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'Double-O Swango': What happened to Dr. Michael Swango, who left trail of dead patients in Midwest, elsewhere

Special agent recounts his investigation into Michael Swango, the doctor who killed his patients

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Michael Swango
Courtesy / Sioux Falls Argus Leader file photo
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Michael Swango was many things.

He was a gifted medical student and doctor and a former Marine. He was also a mass serial killer and a talented con artist. And, for a short time, he was also a South Dakotan.

Dr. Michael Swango is now serving three consecutive life sentences without the possibility of parole at ADX Florence federal prison in Colorado for the death of four of his patients, though many suspect him of dozens more that have not been proven. But for years in the 1980s and 1990s, he stalked the rooms and hallways of hospitals across the country, where he developed a suspicious reputation after his patients would begin mysteriously dying on his watch.

Over the years, some nurses and other coworkers would develop an inkling that something was amiss, but they couldn’t prove it. And when scrutiny would come closing in around him or his superiors would discipline him for infractions, he would eventually move on to another health care outpost, ready to take up another role that put him in a position to begin his work all over again.

Eventually he fled as far as Africa, but a return trip to the United States gave law enforcement the chance they needed to collar him, and thus his final downfall began.

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It was a case that stunned many in both the healthcare profession and law enforcement. Not only were the killings performed by a certified doctor who was sworn by oath to do no harm — in hospitals surrounded by other patients and medical colleagues — but he also managed to elude criminal charges for years while continuously finding employment in new locations.

His reign of terror came to an end in 1997, when he was arrested at Chicago’s O’Hare International Airport and subsequently convicted and sentenced to three consecutive life sentences without the possibility of parole.

Meeting the killer

Many investigators worked on the case, including Bruce Sackman.

Sackman spent 32 years working for the federal government, including 25 with the Veterans Administration, investigating crime within the department. Most of those cases were what he considered standard fair for his office — fraud, prescription drug theft and other graft.

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Bruce Sackman is one of the investigators who worked to bring Michael Swango, a doctor and serial killer, to justice.
Submitted Photo

But he never thought he’d become wrapped up in a serial killer investigation.

“I think it was watching too many Columbo television shows,” Sackman told the Mitchell Republic about how he became interested in investigative work in his younger days. “I'm not a big Dirty Harry kind of guy, but I like the work. And I like the way Columbo works. He doesn’t beat people up or get into shootouts. He’s really smart.”

Sackman was serving as a special agent in charge for the United States Department of Veterans Affairs out of New York when he first became aware of Swango, who had recently been featured on a television program that caught the attention of a doctor at the Veterans Affairs Medical Center in Northport, New York.

In a phone call, she implored him to look closer into Swango, whom she suspected of killing patients at her facility.

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The television special she had seen outlined the unusual behavior of Swango, including the fact that death appeared to follow him almost everywhere he worked. The program also noted that he had actually been imprisoned for a time for poisoning his own co-workers on an ambulance crew. It was a damning piece of television, which Sackman had just happened to miss when it was broadcast the night before.

He had taken phone calls before about tips that led nowhere, but this phone call would prove to be like no other he had ever received.

“I received the phone call that changed my life, literally. I almost didn’t believe this call. Is this April 1?” Sackman asked himself. “How could this guy have passed background investigations and have a position to treat our nation’s heroes? But it happened, and that’s what got me involved in that case, and it changed the course of my career.”

Sackman outlines his investigation of the Swango case, and the cases of other medical serial killers who also preyed hospitalized veterans, in his book "Behind the Murder Curtain: Special Agent Bruce Sackman Hunts Doctors and Nurses Who Kill Our Veterans."

The Swango case almost sounded too sensationalistic to be believed, Sackman said. But his partner had seen the program, and was sure the reporters working on it would not have gone on the record with their story if they had not been sure. So Sackman and his partner headed up to Northport to see what was going on.

There, he met the alleged killer in the flesh. And he was not what Sackman was expecting.

“He was a very handsome, charming guy. It looked like he had just come in from the golf course,” Sackman recalled. “He was tan, wearing aviator sunglasses. If I didn’t know any better and my daughter had brought him home and said he was a doctor at the VA, I would have thought it was like winning the lottery.”

