Online charter school awaits cyber-students

By Joshua Benton
Blade Staff Writer

Page B2

Ohio’s first online charter school is about to open for business, and parents and students seem excited.

“The limits are sky high,” said Larry Terry, 49, of Risingsun, whose son Josh is one of the first students enrolled at the Electronic Classroom of Tomorrow. “So many kids are left in the dark by the schools that it’ll be good to have another option.”

In February, Lucas County approved the electronic classroom as a charter school, though it won’t have traditional facilities. It exists primarily on the Internet, where a nervous student trying to avoid being called on by the teacher instead must worry about finding a note in his e-mail box.

“Logging on is our taking attendance,” electronic classroom Superintendent Coletta Musick said.

Under the model, which is being tried here first, students log on to a web site from home every day and, with the guidance of parents and teachers, decide what they’ll be doing that day. Students can download lessons and reference material; if they hit a snag, they can e-mail one of 35 teachers, who might be 100 miles away but will call them and provide assistance.

Students are tested regularly online, but they generally are allowed to work at an individual pace. If a student completes a grade level in only a few months, he or she can move on to the next one without delay.

The electronic classroom is made possible by Ohio’s charter school law, which allows the online school to receive the state subsidy of about $4,500 per pupil, even though it does not have the facilities costs of regular schools.

As a charter school, the Electronic Classroom of Tomorrow does not charge tuition.

Trail of death follows doctor; Did our medical institutions go mum?

By Joshua Benton and Michael D. Sallah
Blade Staff Writers

Page A1

It’s likely the Adams County, Ill., courthouse had never housed a scene more surreal than it did on Aug. 23, 1985. Everything seemed inverted: a doctor accused of poisoning people, and his boss saying he didn’t mind.

On that day, Dr. Michael Swango, the young physician with an All-America smile, stood in court to await sentencing. A few months earlier, he had been convicted of slipping ant poison into the food and drinks of five paramedics to see how their bodies would react. Several were hospitalized, and all fell violently ill.

Judge Dennis Cashman had heard some bizarre testimony: stories of Swango’s obsession with gory accident scenes, his admiration for serial killers such as Ted Bundy, and his interest in poisons that are difficult to trace.

But perhaps the most chilling witness was Swango’s employer. Robert Haller, the vice president of Toledo-based National Emergency Services, had hired Swango almost a year earlier to be an emergency room doctor in two northwest Ohio hospitals.

Swango’s attorney asked Mr. Haller if, in view of the paramedic poisonings, he would have any concerns about hiring the doctor to work in Ohio hospitals again.

“I would have no problem at all,” he said.

Surprised, prosecutor Chet Vahle stood up and cross-examined Mr. Haller: “Even though he has been convicted, you would rehire him?”

“Yes,” he replied. “Based on what he did for the company, the patients that he treated, if it were up to me, I would.”

The testimony seemed bizarre to Judge Cashman, who recently called it “the most preposterous thing I’ve ever heard in court.” The judge ended up disregarding the testimony and sentencing Swango to five years in prison.

But Mr. Haller’s words take on a more menacing edge today, now that Swango is suspected of killing as many as 60 people around the world – most of them after that 1985 court appearance. Mr. Haller’s testimony was one of the first public symptoms of the medical establishment’s willingness to look past troubling actions.

Despite a stint in prison and a trail of suspicious deaths, Swango went on to work as a doctor in hospitals in South Dakota, Virginia, New York, Zimbabwe, and Zambia. Time after time, the blond, blue-eyed physician poisoned and killed, authorities say, and time after time, he kept moving on: from hospital to hospital, state to state, victim to victim. But he has never been convicted of murder.

That may change. In July, a federal grand jury indicted Swango on three counts of murder stemming from his days as a resident at a New York hospital. Officials in Zimbabwe have issued a warrant for his arrest on more murder charges.

And Ohio officials are following the federal case closely because of several suspicious deaths in Columbus.

“You can bet we have more than a passing interest in this case,” said Edward Morgan, a Franklin County assistant prosecutor who has been investigating Swango since 1985. “This is by far the most frustrating case of my career.”

The question everyone from patients to police is asking: How did Michael Swango, now 45, convicted of poisonings 15 years ago, keep finding work in hospitals, as recently as 1997?

