Swango's father was a career United States Army officer who served in the Vietnam War, was listed in Who's Who in Government 1972–1973, and became an alcoholic.

Eventually, the school allowed him to graduate one year after his entering classmates, on condition that he repeat the OB/GYN rotation and complete several assignments in other specialties.

[2] Despite a very poor evaluation in his dean's letter from SIU, Swango gained a surgical internship at Ohio State University Medical Center in 1983, to be followed by a residency in neurosurgery.

While he worked in Rhodes Hall at OSU, nurses noticed that apparently healthy patients began dying mysteriously with alarming frequency.

Later, it emerged that OSU officials feared that Swango would sue if he was fired without cause, and resolved to quietly push him out of the hospital as soon as possible after his internship ended.

Soon, many of the paramedics on staff began noticing that whenever Swango prepared the coffee or brought any food in, several of them usually became violently ill, with no apparent cause.

A scathing review by law school dean James E. Meeks concluded that the hospital should have called in the police, and also revealed several glaring shortcomings in its initial investigation of Swango.

In 1991, Swango legally changed his name to Daniel J. Adams and tried to apply for a residency program at Ohio Valley Medical Center in Wheeling, West Virginia.

He forged a fact sheet from the Illinois Department of Corrections that falsified his criminal record, stating that he had been convicted of a misdemeanor for getting into a fistfight with a co-worker and received six months in prison,[8] rather than the five years for felony poisoning that he served.

However, when he attempted to join the American Medical Association (AMA), it conducted a more thorough background check than Sanford and found out about the poisoning conviction.

[7] The AMA temporarily lost track of Swango, who managed to find a place in the psychiatric residency program at the Stony Brook University School of Medicine in New York.

Under intense questioning from the head of Stony Brook's psychiatry department, Alan Miller, Swango admitted he had lied about his poisoning conviction in Illinois.

Swango dropped out of sight until mid-1994, when the Federal Bureau of Investigation (FBI) found out he was living in Atlanta and working as a chemist at a computer equipment company's wastewater facility.

In November 1994, he settled in Zimbabwe and used forged documents to obtain a job at Mnene Lutheran Mission Hospital in the center of the country.

He also appealed to the authorities at Mpilo Hospital, Bulawayo, to allow him in the interim to continue working voluntarily there; however, this was opposed by Abdollah Mesbah, a surgical resident, who had often found him snooping around mysteriously in the wards and in the intensive care unit (ICU) even when not on call.

At this time, Swango rented a room in Bulawayo from a widowed woman who subsequently became violently sick after a meal she had prepared for herself and a friend.

The woman consulted a local surgeon, Michael Cotton, who suspected arsenic poisoning and persuaded her to send hair samples for forensic analysis to Pretoria, South Africa.

[2] While this was happening, Tom Valery, chief investigator for the Office of Inspector General of the Department of Veterans Affairs (VA), consulted with Charlene Thomesen, a forensic psychiatrist.

Because of her considerable clinical expertise, Thomesen was able to review documents and evidence and give a criminal profile of Swango, along with her assessment of why he had committed such crimes.

There was enough evidence for Immigration and Naturalization Service agents to arrest Swango in June 1997, on a layover at Chicago O'Hare International Airport on his way to Saudi Arabia.

[2] Faced with hard evidence of his fraudulent activities and the possibility of an extended inquiry into his time in Zimbabwe, Swango pleaded guilty to defrauding the government in March 1998.

[2] Although the FBI, the VA, and prosecutors for the Eastern District of New York were convinced Swango was a serial killer, they knew it would be difficult to prove beyond a reasonable doubt.

Federal inmates must serve at least 85 percent of their sentences before being eligible for time off with good behavior, meaning that they likely had only three years to prove that Swango was indeed a murderer.

[15] Additionally, prosecutors found evidence that Swango lied about the death of Cynthia Ann McGee, a patient he treated during his internship at OSU.

Eventually, prosecutors agreed to not pursue the death penalty or extradition in return for Swango accepting a sentence of life in prison without parole.

[18] He was sent to ADX at his own request; he had been stabbed by another inmate while serving time for lying to the VA, and feared he would be attacked again if he were placed in general population.