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.
In the section of his application detailing previous jobs, he left out nine hospitals, including the two that fired him for suspected drug abuse. He answered "no" to a long list of questions about misconduct, saying he had never been disciplined or used illegal drugs.
He also asked the state to waive its requirement that he send a photocopy of his American Registry of Radiologic Technologists identification card. He claimed that his wallet had recently been stolen and complained in a rambling email about having trouble getting a school he attended to send proof of his degree.
Cook, the spokesman for the American Registry of Radiologic Technologists, said Kwiatkowski's case underscores the need for a national database of disciplinary actions.
The agency has about 315,000 technicians registered with it. It handles about 3,000 complaints per year. Last year, it issued 222 public sanctions for misconduct that ranged from criminal convictions to failure to follow professional standards.
"If ARRT had more access to information held by state agencies, employers and others, we believe this number would be higher," Cook said.
Things finally began to unravel for Kwiatkowski in New Hampshire, where a temporary stint at Exeter Hospital starting in April 2011 turned into a permanent job in a cardiac catheterization lab. A co-worker complained that she saw Kwiatkowski acting strangely and sweating, with bloodshot eyes. He was sent home after saying his aunt had died.
Another co-worker said he once saw him with white foam around his mouth. Others told of him shaking, sweating through his scrubs and frequently running off sick to the bathroom, sometimes in the middle of a procedure. A patient's relative discovered a fentanyl syringe in a public bathroom.
In April, Kwiatkowski was charged with leaving the scene of an accident after he backed into a car and drove away.
In May, three doctors simultaneously reported that patients recently treated in the catheterization lab had tested positive for hepatitis C. Within days, Kwiatkowski was also identified as having hepatitis C, and he was suspended as the state began investigating.
In July, police in Massachusetts said they found him intoxicated in a hotel room with a suicide note. He was arrested soon after.
Laboratory testing found that 31 patients had a strain of the hepatitis C virus matching the one Kwiatkowski carried, health authorities said. It isn't clear when he contracted hepatitis C. Prosecutors said in court papers that they have evidence he tested positive at least as far back as 2010. Michigan officials said he tested negative in 2006.
In response to the AP story, Exeter Hospital on Tuesday called for mandatory disclosure by health care facilities about problem workers. The hospital said there should be a national registry system covering all workers providing patient care, and hospitals that share information should be protected from employment lawsuits.
Also Tuesday, the University of Pittsburgh Medical Center said it sent letters to about 2,000 patients who may have been exposed to hepatitis C by the former medical worker. The hospital said the letters were not in response to the AP story.
Kwiatkowski's license in New York is still listed on a state website as active and in good standing.
David B. Caruso reported from New York. Associated Press writers Eric Tucker in Washington, Paul Davenport in Phoenix and Ed White and Mike Householder in Detroit contributed to this report, as did AP researcher Jennifer Farrar in New York.