For Judge Cashman, the trail begins at the Ohio State University Medical Center, where Swango began his medical career in the early 1980s. It was there the young, handsome doctor was first linked to a suspicious death, and many blame OSU for being more concerned with protecting its own image than in finding out whether one of its physicians might be a killer.

“I think they’re more culpable than anyone else in this entire thing,” Judge Cashman said. “They tried to keep the police out.”

At first glance, the young Michael Swango looked nothing like the popular image of a serial killer.

With his goofy, boy-next-door grin, gentle charm, and obvious intelligence, Swango seemed destined for success. He was valedictorian of his Quincy, Ill., high school class and ranked in the 97th percentile on his college boards.

Growing up, he spent his spare time reading true-crime books and looking for bizarre crime stories in newspapers. The habits did not seem outrageous at the time.

He attended Milliken University, a private liberal-arts college in Decatur, for two years on a music scholarship; he had been one of the state’s best clarinetists in high school. But despite excellent grades, he decided to drop out after his sophomore year and join the Marines.

After an honorable discharge in 1976, he enrolled at small Quincy College, in his hometown. Again, he had outstanding grades: a 3.89 grade point average with a double major in chemistry and biology.

In 1979, he was accepted into the Southern Illinois University medical school, and he quickly began to stand out in the student body. He wore his Marine fatigues and had a fanatical devotion to physical fitness. He earned the nickname “Double-0-Swango” from classmates after several patients seemingly on their way to recovery died unexpectedly after Swango saw them. The nickname jokingly referred to James Bond, Agent 007, who had a “license to kill.”

Despite a few academic problems at SIU, he graduated in 1983 and was accepted into the prestigious neurosurgical residency program at Ohio State. He was the only student offered a spot in the program out of 60 applicants.

Six months after beginning his studies, a series of events occurred that would cast a shadow over the medical center, the crown jewel of the university, for years to follow. Two later analyses of Swango’s stay at Ohio State -one from law school dean James Meeks and one by the Franklin County prosecutor’s office – provide much of the detail.

It was Feb. 7, 1984, when a nurse making her rounds entered Room 900 at the Medical Center and noticed Swango at the bedside of Rena Cooper, a 69-year-old woman who hours earlier had had surgery on her lower back.

The nurse said later that “it appeared as if he were adding something to [Cooper’s] IV line with a syringe. I said nothing because I thought he would be done soon.”

The nurse left, and then about two minutes later, she heard Mrs. Cooper’s bed rails shake and heard her roommate screaming.

She rushed back to Room 900 and found Mrs. Cooper turning blue. She still had a pulse, but she had stopped breathing.

Another nurse called a “Code Blue” and doctors arrived to treat Mrs. Cooper. After about 15 minutes of care and the insertion of a tube down her throat, Mrs. Cooper was breathing on her own again.

She then asked for a note pad to write something down. According to at least one of the nurses present, she wrote out two messages: “Who was that blond doctor?” and “Someone came in and put something in my IV tube.”

A few minutes later, a nurse’s aide spotted Swango four rooms away. He later recalled to investigators: “He had a goofy look on his face … like a kid with his fingers in the cookie jar.”

The aide, suspicious, went into the room Swango had just exited and found a syringe on the bathroom sink with its plunger depressed. It was a large needle, used only when a large dosage of medication needs to be injected very quickly.

The aide brought the syringe to the attention of another nurse, who wrapped it in a paper towel and placed it in a cabinet under the sink.

Meanwhile, the neurological unit was buzzing about the possibility that Swango had been involved in Mrs. Cooper’s sudden inability to breathe. Suddenly, unusual deaths over the last few weeks started to seem more sinister.

Just one day earlier, an elderly woman who had been recovering well from a head injury mysteriously had died on the same floor without warning. A nurse later told investigators that she saw Swango in the morning hours of Feb. 6, 1984, using at least two syringes on the patient.

Other deaths started to seem suspicious. On Jan. 14, a healthy 19-year-old gymnast recuperating from a car accident had been suddenly found dead in her room. Less than a week later, a 21-year-old man was found dead in bed. On Jan. 24, a 43-year-old man was discovered dead.

That Swango was on duty on the same floor during all of the deaths was not lost on the nurses.

