Case of Shadowy Doctor Includes Poisonings, Lies, Deaths, Hubris : Medicine: Michael Swango charmed his way into jobs despite his troubled past. Medical Establishment rarely checked his stories.
Barron Harris walked into a New York hospital last September, sick with pneumonia. Days later, he lapsed into a coma. Weeks later, he died.
No one knew why.
Weeks earlier, Andrew Woods had entered the same hospital. He, too, had pneumonia, and he says he developed seizures.
He didn’t know why.
The two military veterans of two generations had one common bond: Michael Kirk, the charming doctor who had prescribed some of their medication and hovered attentively nearby.
But Kirk was concealing a web of frightening secrets: He had lied to his patients about his name, he had lied to his superiors about his criminal record, and he had lied to everyone about his troubled past.
The solicitous doctor--real name, Michael Joseph Swango--had served two years in an Illinois prison for tainting fellow paramedics’ food with ant poison. He had been under suspicion years ago in several Ohio hospital deaths. His medical license had been revoked in two states. And he had been kicked out of a South Dakota medical school.
Then came New York, the latest stop in a bizarre 11-year odyssey of a troubled man so determined to be a doctor that he stitched together half-truths and out-and-out lies to manipulate the medical Establishment, exploit the legal system and cajole his way into a world of life-and-death decisions.
Swango lost his job in New York when his past was revealed. He has not been charged with wrongdoing there, but the FBI is investigating.
His story is more than a tale of a once brilliant, promising young student with a diabolical mind and a ghoulish fascination with gore. It’s a cautionary example of how medical authorities blindly trusted one of their own, violating their own common-sense policies.
“It’s outrageous that something like this could pop up time and time again,” said Dennis Cashman, the Illinois judge who sentenced Swango to prison in 1985 for the poisonings.
Last summer, Michael Swango was among 12 of 190 applicants to win a psychiatric residency at what was then the University Hospital at Stony Brook. Just months earlier, the school’s emergency medical department--nine floors up--had rejected his application, citing too many gaps in his resume.
While being interviewed by Dr. Alan Miller, director of the Psychiatric Residency Program, Swango volunteered that he had been convicted of battery in a barroom brawl. He did not mention, however, that he had served time for poisoning colleagues.
No one checked his story or his credentials, a violation of policy. But it was not the first time Swango had sweet-talked his way into a job.
“He was a pathological charmer,” said Stephen Villano, associate dean at the medical school. “He found a sympathetic ear and pushed the right buttons, asking to be given a second chance.”
“This was no slouch that he had to convince,” Villano said of Miller, a respected mental health expert who has served as a consultant worldwide. “But Swango was so polished he was able to fool this giant.”
Swango, 39, was assigned to Northport Veterans Administration Medical Center in August. At some point, he changed his name. He told some folks that it was to make a fresh start, others that it was his stepfather’s name.
The reports were glowing.
“He was extremely caring,” said Andrew Woods, a 41-year-old Vietnam veteran and Northport patient. “He’d spend a long time, sometimes hours, just talking, asking me how I was.”
Woods said Kirk--the name he knew him by--never gave him medication directly, but wrote prescriptions for it. When he developed mysterious seizures, he said, his wife had him transferred.
Barron Harris, a 60-year-old Korean War veteran, was hospitalized Sept. 29 with a fever. The retired cabinet-maker, who had emphysema, was transferred to intensive care, where he became agitated and began tearing out his IV tubes, his widow said.
Elsie Harris said Swango--they, too, knew him as Kirk--told her he gave her husband a sedative Oct. 2. A day later, Harris lapsed into a coma.
“I said to Dr. Kirk, ‘How? Why?’ ” she recalled. Elsie Harris said he told her he hoped it wasn’t something he--or others there--had done to put her husband in that state.
Harris died Nov. 9; autopsy results have yet to be released.
The Harris and Woods families and a third patient have filed suits totaling $30 million against the State of New York, alleging malpractice and negligence, but Swango has not been sued. His whereabouts are unknown.
