For Exeter Hospital, a 116-year-old institution with 2,000 healthcare workers, he adds, "this has been a painful way to learn that lesson."
For outsiders, the spiraling saga began May 31, when hospital officials acknowledged that four patients cared for in Exeter's cardiac catheterization lab were found to be infected with a hepatitis C viral strain that could only have come from one person.
Infection control practice lapses were ruled out.
On June 13, Montero told reporters that the likely culprit is an unnamed hospital employee who diverted, for personal use, quantities of unnamed drugs intended for patients.
According to media reports, criminal charges are likely.
Lookback procedures were launched to see how many patients might have been at risk of being infected, resulting in a count of an estimated 1,200 people treated in the cath lab as far back as October 1, 2010. All were advised to undergo testing at the hospital's expense. So far, another 17 individuals have been found infected with the same strain, for a total of 21.