After a nurse formally complained, the medical center’s top officials, joined by two attorneys, held a special meeting on Feb. 8. The group decided to allow Dr. Joseph Goodman, a neurosurgery professor, to conduct an inquiry. But law enforcement officials were never notified.

What followed was an investigation that still is being criticized today.

According to the law school dean’s later evaluation of the inquiry, Dr. Goodman did not interview any of the nurses or residents who tried to revive the dead patients. He never talked to Rena Cooper’s roommate, who said she saw Swango inject something into Mrs. Cooper’s IV line. He did not inspect the syringe saved by the nurse, records show, even though he was told about it. No autopsies or tests were conducted on any of the alleged victims.

A few days later, Dr. Goodman announced the complaints against Swango were unfounded. It was unusual to have seven deaths in just over two weeks on the same floor – the norm was two or three – but Dr. Goodman said that they could not be pegged on Swango.

Dr. Manuel Tzagournis, then dean of the medical college, decided that Swango would be allowed to return to the hospital. Dr. Michael Whitcomb, OSU medical director, was asked to conduct a follow-up inquiry – again without involving the police.

No notes or reports were made of his investigation, which consisted of only three interviews. Dr. Tzagournis ordered that Swango, who had been given a few days off, should continue his internship. The investigation was officially over.

On the day that Swango was exonerated, another death occurred on the same floor where he was then working, a 72-year-old leukemia patient. The death bothered Dr. Marc Cooperman, who said his patient was not in any danger. “I could never understand why this thing would have happened to somebody who had undergone a straightforward surgical procedure five days earlier and was walking around having no problems.”

Two other patients died in the ensuing days – both treated by Swango and both showing no signs of decline before their deaths.

In late February, after Dr. Whitcomb’s investigation ended, the OSU residency review committee decided that after Swango finished his first year as a resident in June, he would not be allowed to return.

But that did not stop three doctors on staff from writing Swango letters of recommendation to be fully licensed to practice medicine in Ohio. One rated him “good” in medical knowledge, ability to work with peers and staff, and relationship with patients. Another called him “excellent” in all three categories.

The final letter of recommendation mentioned some “reservations” about Swango, but said only: “There was a suggestion concerning a patient’s demise with regard to Dr. Swango having been in attendance proximate to demise. This was investigated rather thoroughly and Dr. Swango was exonerated.” (The doctor was mistaken when he referred to Rena Cooper as dead.)

In his last few months at OSU, Swango continued to be linked to suspicious illnesses.

One day while working at OSU’s Children’s Hospital, Swango volunteered to bring three fellow medical residents “extra spicy” fried chicken. Three hours later, all three doctors were violently ill, with symptoms lasting several days. “One guy was throwing up so bad, he had to have his eyes treated,” Edward Morgan, the prosecutor, said. “This was after they were served their dinner by the good doctor.”

Swango was let go from the residency program in June. But, in part because of the letters written by OSU doctors, state medical officials gave Swango his medical license in September, 1984.

Suddenly without a job, Swango decided to head back to his hometown, Quincy, Ill. He took a job with the Adams County Ambulance Corps, where he had worked briefly before going to OSU.

It struck some of his coworkers as odd that someone with a medical degree would want to be a paramedic. “He just told me he wanted to take a break,” said paramedic Mark Krzystofczyk.

The medics were alarmed by some of Swango’s bizarre habits, such as his penchant for clipping newspaper articles about gory accident scenes and poisonings. He carefully would place the articles in four scrapbooks he considered prized possessions. Mr. Krzystofczyk asked Swango why he did it. “It’s just a compulsion,” Swango replied.

“He made it very clear that if anyone messed with his scrapbooks, he would get very upset,” Mr. Krzystofczyk recalled.

Early on Sept. 14, Swango arrived at the paramedics station with a box of donuts and offered them to his colleagues. Within a few minutes, all four paramedics who ate donuts were sick.

“I was on my side in the fetal position vomiting for two days,” Mr. Krzystofczyk said. “And I wasn’t as bad as the others.”

The next day, when Swango was working at a high school football game, he offered to bring his partner a Coke. After taking a few sips, his partner became violently ill. On Sept. 27, he offered to fetch a 7-Up for another paramedic, who was surprised when Swango handed him the can that had been opened. In minutes, he was vomiting.

