-cig may soon be unwelcome in New York City.

New York City Mayor Michael Bloomberg is so concerned with public health, he doesn't want people to even feign smoking anymore.

The mayor who banned trans fats and tried to kill large sugary drinks has turned his attention to electronic cigarettes, those pen-shaped devices that are supposedly a safer way to get your nicotine fix. The city's Health Committee is considering several proposed ordinances related to cigarettes, including one that would classify e-cigarettes as tobacco products, according to a leaked copy of those proposals obtained by the Consumer Advocates for Smoke-Free Alternatives Association.

The proposals, via CASAA, would:

• Redefine "tobacco products" under New York City law to include e-cigarettes and related components, parts, and accessories
• Ban the display of e-cigarettes and smokeless tobacco in retail stores
• Ban the sale of e-cigarettes or e-liquid in flavors other than tobacco, menthol, mint and wintergreen in areas other than an age-restricted "tobacco bar." New York City law prohibits "tobacco bars" that were not open in 2001, and thus even an e-cigarette store in New York City would be prohibited from selling flavored e-cigarettes!
• Mandate that e-cigarette products and parts, components, and accessories only be sold in their original packaging [CASAA]

The battery-powered cigarettes typically use liquid cartridges containing nicotine and some other chemicals. They do not, however, contain tobacco, so they technically fall outside the laws that regulate traditional cigarettes. Would-be smokers are therefore allowed to "light up" in city establishments, like bars, confounding bouncers and patrons who often mistake an e-cig's small cloud of vapor for the real thing.

The proposals under consideration, critics say, would effectively outlaw e-cigarettes by regulating them into extinction.

"This is a de facto ban on electronic cigarettes," Dr. Michael Siegel, a professor at the Boston University School of Public Health, tells Gothamist. "Pretty much all electronic cigarettes are flavored; they're essentially flavored products. You're basically telling a bunch of ex-smokers to go back to cigarettes."

Across the country, California's legislature is considering similar legislation that would treat e-cigarettes like other tobacco products.

Yet whether e-cigarettes are actually safer than the real thing is still up for debate.

The Food and Drug Administration issued a warning about the products back in 2009, saying some samples contained ingredients found in anti-freeze. The agency added that the products were not approved by the FDA, and could not be deemed safe without further testing. Furthermore, critics say e-cigarettes serve no purpose but to perpetuate nicotine addiction.

A more recent Drexel University study released this month, however, concluded that the supplementary chemicals in e-cigarettes were not harmful to users or bystanders.