Efforts by the Associated Press to reach him at his former apartment and through a stepbrother were unsuccessful.
He was dismissed by Stony Brook in October, and Miller resigned days later. But that doesn’t ease the pain for some who had trusted him.
“He was someone you would want to bring home to meet your daughter,” Elsie Harris said of Swango. “Sometimes, I would walk in and he’d be standing there alone at the head of my husband’s bed, just looking at him.
“Right now,” she added, “we would like to rip him apart.”
The road to New York began in Quincy, Ill., a quiet Mississippi River town, where Michael Swango seemed destined for success.
The blond, hazel-eyed student was a clarinet player, school band president and valedictorian. He was voted Most Likely to Succeed in the class of 1972.
Classmate Steve Siebers said Swango was highly motivated and “probably the smartest kid I’ve ever known.” He remembers him excelling in a physics class that bewildered everyone else. He also recalls that Swango seemed to overreact when peers teased him.
Swango’s father, now dead, was a decorated Army veteran who served in Vietnam. The son won a music scholarship, but dropped out to join the Marines.
After the military, Swango enrolled in Quincy College, hoping to become a doctor.
“I wrote glowing reports for him to get into medical school. He was very conscientious,” recalled William Gasser, his chemistry professor--who later analyzed tea Swango had been suspected of poisoning.
John Natalini, his college adviser, admired Swango’s tenacity.
“He got very good grades. He spoke well. He was a gentleman,” said Natalini, who later shipped science journals to Swango in prison. “Nothing would say there’s going to be problems in the future.”
But the problems started soon after.
At Southern Illinois University School of Medicine in Springfield, Swango was regarded as a loner; peers called his last-minute cramming “Swango-ing,” and he stretched himself even more by working part time as a paramedic.
At the end of his last year in medical school, some members of a student governing body moved to have him expelled.
Dr. David Chapman, a classmate who now is a doctor in Springfield, said he and others thought Swango was doing a superficial job working with patients--he would jot down their histories in five minutes, when they should take an hour.
The group failed to win the unanimous backing required for expulsion, but did succeed in holding Swango back in school, Chapman said. Swango lost a neurosurgery residency in Iowa, but he did graduate.
His next stop was Ohio. There was more trouble there.
Swango lasted only one year at an Ohio State University Hospitals internship that was supposed to lead to a three-year neurosurgery residency.
He left in 1984. The official reason: He didn’t perform well.
More than a year later, Ohio authorities, contacted by the Quincy Police Department for a background check on Swango, discovered there was more to it.
Edward Morgan, an assistant Franklin County prosecutor, said he and Ohio State police learned the hospitals had conducted a secret, internal probe prompted by an unusual number of code blues, or emergency alerts, that led to several unexpected patient deaths or suspicious illnesses.
All occurred in areas where Swango had worked, Morgan said.
In an affidavit taken by campus police at least 18 months later, a nurse said she entered a woman’s room to find Swango “putting what appeared to be something into the patient’s IV tube line with a syringe.”
A code blue was called; the patient had stopped breathing. After the patient was revived, she wrote a note saying a blond person had injected her IV. A nurse’s aide said she saw Swango leave a room down the hall and found a syringe in a sink in that room.
Morgan said three bodies were exhumed to test for poisons; none was found. But he also noted that castor beans found in Swango’s Quincy apartment can be used to produce a poison that tests can’t detect.
In one exhumation, a man believed to have died in 1984 due to injuries from an automobile accident was found to have a wad of gauze stuck down his throat. There was no medical reason for it, said attorney Wayne Link, who represented the widow in an unsuccessful suit against the hospital.
The coroner ruled the death a homicide.
Link said the widow had learned of her husband’s death from Swango, who called her and kept repeating the news to her.
Morgan reported another strange occurrence: Doctors at a hospital on Swango’s rotation became violently ill--some vomited so hard they broke blood vessels in their eyes--after eating chicken Swango purportedly purchased at a fast-food restaurant.
The prosecutor said the symptoms were consistent with arsenic poisoning.
