On January 14, 1984, Cynthia Ann McGee, nineteen, a gymnast recovering at Ohio State University Hospital from injuries in a road accident, stopped breathing and died. A nurse had seen a new surgical intern, Michael Swango, go into her room with a syringe. He had injected her with potassium, and he told colleagues she had died of heart failure. It took sixteen years, and his own admission in court, for anyone to be able to charge him with it.
That winter and spring in Rhodes Hall, the surgical wing at Ohio State, nurses noticed that patients who had seemed healthy were dying or collapsing without warning, and that each time Swango had been the intern on the floor. One nurse caught him injecting something into a patient who then became strangely ill. When the nurses took their concerns to the administration they were accused of paranoia. A cursory internal inquiry cleared him, and the hospital did not go to the police. Officials, it later emerged, were afraid he would sue if he were fired without cause; instead they withdrew the offer of a neurosurgery residency that was to follow his internship and let him leave quietly when it ended in June. When Franklin County prosecutors later looked at the deaths, too little physical evidence remained to bring charges.
He was born James Michael Swango in Tacoma, Washington, on October 21, 1954, and raised in Quincy, Illinois, the middle child of Muriel and John Virgil Swango. His father was a career Army officer who served in Vietnam and was listed in Who's Who in Government; he came back depressed, drank heavily, and the marriage ended in divorce. Swango saw little of him and was closer to his mother. He played clarinet in the band and was valedictorian of the Quincy Catholic Boys High School class of 1972. He enlisted in the Marine Corps, trained at San Diego, never served overseas, and was honorably discharged in 1980, keeping from it a habit of hard exercise; when instructors criticized him he did pushups as a punishment. He graduated summa cum laude from Quincy College with the American Chemical Society Award and went on to the Southern Illinois University School of Medicine. He kept scrapbooks of disasters and violent deaths.
At SIU he was a brilliant student who preferred working ambulance shifts to studying, and he showed a fascination with dying patients that was barely noticed at the time. Patients assigned to him went into cardiac arrest again and again, and at least five of them died. A month before graduation he was caught faking the checkups on his obstetrics rotation. A unanimous vote was needed to expel a student, and one member of the committee voted to give him another chance. He graduated a year behind his class, in 1983, after repeating the rotation, carrying a dean's letter with a very poor evaluation.
Back in Quincy in July 1984, he went to work as an emergency medical technician with the Adams County Ambulance Corps, although an ambulance service in Springfield had fired him for making a heart patient drive himself to the hospital. His colleagues noticed his morbid talk; one reported him saying that he sometimes felt he had an evil purpose in life. They also noticed that when Swango made the coffee or brought in food, several of them became violently ill. In October 1984 Quincy police arrested him after finding arsenic and other poisons in his possession, among them an ant poison containing arsenic that he had been putting in doughnuts and iced tea. While awaiting trial, on January 20, 1985, he took a job at the Fisher-Titus Medical Center in Norwalk, Ohio, and had worked fifty-two hours over five days when officials there learned of his past and pulled his privileges. On August 23, 1985, he was convicted of aggravated battery and sentenced to five years. The conviction brought a scathing review at Ohio State by the law school dean, James E. Meeks, who concluded that the hospital should have called the police.
He was released in 1989 and moved to Newport News, Virginia, where he worked as a counselor at the state career development center until he was forced out for working on a disaster scrapbook on the job, and then as a laboratory technician for a coal company, where several employees went to doctors with persistent, worsening stomach pain. There he met Kristin Lynn Kinney, a nurse at Riverside Hospital, and they planned to marry. In 1991 he left to get back into medicine. He legally changed his name to Daniel J. Adams and applied to a residency in Wheeling, West Virginia. To reestablish himself he forged an Illinois Department of Corrections fact sheet recasting his felony poisoning conviction as a misdemeanor for a fistfight with a co-worker and a six-month sentence, and a letter from Governor Gerald L. Baliles of Virginia purporting to restore his civil rights on the strength of his exemplary conduct since.
In July 1992 the papers got him into a residency at what is now Sanford USD Medical Center in Sioux Falls, South Dakota, where he made a strong impression. Then he applied to join the American Medical Association, which checked his background far more carefully than the hospital had and found the poisoning conviction. On Thanksgiving Day an episode of the television series Justice Files carried a segment on him. Amid the AMA report and calls from frightened colleagues, the hospital fired him. Kinney, who had been suffering violent migraines in Sioux Falls, went home to Virginia, and after she left him the headaches stopped.
In 1993 Stony Brook University School of Medicine in New York took him into its psychiatry residency without properly checking his application, and his first rotation, in internal medicine, placed him at the Veterans Affairs Medical Center in Northport, Long Island. Patients began dying there without explanation. Four months later Kristin Kinney killed herself; arsenic was reported to have been found in her body, and her family has long believed that poisoning caused the disorientation that preceded her death. Her mother, Sharon Cooper, horrified that a man with his history was practicing medicine, alerted a nurse friend of Kinney's in Sioux Falls, who told the dean there, Robert Talley, who called the dean at Stony Brook, Jordan Cohen. Questioned by the head of psychiatry, Alan Miller, Swango admitted lying about the Illinois conviction and was fired on the spot. Cohen and Miller were both forced to resign before the end of the year, but before he left Cohen sent a warning about Swango to all 125 American medical schools and all 1,000 teaching hospitals.