All six paramedics eventually recovered. But they were getting suspicious of the pattern: Swango gives someone food or a drink, then that person gets violently ill.

On Oct. 12, when Swango was out on an ambulance call, two paramedics noticed something that confirmed their worst fears: Swango’s duffel bag was open and inside they found two bags of Terro ant poison, whose primary ingredients are arsenic and sugar.

One was full; one was empty. They looked arsenic up in a medical encyclopedia and discovered that the symptoms of arsenic poisoning were exactly what they had been suffering.

The paramedics decided to set a trap for Swango. One of them brewed a pot of iced tea, adding no sweetener. Two glasses were poured before the two paramedics were called out for a run. When they came back, they tasted the tea and it was extremely sweet – a sign that something sweet had been added.

They saved the tea and later had it tested: It contained 35 milligrams of arsenic.

On Oct. 26, Swango was arrested and charged with seven counts of battery. Police searched his apartment and found a virtual chemistry lab. “Detectives found numerous chemicals, suspected poisons, and poisonous compounds,” the police report said. “Underground-type magazines were observed that gave technical information on exotic poisons…. Handwritten recipes for poisons/poisonous compounds were observed.”

They also found syringes, a jug of sulfuric acid, three guns, and a variety of materials related to Satanism and the occult.

The same day of the arrest, Quincy investigators called Ohio State campus police as part of a routine background check.

They wanted to know more about this Michael Swango, who had spent a year roaming the halls at the OSU medical center.

Campus police said they had never heard of him.

After Swango was released on bond, he decided to seek work elsewhere. He looked toward Toledo.

Just days after his arrest, he applied for a job at National Emergency Services, a Toledo company that hires doctors out to hospitals in rural areas across the country. Robert Haller interviewed the young applicant, who did not mention anything about his problems with the Quincy paramedics.

“Everyone was impressed. He seemed like a really fine physician. He came with glowing credentials,” he said, referring to the letters of recommendation from Ohio State.

Mr. Haller said Swango presented himself as an eager doctor who wanted to take some time off from his residency to pay some bills.

Mr. Haller said he drove Swango to two area hospitals where he would be working – Fisher-Titus Medical Center in Norwalk, O., and Wyandot Memorial Hospital in Upper Sandusky – and introduced Swango personally to the people he would be working with. “Everybody seemed to like him,” Mr. Haller said.

It is unclear how much work Swango did at the two hospitals. Fisher-Titus spokeswoman Deb Reed said Swango worked only two shifts there. Wyandot Memorial administrator Joe Dettorre said he could not determine how often Swango worked there.

Both hospitals say they conducted brief internal investigations into the patients Swango had seen. Both said they found no problems. Neither hospital brought in law-enforcement personnel to help in the investigations.

At Fisher-Titus, Dr. Timothy Thomas, then the director of emergency services, said in 1985 that he had checked the charts of all the 52 patients Swango may have seen. He said he found nothing unusual.

In any event, Swango’s employment in northwest Ohio was relatively brief. On Jan. 31, the news broke that a former OSU doctor had been charged with poisoning coworkers in Illinois.

When OSU police were contacted by Quincy officials in October, Ohio State officials immediately began a series of meetings to plan their response, according to then-OSU police chief Peter Herdt.

Campus police were stunned. They had no idea a prior investigation had been conducted of suspicious poisonings at the medical center.

The chief was brought into the discussions, he said, but was not pleased with what he heard. He said he was informed that no report or notes were taken by the doctors during the internal probes seven months earlier. He said he was told the investigation locally was over.

“I never knew we had a dead body on campus until a year later,” Mr. Herdt said.

He said he was informed by OSU officials that no crimes occurred on campus involving Dr. Swango, and they did not want the case reopened. But public pressure was mounting as news reports talked about the mysterious doctor who was being linked to deaths.

Quincy officials began to complain publicly that OSU officials were not being cooperative in their investigation. Finally, OSU police were given limited authority to investigate Swango’s time in Columbus.

In April, Swango went on trial in Illinois. Judge Dennis Cashman found him guilty of six of the seven counts of battery. (The seventh was thrown out because the level of arsenic in one paramedic’s hair was significantly lower than the others.) In August, he was sentenced to five years, at the hearing at which Mr. Haller said he and the two northwest Ohio hospitals would be willing to rehire Swango to work with patients again.

