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. In February another patient, Rena Cooper, was injected with a poisonous substance and survived; his federal indictment later charged him with that assault. 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. In 1985 Ohio authorities did open a murder investigation into his time on the wards. Too little physical evidence remained to bring charges, but Swango learned that the inquiry existed, and from then on he kept it from every hospital that considered hiring him. The concealment was later set out in his federal indictment.
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. Ohio State took him anyway.
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. The co-workers recovered. 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 the year before.
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 set out 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 run by the University of South Dakota, with time at the Veterans Affairs hospital in Sioux Falls and at what is now Sanford USD Medical Center, 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 program dismissed him once administrators learned the facts of the conviction and of his months at Ohio State. 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, on which he described the Illinois conviction as the result of a barroom brawl. His first rotation, in internal medicine, placed him at the Veterans Affairs Medical Center in Northport, Long Island, and there, within a few months, he killed three men in his care by injecting them with toxic substances: George Siano, Aldo Serini, sixty-two, and Thomas Sammarco, seventy-three. Siano's age appears as sixty in some accounts and sixty-two in others. In two of the cases he told staff that the families had asked that the men not be resuscitated. He also injected a fourth veteran, Barron Harris. The indictment charged that as an assault, not a murder, and the VA inspector general's account says Harris survived the injection; other accounts have Harris slipping into a coma and dying on November 9, 1993. No murder count was ever brought for him.
Four months into the residency 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; the FBI laboratory later analyzed hair samples taken from her, though no charge ever followed. 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 in October 1993. 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 and the VA's Office of Inspector General 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. Federal prosecutors in Brooklyn were preparing charges of making a false statement to obtain the Northport post and of improperly using controlled substances there, but before they were filed he left the country. In November 1994, on forged documents, he was hired through the Zimbabwe Association of Church Hospitals and posted to the Mnene Lutheran Mission Hospital in central Zimbabwe, and patients there began dying too. Two who lived were later named in the American indictment: Kenias Mueaza, injected on May 14, 1995, and Virginia Sibanda, injected on July 7, 1995.
The medical director, Dr. Christopher Zishiri, had him suspended that July, 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, through KAMA Enterprises, an employment agency in Portland, Oregon, and on a false résumé, he landed a post at the Royal Hospital in Dhahran, Saudi Arabia. In June, on a layover at Chicago's O'Hare airport on his way there from Africa, immigration agents arrested him on the federal warrant from New York. 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 fraud sentence gave the government a deadline. Investigators believed they were dealing with a serial killer and that they had roughly three years to prove it in a federal hospital where the dead had already been buried. Agents and healthcare inspectors from the VA inspector general's office, the FBI and federal prosecutors spent thousands of hours on records, laboratory work and interviews with witnesses in the United States and Africa; the inspector general's own forensic laboratory examined handwriting and medical documents. The bodies of the Northport dead were exhumed and toxic substances were found in them. The investigators also pieced together his lies about Cynthia McGee and the Ohio investigation he had hidden.
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, on nine counts, and pleaded not guilty.
On September 6, 2000, in the federal courthouse at Central Islip, before Judge Jacob Mishler, he pleaded guilty to five of the nine counts: the three murders and two counts of fraud for lying his way into medical jobs. In return the government agreed not to seek death, and Zimbabwe agreed not to seek his extradition. In each killing, he told the court, he had acted by "administering toxic substances which I knew were likely to cause death." He admitted lying about his role in a fourth death and about his 1985 conviction. He declined to address the court before sentence and, according to reporters in the room, fidgeted slightly and showed no emotion.
Prosecutors read passages from his notebook describing the pleasure he took in killing. One had been copied from a book about the nineteenth-century murderer H. H. Holmes, The Torture Doctor, and described a man who could feel that he was "like a god in disguise." The assistant United States attorney, Gary Brown, told the court that basically Swango liked to kill people. Families of the dead were present. Carol Fisher, Thomas Sammarco's daughter, said: "I just hope Michael spends the rest of his life in a living hell." The stepdaughter of another of the men said the institutions where the murders happened should also be held to account. Mishler imposed three consecutive life terms without parole. The United States attorney, Loretta E. Lynch, said Swango had used "a web of lies and deception" to win the trust of hospital administrators across the country and abroad.
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.
Four murders are established by his own pleas: McGee in Ohio, and Siano, Serini and Sammarco at Northport. Beyond them the numbers are estimates, and they should be read as such. Barron Harris, Rena Cooper, Kenias Mueaza and Virginia Sibanda are documented as people he injected, with Harris's fate reported differently from one source to the next. Zimbabwe charged him with poisoning seven patients, five of whom died, but that case never came to trial. 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. Neither figure rests on a conviction.
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. The institutions that employed him are part of the record too. 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, and it took a nurse's mother in Virginia, a chain of phone calls between deans and a seven-year federal investigation to stop him.
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.