At least 15 military service members or their relatives are believed to have been infected with hepatitis by a nurse suspected of stealing their painkillers during surgery.
The nurse, retired Army captain Jon Dale Jones, was arrested this month in Miami on federal charges of assaulting three of those patients and possession of a controlled substance by fraud.
Federal prosecutors said they believe Jones spread the disease in 2004 during surgeries at an El Paso military hospital by diverting fentanyl - a powerful painkiller often used for anesthesia - from patients to himself.
The outbreak - and the nearly three-year-long criminal investigation that followed - apparently did not prevent Jones from continuing to work as nurse in Texas and at least two other states and Washington, D.C.
Jones, 45, has pleaded not guilty and was released on bond.
"We are confident that when everything comes out in court, he will be exonerated and acquitted," said Jim Darnell, the nurse's lawyer.
Details surrounding the case remain sketchy. It's not clear how Jones allegedly transmitted the potentially deadly disease to his patients or obtained the drugs they were supposed to have received during surgery. Jones has denied using dirty needles.
Court records show the alleged victims include the son of a former Fort Bliss commanding general, an active-duty soldier, the wife of a retired Marine Corps gunnery sergeant and a retired Army chief warrant officer.
Staff Sgt. Ivan James Westrick, 33, of El Paso, was one of those allegedly infected with hepatitis C after a grenade blast claimed his left hand, lower arm and part of his right hand.
Michael Volk, an attorney representing Westrick and seven other infected patients, has filed lawsuits against Jones and the nursing agency that employed him at the Army hospital, claiming the infections caused irreparable harm and forced them to undergo extensive and aggressive medical treatments.
Volk declined to discuss the cases with The Associated Press and rejected requests for interviews with his clients following a federal judge's decision to put those lawsuits on hold pending the outcome of the criminal case against Jones.
Hepatitis C is a blood-borne disease that can lead to cirrhosis of the liver or liver cancer. It is treatable, but there is no cure. Symptoms vary but can include nausea, vomiting, diarrhea, fatigue, pain and jaundice.
Court records show Jones tested positive for hepatitis C after the outbreak was discovered in October 2004. He was taken off the surgery unit but continued to work elsewhere at William Beaumont Army Medical Center as a civilian contract employee until June 2005. Army officials, who declined to comment on the details of the case, have said it's not clear whether he quit or was fired.
Paul Bracken, an El Paso lawyer representing Columbia Health Care, one of two contract companies Jones worked for at the Army hospital, declined to comment on the criminal and civil cases.
The Centers for Disease Control and Prevention linked Jones to the outbreak about a month after he left, saying he and infected patients shared the same strain of hepatitis C, according to court records. The FBI launched its own investigation a short time later.
Jones then moved to Washington, D.C., where he was a nurse at Georgetown University in August 2005, remaining there until he was fired in late 2006, according to Marianne Worley, a Georgetown spokeswoman. She declined to say why he was fired, but said the hospital is cooperating with investigators.
Jones next turned up in Florida, where last year he opened his own anesthesiology business, Jones Anesthesia, LLC. He was living there when he was indicted on Feb. 27 by a federal grand jury in El Paso on the assault and drug charges.
It remains unclear how much, if anything, agencies that license nurses in states where Jones has worked were told about the CDC and FBI investigations.
The Texas Department of State Health Services was notified that Jones tested positive for hepatitis C and it, in turn, alerted the Texas Board of Nurses.
It does not appear, however, that disciplinary action was taken against Jones, and his nursing license remained intact until he moved to Virginia. There also was no record of complaints or discipline in other states.
El Paso FBI Special Agent in Charge David Cuthbertson said CDC and Texas health officials were aware of the outbreak before the criminal investigation began. It was up to them to decide if others needed to be told about Jones or a possible public health risk, he said.
Experts said it is difficult to prevent a nurse, doctor or other health professional under investigation in one state from moving to and practicing in another.
Most state health agencies will not share complaint information with other states before investigating the allegations internally, said Dr. John Schufeldt, a Phoenix emergency room physician and lawyer who handles malpractice cases.
"It would not be the first time and it probably won't be the last," Schufeldt said of health care workers who move while under scrutiny elsewhere. "But it eventually catches up to them."
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