Sackman asked him about the television piece broadcast earlier, and about the alleged poisoning that had taken place, among other specifics. Swango proved to be a very smooth interview, deftly deflecting questions. But as the pressure increased from Sackman, cracks began showing in Swango’s facade.

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“I pressed harder and that’s when his friendly nature changed and he asked us to leave,” Sackman said.

Sackman had no proof, and without it Swango could decline Sackman’s request to search his room. With nothing immediate to move on, Sackman left. And shortly thereafter, Swango did the same.

“I said to myself, ‘Bruce, you don’t have any proof and we can’t even search his room,’” Sackman said. “After that, Swango was gone.”

Trail of death

Swango, born in the state of Washington and raised in Illinois, was considered a bright upcoming student before attending the Southern Illinois University School of Medicine. It was here that coworkers began noticing a troubling trend. He showed a fascination with dying patients, and preferred working as an ambulance attendant instead of studying. He eventually graduated behind schedule.

He moved on to Ohio State University Medical Center, where more serious concerns were raised by staff. His patients, many of whom were considered stable, began to mysteriously die without explanation. Amid the reports and a sub-par performance record, administrators canceled the residency it had offered him, and he returned to his home town of Quincy, Illinois, to work as an emergency medical technician on an ambulance crew.

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Behind The Murder Curtain, a book by Bruce Sackman, outlines the investigation into Michael Swango, a doctor and serial killer, as well as three other medical serial killers.
Submitted Photo

It was at this stop that he notoriously poisoned his own ambulance colleagues with arsenic, a move that resulted in five years in prison on aggravated battery charges.

At various stops during his career, some colleagues had reported seeing Swango inject patients with an unknown substance shortly before they died. It was reported on another occasion that he emerged from a dying patient's room with a smile on his face. Some of his fellow medical students had dubbed him Double 0 Swango, a play on words of the code number for James Bond, who in literature had a license to kill.

To the outside observer, this would seem like the likely end to his medical career in any shape or form. But Sackman said information was harder to come by in those days, and Swango used every trick in the book to keep access to the medical field.

Background screenings for hiring have improved greatly in the time since Swango stalked hospital hallways, Sackman said.

“This was all pre-internet. It was a little harder to get information on a person’s background than it is now,” Sackman said. “Medical credentialing is 100 times more restrictive now than it was back then. In fact, one of the good things to come about from the case is how medical credentialing has improved dramatically, because nobody wanted to hire a guy like this ever again.”

South Dakota stop

After being released from prison in 1989 on the poisoning charges, he worked for a time in Virginia before finding his way to Sioux Falls, where he again took up position as a doctor, this time with what is now Sanford Health. In both Virginia and South Dakota, he used his inherent charm and a variety of forged legal documents to re-establish his career in the medical field.

He falsified his criminal record, changing his aggravated battery conviction and prison sentence into a misdemeanor for getting into a fight with coworkers, resulting in six months in prison as opposed to the five years he actually received for felony poisoning. He even faked a letter from the governor of Virginia that stated his right to vote and serve on a jury had been restored.

As horrific as the allegations at his other career stops were, his time in Sioux Falls was marked by a notable absence of suspicious activity. By accounts he was considered a valued member of the medical staff, and if anything seemed out of the ordinary, nobody came forward to point it out.

Sackman said it is possible Swango was trying to lie low, but it’s possible he was up to his old habits and he just kept it under better wraps, though he notes that is strictly speculation. He also said, in his experience as an investigator, whistleblowers to crimes would often face blowback in the form of accusations of paranoia, which could make it unappealing for an individual to step forward with shocking claims.

“Management more often than not supports the accused and not the whistleblower. That’s true the world over,” Sackman said.

He has a hard time fully believing that Swango had reformed himself in South Dakota.

“Was he a good boy during that time? Could be. Did something happen that nobody noticed? Could be. I just don’t really know the answer,” Sackman said. “I think things were going well for him, but I don’t see how he could resist the temptation of taking someone out. I don’t see how he could control himself, and the more work he did, the better he got at it.”