Swango began serving his sentence. On Aug. 21, 1987, after only two years in custody, he was released. One might think his felony record and history of suspicious deaths might end his medical career. The next decade would prove that thought wrong.

After his release, Swango moved to Virginia and tried to get back into the medical business. He applied for a state medical license but was rejected. But that did not stop him from getting back into his field.

He found work at a career counseling business that helps people get into medical school. According to James Stewart, a journalist who wrote a book called Blind Eye about Swango, three of his coworkers there came down with the sudden vomiting and other symptoms that seemed to follow the doctor.

He legally changed his name to David Jackson Adams and, in 1991, tried to catch on at a hospital in West Virginia. He claimed that his battery conviction in Illinois had been the result of a barroom brawl. But an administrator checked up on Swango’s story and discovered the Quincy poisonings. Swango did not get the job.

Throughout this period, Swango kept in touch with Robert Haller, his old boss in Toledo. “He called me a couple times after he got out of prison, wondering how he could get back into medicine,” he said. “We talked about it, but I told him that I was no longer in the field [he left National Emergency Services in 1985], and I couldn’t do much for him.”

Swango used Mr. Haller, who now lives in South Bend, Ind., as a reference several times.

Swango next tried at the University of South Dakota in Sioux Falls, which accepted his latest story: that he had been one of the paramedics who fell ill in Quincy and that he had been framed by a corrupt crime lab. Officials believed his story enough to offer him a position in their internal medicine residency program in March, 1992.

Amazingly, at one point during the hiring process for Swango, South Dakota officials asked Ohio State officials for some documentation on Swango’s time there. But even after learning that Swango was about to get a job in South Dakota, Ohio State did not alert the hospital of his problems there.

Swango was a popular resident in South Dakota until October, 1992, when he decided to apply for membership in the American Medical Association. An employee there decided to check on his Quincy conviction and got a call from Judge Cashman saying Swango should not be allowed to practice medicine.

Swango withdrew his application, but an AMA employee alerted an official at the medical school. Then Swango had a stroke of bad luck: The Discovery Channel broadcast a show about his problems in Illinois. Officials started getting phone calls from horrified hospital workers. Swango quickly was suspended and fired not long after.

The next year, he applied for a spot in a psychiatric residency program at the State University of New York at Stony Brook, on Long Island. Swango seemed like a strong applicant, and he openly admitted he had served time in jail, although he continued to say it was for a barroom brawl.

Stony Brook officials did not make some basic background checks, like calling the Federation of State Medical Boards, which would have informed them of Swango’s license being suspended in Ohio and Illinois. In June, 1993, he was accepted into the residency program.

While no suspicious deaths appear to have occurred in South Dakota, the same was not true on Long Island.

Several patients who seemed well on their way to recovery died suddenly while Swango was working nearby. Eventually, a tip from someone in South Dakota led to Swango being exposed. He was fired in October, 1993. Soon after, FBI agents started looking for Swango, but by that point, he was on the run.

After a stop in Georgia working at a company that treats metro Atlanta’s water supply, Swango went to one place where he thought his history would not haunt him: Africa. He applied for a job as a bush doctor in Zimbabwe.

Swango was hired, and not long after, people started to die mysteriously. Hospital officials became suspicious, and Swango was fired after almost a year. He soon found employment at another nearby hospital – requesting that he live in the hospital, giving him full access to patients at almost any hour of the day or night. After a short time there, a local reporter began asking questions and Swango was fired again. More people began to appear with symptoms similar to the paramedics in Illinois: intense vomiting and nausea.

He moved on to Zambia, where he worked for a few months before Zimbabwan officials alerted the hospital there of his past and he was fired again. He headed to South Africa, where he worked through a physician placement agency to find a job. He landed one in Saudi Arabia, working at a hospital run by the Saudi royal family.

There was one catch, though: Swango had to fly back to the United States, pick up his visa, then fly to Saudi Arabia.

On June 27, 1997, he landed at O’Hare International Airport in Chicago. A customs official ran his passport number through a computer and found he was wanted on federal fraud charges relating to lies he told while applying for his job on Long Island. His run was over.

In March, 1998, Swango pleaded guilty to the fraud charges and was sentenced to 42 months in prison. He was due to be released in July when federal officials came forward with the case that might keep Swango in prison for the rest of his life.

