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Another co-worker said he once saw him with white foam around his mouth. Others told of him shaking, sweating through his scrubs and frequently running off sick to the bathroom, sometimes in the middle of a procedure. A patient’s relative discovered a fentanyl syringe in a public bathroom.

In April, Kwiatkowski was charged with leaving the scene of an accident after he backed into a car and drove away.

In May, three doctors simultaneously reported that patients recently treated in the catheterization lab had tested positive for hepatitis C. Within days, Kwiatkowski was also identified as having hepatitis C, and he was suspended as the state began investigating.

In July, police in Massachusetts said they found him intoxicated in a hotel room with a suicide note. He was arrested soon after.

Laboratory testing found that 31 patients had a strain of the hepatitis C virus matching the one Kwiatkowski carried, health authorities said. It isn’t clear when he contracted hepatitis C. Prosecutors said in court papers that they have evidence he tested positive at least as far back as 2010. Michigan officials said he tested negative in 2006.

In response to the AP story, Exeter Hospital on Tuesday called for mandatory disclosure by health care facilities about problem workers. The hospital said there should be a national registry system covering all workers providing patient care, and hospitals that share information should be protected from employment lawsuits.

Also Tuesday, the University of Pittsburgh Medical Center said it sent letters to about 2,000 patients who may have been exposed to hepatitis C by the former medical worker. The hospital said the letters were not in response to the AP story.

Kwiatkowski’s license in New York is still listed on a state website as active and in good standing.

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David B. Caruso reported from New York. Associated Press writers Eric Tucker in Washington, Paul Davenport in Phoenix and Ed White and Mike Householder in Detroit contributed to this report, as did AP researcher Jennifer Farrar in New York.