But the trail was cold by time his office learned what had gone on, Morgan said. Syringes and other physical evidence had disappeared, fingerprints weren’t taken, and Swango hadn’t been interviewed by a trained investigator.
“I can’t tell you what a hospital should do when they think they have an intern running amok,” Morgan said. “They made an inquiry to what the heck was going on and . . . they got rid of the problem. But the problem continued for other people.”
Malcolm Baroway, director of communications at Ohio State University, said the hospital’s first internal probe was aided by an attorney who said they didn’t have evidence that would hold up in court.
When the Quincy case surfaced, the university president, who had been unaware of the hospital probe, ordered an investigation.
That report concluded the first probe was inadequate, but noted that personal animosities and low morale may have given rise for someone “to find blame when none was warranted.”
Morgan doesn’t buy it.
‘If it was just one or two incidents, fine,” he said. “If you add it all together, you’ve got a sick puppy here.”
“Where’s there smoke, there’s fire. And there was a lot of smoke.”
By the summer of 1984, Swango was back in Quincy, working part time as a paramedic. That fall, several paramedics reported becoming ill after eating doughnuts he brought to work.
Brent Unmisig ate one and vomited. The next night, the paramedic says, Swango handed him a soft drink at a football game. He got sick again.
He and other paramedics discovered that their symptoms--nausea, vomiting, dizziness, headaches--matched those of arsenic poisoning.
Weeks later, Unmisig said, when some paramedics faked a call 35 minutes away to divert Swango, others found arsenic-based ant poison in his bag.
Later, one paramedic left a pitcher of unsweetened tea when a crew was dispatched for a call. When they returned, it was sweet; a co-worker said he saw Swango leaving the area. Tests found arsenic in the tea.
After Swango was arrested, Tero ant poison, books on satanism, guns, survival knives and recipe cards for pesticides, botulism and cyanide mixtures were found in his apartment. Some co-workers were not surprised.
“He would call people on calls that had been pretty gruesome and try to elicit details,” said Mark Krzystofczyk, a former paramedic. “He kept a scrapbook.”
Trial testimony painted a grisly portrait: Swango cheering TV reports of a shooting rampage in California, saying, “Every time I get a good idea, someone beats me to it,” expressing admiration for serial killers, and saying the ultimate call would be a tanker crashing into a busload of kids, creating an explosion that would impale them.
Swango denied the poisonings, but admitted to some ghoulish remarks, saying he was trying to defuse tension.
Medical professionals concede that black humor is common in such situations. And paramedics concede there was another side to him--the calm, cool, consummate professional.
“The worse the call,” Unmisig said, “the better he would act and perform.”
Prosecutors said they didn’t think he was trying to kill anyone, and Swango was convicted of aggravated battery.
“I really don’t know what his motive was,” Unmisig said. “I was never mean to the man. I didn’t do anything to harm him or embarrass him.”
In sentencing Swango to the maximum five years, Judge Cashman said he didn’t understand how someone so smart could leave such a blatant trail.
But Swango maintained his innocence.
“In no way, shape or form, under no conceivable circumstances,” he said, “am I now or could I ever be, a danger to any human being on the face of the earth.”
Swango served two years in prison and was released in August, 1987.
Before his release, in a 1986 interview with the ABC-TV show “20/20,” he again denied wrongdoing.
“I could never do any of the things that have been alleged I’ve done,” he said. “I think my whole life speaks for that, everything I’ve done in the past--my work, both as a paramedic and a doctor--and . . . I simply could have not done those things.”
After Swango’s release, Cashman said, he received calls from private medical-placement groups, including one in Atlanta, inquiring about Swango’s character. “I just told them it probably would be wise to stay away from assisting him,” he said.
The judge also said he heard reports that Swango had forged documents suggesting he helped a fellow doctor in a brawl and had been pardoned for his crime. He is angry that those accounts have been accepted at face value.
“The medical profession has a certain arrogance that they would choose to believe a doctor over the courts,” Cashman said.