Because Northport was a federal hospital, the FBI took an interest. In mid-1994 agents found him in Atlanta, working as a chemist at the wastewater plant of a computer equipment company, which fired him for lying on his application once the FBI called. A warrant was issued charging him with using fraudulent credentials to get into a VA hospital, but by then he had left the country. In November 1994, on forged documents, he took a post at the Mnene Lutheran Mission Hospital in central Zimbabwe, and patients there began dying too. The medical director, Dr. Christopher Zishiri, had him suspended, but without proper autopsies nothing could be proved. Swango hired a lawyer, David Coltart, to fight the suspension and asked to work as a volunteer at Mpilo Hospital in Bulawayo; a surgical resident there, Abdollah Mesbah, who had often found him roaming the wards and the intensive care unit when he was not on call, opposed it. In Bulawayo he rented a room from a widow who became violently ill after a meal she had made for herself and a friend. A surgeon, Michael Cotton, suspected arsenic and had her hair tested in Pretoria; the results showed toxic levels, and the Zimbabwe police sent them through Interpol to the FBI. Swango slipped across the border into Zambia and then to Namibia, and was charged in Zimbabwe in his absence.
In March 1997 he applied, with a false résumé, for a job at a hospital in Dhahran, Saudi Arabia. In June, on a layover at Chicago's O'Hare airport on his way there, immigration agents arrested him on the federal warrant. Tom Valery, chief investigator for the VA's Office of Inspector General, had been building the fraud case with a forensic psychiatrist, Charlene Thomesen. Facing that evidence and the prospect of a wider inquiry into Zimbabwe, Swango pleaded guilty in March 1998 to defrauding the government. In July 1998 he was sentenced to three and a half years, and the judge ordered that he never be allowed to prepare or serve food or to handle drugs while in custody.
The investigators believed they were dealing with a serial killer and that they had about three years to prove it. Bodies were exhumed and toxic substances were found in them. They also found evidence that Swango had paralyzed a patient, Barron Harris, with an injection of what was supposed to be a sedative; Harris slipped into a coma and died on November 9, 1993. They found his lies about Cynthia McGee. A week before a federal complaint was filed, FBI agents told him in prison that on the day of his release he would be extradited to Zimbabwe, where he faced charges of poisoning seven patients, five of whom had died, and where he could expect a death sentence. He opened plea talks. On July 11, 2000, days before he was due to walk out, prosecutors in the Eastern District of New York charged him with three counts of murder and with assault, false statements, mail fraud and conspiracy to commit wire fraud; he was indicted on July 17 and pleaded not guilty.
On September 6, 2000, before Judge Jacob Mishler, he pleaded guilty to the three murders and to wire fraud and mail fraud, in return for the government's agreement not to seek death or extradition. He admitted killing Thomas Sammarco, seventy-three, George Siano and Aldo Serini, sixty-two, all at Northport over three months in 1993, by giving them toxic substances he knew were likely to kill them; Siano's age appears as sixty in some accounts and sixty-two in others. He admitted lying about his role in a fourth death and about his 1985 conviction. In two of the cases he had told staff that the families had asked that the men not be resuscitated. Prosecutors read passages from his notebook describing the pleasure he took in killing, and the assistant US attorney, Gary Brown, told the court that basically Swango liked to kill people. The stepdaughter of one of the dead said the institutions where the murders happened should also be held to account. Mishler imposed three consecutive life terms without parole.
He was then taken to Columbus, and on October 11, 2000, he pleaded guilty in Franklin County to the aggravated murder of Cynthia Ann McGee and was sentenced to twenty years to life, the maximum available for the offense as it stood in 1984. Prosecutors said they could not have charged it without his admission; their evidence was a nurse who had seen him go into McGee's room with a syringe.
The four deaths he admitted are a fraction of those laid at his door. In Blind Eye, published in 1999, James B. Stewart, who grew up in Quincy, counted thirty-five suspicious deaths linked to him by circumstantial evidence, including those at SIU, and the FBI has said he may have been responsible for as many as sixty. With patients he usually gave an overdose of whatever drug had been prescribed, or wrote unnecessary prescriptions for dangerous ones; with colleagues and acquaintances he used poison, most often arsenic, in food and drink. Ohio State cleared him and told nobody. Illinois and Ohio took his license, but the record did not follow him. South Dakota hired him on forged papers, Stony Brook did not check his application, and a mission hospital in Zimbabwe took him on after that. Each place passed him along to the next.
He is held at ADX Florence, the federal supermax in Colorado, at his own request: he had been stabbed by another inmate while serving the fraud sentence and feared another attack in a general population unit.