Swango was indicted on July 11. He faces two more fraud counts and three counts of giving false statements. But he was also charged with one count of assault and – almost 20 years after the first suspicious death linked to him – three counts of murderstemming from his time in New York.

The Michael Swango story stretches across at least seven states and four foreign countries. But officials in Columbus believe the story should have ended years ago at Ohio State.

“You had a small group of administrators who made tragic mistakes in their decisions,” said former OSU police chief Peter Herdt, who is now chief in Clearcreek Township, O. “This could have been stopped in 1983. Everything could have been stopped in 1983 if they would have called the police department.”

Once a full investigation had begun at OSU, much of the evidence was either gone or useless, according to a later university analysis.

The syringe found in the room Swango had just exited had been discarded. The IV line connected to Mrs. Cooper was also tossed. Several bodies were exhumed, but enough time had lapsed that the level of toxins in the corpses could never be detected.

“To go back and try to collect evidence two years later, it’s extremely hard,” said Edward Morgan, the Franklin County prosecutor and a native Toledoan. “Let’s face it: poison is the perfect murder weapon. It’s too difficult to extract after the fact. And that was one of our biggest problems.”

Judge Cashman, who has been one of Swango’s most dogged pursuers, said that OSU should be one of the primary targets of blame. “What they did was outrageous,” he said. “They wanted to protect their liability.”

Dr. Tzagournis, Dr. Goodman, and Dr. Whitcomb, the team of OSU medical administrators who investigated Swango, did not return phone calls seeking comment.

Ohio State eventually had its law school dean, James Meeks, review the procedure the hospital used in investigating Swango. He issued a report in April, 1985, that called OSU’s investigation “far too superficial” and criticized the decision not to call in the police and keep an accurate record of their inquiry. But it denied any cover up.

“What we have investigated,” the report said, “is sufficient to convince us that the matter warranted a more thorough inquiry than a reading of the medical records of the patients who died.”

Mr. Morgan prepared his own report for the Franklin County prosecutor’s office, and it was scathing. He criticized the investigation for putting no single person in charge, for failing to call the witnesses to the Rena Cooper incident for statements, and for ignoring physical evidence.

David Ferguson, OSU’s associate vice president for university relations, defends the university’s actions.

“We feel as if at the time we did everything we possibly could to look into the circumstances,” he said. “Hindsight is always 20/20. There are things we might have done differently. But there is nothing to suggest we were in any shape or form negligent.”

Last year, OSU issued a statement saying that “we should have called in outside police authorities to investigate” earlier.

Mr. Ferguson said if a similar circumstance came up now, “we’d take an even harder look.” Still, he said that OSU authorities are not investigating the suspicious deaths at the hospital, even though murder has no statute of limitations.

Attempts have been made to strengthen the system that protects patients from rogue doctors. In 1990, the National Practitioner Data Bank was created to allow hospitals to check on the disciplinary records of doctors. But consistently over the last decade, bad doctors have continued to practice, either because hospitals do not report disciplinary actions to the data bank or do not check with the data bank when making hiring decisions.

Michael Donio, director of projects for the People’s Medical Society, said the system in place is too weak. “There was no excuse for not doing thorough background checks on [Swango],” he said. “In my opinion, that constituted a violation of the public trust. How long does it take to make a phone call? Five minutes?”

It’s difficult to know how many people Swango may have killed. Judge Cashman said an FBI agent told him several years ago that investigators were confident the number was at least 60. Mr. Stewart, the author of Blind Eye, puts the number at about 35.

Unless Swango makes a detailed admission of his crimes, it may be impossible ever to know. Negotiations are under way between Swango’s attorney and federal prosecutors. Swango is in federal custody in New York City.

Mr. Morgan said he gets calls from relatives of the deceased medical center patients. “This isn’t something that just goes away. They have lived with this for a long time, and they still live with it,” he said. “Every time they see something in the newspaper or on TV about this, it brings it all up again…. I sympathize with them.”

Mark Krzystofczyk, the Quincy paramedic who was one of the doctor’s first victims, said he never doubted that Swango – charming, handsome, and smart – would find a way to poison more people . “The only thing we ever said after his trial was that he didn’t get enough time,” he said. “It wasn’t long enough. He would be out there again.”