George Siano, a 60-year-old White man, entered the Veterans Affairs Medical Center in Northport, New York, as a patient at a moment when the hospital’s corridors seemed ordinary on the surface—monitors humming, nurses moving from room to room, charts clipped to bedsides—yet, according to federal prosecutors, something predatory had already slipped into place. On or about July 1, 1993, a resident physician named Michael J. Swango began working there, and within weeks, Siano’s fate was sealed in a quiet chain of actions that looked, at first glance, like routine medicine.
On or about July 26, 1993, investigators later alleged, Swango took steps to make it easier for death to be accepted instead of resisted. He falsely advised doctors and staff that Siano’s family and attending physician had agreed to a “do not resuscitate” order, then recorded that order in Siano’s chart even though, prosecutors said, the family had not requested it.
That same day, the indictment states, Swango murdered Siano by administering an intravenous injection of epinephrine that caused cardiac arrest. In court years later, Swango would admit that he intentionally killed his victims by administering toxic substances he knew were likely to cause death.
Siano was not the only patient whose death would later be pulled into the same grim frame. Federal prosecutors tied Swango to additional killings at the Northport VA in 1993, alleging he murdered Aldo Serini in September with injections of one or more toxic substances that caused respiratory failure, and murdered Thomas Sammarco in October with succinylcholine, producing paralysis and stopping breathing. The indictment also described an assault on another patient, Barron Harris, involving succinylcholine. As the weeks passed at Northport, the paperwork itself became part of the alleged method: the indictment describes false statements around DNR orders, painting a picture of a doctor trying not only to end lives, but to soften the alarm that might have brought those lives back.
Swango’s time at Northport ended in the fall of 1993, after the residency program learned the true nature of his prior conviction; he was suspended from patient care and terminated from the program in October. But the story didn’t end with a firing. Over the years that followed, Swango moved through a widening arc of investigations and prosecutions, with authorities later describing a pattern of deception used to obtain medical positions. By the late 1990s, his legal troubles had already put him in federal prison on fraud-related conduct tied to lying to get medical jobs, and then, just before he was to be released, the Northport deaths came roaring back into the center of the case.
In July 2000, federal prosecutors charged Swango in a nine-count indictment that included the murder of George Siano. On September 6, 2000, in Central Islip, Swango pleaded guilty to murdering Siano and the two other Northport patients, and the court sentenced him to life without parole—three consecutive life terms—rather than risk a trial that could have exposed him to the death penalty. Judge Jacob Mishler imposed the consecutive sentences to ensure Swango would spend the rest of his life in prison, and even directed that Swango be barred from prison duties involving food or drugs. The VA’s Inspector General later summarized the result bluntly: Swango pleaded guilty to the murder of three veterans in his care at the Northport VA and received three consecutive life terms without parole.