Swango could very well have remained in Sioux Falls for some time, but he committed a critical blunder. He attempted to join the American Medical Association, whose background check for membership was considerably more thorough than most hospitals. The AMA review spotted his conviction for poisoning, and once again Swango was on the run.

He eventually resurfaced again at Northport, where he came to the attention of Sackman before bolting to places unknown.

Dozens of deaths suspected

By 1994, Swango had fled overseas to Zimbabwe, where he again tried to establish himself as a doctor.

“After that he was gone and went to Zimbabwe, and when he was there he killed men and women and children. Everyone.” Sackman said. “The medical staff in Zimbabwe were competent, and they started to realize that something was going on, and they tried to charge him, but he beat the charges and had returned to the United States to renew his passport. That’s where we arrested him.”

Swango was initially arrested for lying to government investigators, not murder.

“Not for murder, there was no evidence of that, but for lying to the government. He lied on his applications and he lied to me. That gave us a window to start the investigation and make a determination on whether he had killed anyone,” Sackman said.

That investigation — extensively outlined in Sackman’s book — paid off with the conviction of Swango's involvement in four deaths.

“We started doing the background investigation and followed from when he was in medical school to the time he came to us, and that’s when we found he left a trail of suspicious deaths as far back as medical school,” Sackman said. “These cases are extraordinarily hard to prove. The victims many times are very ill, and many times they could have expired from the natural disease process.”

That’s part of the reason why he was only convicted in the involvement of four deaths — he confessed to them in exchange for not being extradited to Africa and to avoid the death penatly in the United States — instead of the dozens he is suspected of, Sackman said.

“I’ve heard and I’ve read and we’ve discussed that it was somewhere in the vicinity of 60 people. Medical serial killers kill so many people that even when they cooperate, they can’t even remember. Can you imagine?” Sackman said.

Moving forward

In addition to writing his book, Sackman has become an in-demand speaker due to his work in the field of medical killers. Prior to the outbreak of COVID-19, he was a featured speaker on the subject in far-away locales like Europe, Dubai, Sweden and across the United States. He has consulted with foreign police on cases, as well.

Sackman said many people are stunned by how easy it appeared for Swango to continue his killing despite suspicions. But doctors are revered in American culture, and deaths are a common occurrence at hospitals. Combine that with his skill in administering poisonous doses of chemicals that were difficult to track and his smooth people skills, it becomes more clear how he was able to avoid detection.

“If you think about it, you’re working where death is a common occurrence. Then he also had the chance to work alone, to draw that curtain around himself and the victim,” Sackman said. “Nobody is going to see it.”

At its heart, it’s a terrifyingly sad story, Sackman said, but the conviction remains a beacon of sorts to investigators trying to root out killers hiding amongst the excellent doctors and nurses who are doing everything that they can to help their patients, not harm them.

Sackman said he hopes the Swango case gives law enforcement and prosecutors the confidence to move ahead with investigations. Being as difficult as these cases can be to prove — the investigations are expensive and time-consuming — and there’s no guarantee of eventually bringing a killer like Swango to justice.

He is proud of his work on the case as well as the others on which he has worked, but he is not a one-man show. He is thankful for the help his colleagues provided as they studied the case.

“No one investigator could do this himself or herself. It takes a team to do it. Doctors, toxicologists, forensic nurses. We had quite a team of people working on this thing, because that’s what it takes,” Sackman said.

It takes observant, brave professionals calling out what they see as suspicious activity when they see it. It takes the work of law enforcement officials acting on those suspicions. It takes medical examiners to help prove the causes of deaths that at first blush may seem unremarkable.

Only with their help can people like Sackman and his team bring justice to those who were the victims of murderers like Swango.

“I always like to say thank you to the very professional doctors and nurses who brought these cases to our attention. Without them we would never have known about it. It was those who came forward and told us about it. Without them, we wouldn’t even be having this conversation,” Sackman said. “But the public needs to know these (killers) are the remote outliers. Overwhelmingly, medical professionals are the salt of the earth.”

Erik Kaufman joined the Mitchell Republic in July of 2019 as an education and features reporter. He grew up in Freeman, S.D., graduating from Freeman High School. He graduated from the University of South Dakota in 1999 with a major in English and a minor in computer science. He can be reached at ekaufman@mitchellrepublic.com.
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