Published reports in 1989 indicate Swango worked at a medical-career vocational school and placement center in Newport News, Va., where three co-workers became ill; police say they don’t comment on investigations unless charges are filed.
In 1990, Swango legally changed his name to David Jackson Adams and was certified as an emergency medical technician in Virginia. While working for an ambulance company, a hospital nurse recognized him--possibly from the TV interview--as a doctor who had served time in prison.
In November, 1991, hospital officials told the state Office of Emergency Medical Services they had learned that Adams--who had reverted back to Swango by then--had been convicted in a poisoning case, agency official Scott Winston said.
Winston notified Swango of potential problems because of a state law prohibiting felons from holding that job. Swango repeatedly balked when asked for records pertaining to his conviction, Winston said, and the issue died. He retained his job.
Around the same time, using the Adams name, he applied to the Ohio Valley Medical Center in Wheeling, W.Va.
“To tell you the truth, we liked the guy,” said Dr. Jeffrey Shultz, who heads the internal medicine residency program.
But the name change and an admission that he had been in prison--he again claimed it was for a bar fight--alarmed Shultz, who contacted Illinois authorities and learned the truth.
“It made the hair stand up on the back of my neck,” he said.
From 1989 to 1991, Ohio State received inquiries about Swango from hospital or medical boards in North Dakota; Washington, D.C.; and Virginia. It’s not known if those were the only places where he tried to get a foothold back into medicine.
In 1992, Swango was back in a hospital setting again--despite his admission that he had served time for poisoning co-workers.
“You’ve got to know this guy,” said Dr. Anthony Salem, director of the internal medicine residency program at the University of South Dakota School of Medicine, which accepted Swango into a one-year program.
“He had convinced me not only that he was not guilty . . . but that it was a total miscarriage of justice.”
Salem said Swango told him he didn’t understand why he had been arrested in the poisonings because he had gotten sick himself. He said he’d changed his name to start over, but had reverted to his original one when it became a hassle.
“I believed him rather than calling the court and saying, ‘Send me the documents.’ . . . I said, ‘Well, shoot, let’s give him a chance.’ ”
Salem said he did check Swango out--he knew he lost his medical license in Illinois and Ohio for an unspecified felony and was denied a license in Virginia--but thought he knew why, so he didn’t pursue it.
But just before Thanksgiving, 1992, South Dakota officials were alerted to Swango’s past by two developments, Salem said: He applied for membership in the American Medical Assn., and some hospital employees saw an updated rerun of his “20/20” interview on cable.
Swango was confronted, dismissed and lost his appeal in February, 1993.
Ironically, just before those events, Salem said he told Swango he was performing well enough to keep him past his year’s residency. A check of medical records in cases where Swango may have been involved found no irregularities, Salem added.
Though Salem said he’s embarrassed, he’s not calling for new safeguards to prevent this from happening again.
“Do you set up a major national system to catch this aberration that comes up 1 in 1 million or 2 million?” he asked. “There was ample opportunity for those people we contacted to say, you better think about this.”
Eventually, at least one hospital decided to take the initiative in doing just that.
After he was dismissed, officials at Stony Brook sent letters to 126 medical schools--where Swango must apply to complete his residency--alerting them to his history. Villano said more than 60 requested his photo.
Of course, that was after Swango had slipped through their safety net.
Despite his strange history, Michael Swango still arouses sympathy.
“Do I still think he’s a human being capable of being a contributing member to society? Yes, I do,” said attorney Daniel Cook, who represented Swango in Quincy and was his high school history teacher.
“It’s somewhat of a shame to see him in this situation,” said high school classmate Siebers. “I would have expected a lot of great things from him.”
Others are less charitable, and more leery of his next step.
“He’s trying to find a niche where somebody is going to believe his smiling face and take him at his word,” said Chet Vahle, who prosecuted Swango in Quincy. “He wants to be a doctor and he’s willing to do anything he has to do to get there.”
Krzystofczyk, the former paramedic, puts it another way.
“We all figure,” he said, “Mike’s not done yet.”
Pat Milton, an AP correspondent in Mineola, N.Y., contributed to this report.