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Medical records reveal deceased Texas Ebola patient sent home with high fever Medical records reveal deceased Texas Ebola patient sent home with high fever
(about 1 hour later)
Thomas Duncan, the first person to die of Ebola in the US, was released from hospital with a 103F fever on his first visit, despite telling a nurse he had recently travelled from Africa and exhibiting key symptoms of the deadly virus, it was revealed on Friday.Thomas Duncan, the first person to die of Ebola in the US, was released from hospital with a 103F fever on his first visit, despite telling a nurse he had recently travelled from Africa and exhibiting key symptoms of the deadly virus, it was revealed on Friday.
Duncan, a Liberian national, was released from Texas Health Presbyterian Hospital even though his fever spiked on his first visit to the emergency room on 26 September, according to his medical records obtained by the Associated Press. A “physician’s note” from the visit says Duncan was “negative for fever and chills” despite having a 103F (39.4C) temperature. Duncan, a Liberian national, was sent home from Texas Health Presbyterian Hospital even though his fever spiked on his first visit to the emergency room on 26 September, according to his medical records obtained by the Associated Press. A “physician’s note” from the visit says Duncan was “negative for fever and chills” despite having a 103F (39.4C) temperature.
The family provided the AP with more than 1,400 pages of Duncan’s medical records, which apparently chronicle the events that ultimately culminated in his death at 7.51am on Wednesday.The family provided the AP with more than 1,400 pages of Duncan’s medical records, which apparently chronicle the events that ultimately culminated in his death at 7.51am on Wednesday.
Duncan arrived in Dallas from Liberia on 20 September to be reunited with Louise Troh, the mother of his child whom he intended to marry. A few days later, Duncan fell ill. He went to Texas Health Presbyterian hospital in Dallas, complaining of abdominal pain, dizziness, a headache and decreased urination, according to the AP. The records show that Duncan reported his level of pain was eight on a scale of 10. Doctors ran a series of tests, ruling out appendicitis and a stroke, among other ailments. Duncan arrived in Dallas from Liberia on 20 September to be reunited with Louise Troh, the mother of his child, whom he intended to marry. A few days later, Duncan fell ill. He went to the hospital complaining of abdominal pain, dizziness, a headache and decreased urination, according to the AP. The records show that Duncan reported his level of pain was eight on a scale of 10. Doctors ran a series of tests, ruling out appendicitis and a stroke, among other ailments.
When the examination was over, the doctors prescribed him antibiotics and told him to take Tylenol, an over-the-counter drug designed to relieve pain and fever. Duncan returned home to the apartment he was sharing with Troh and her relatives.When the examination was over, the doctors prescribed him antibiotics and told him to take Tylenol, an over-the-counter drug designed to relieve pain and fever. Duncan returned home to the apartment he was sharing with Troh and her relatives.
Four days after he first began feeling sick, his condition worsened and he was rushed to the hospital by ambulance, where he was admitted and quickly placed in isolation. The Centers for Disease Control and Prevention (CDC) confirmed last Tuesday that Duncan had tested positive for Ebola.Four days after he first began feeling sick, his condition worsened and he was rushed to the hospital by ambulance, where he was admitted and quickly placed in isolation. The Centers for Disease Control and Prevention (CDC) confirmed last Tuesday that Duncan had tested positive for Ebola.
Over the weekend, Duncan’s liver function declined, he was placed on dialysis and was breathing through a respirator. The hospital began treating Duncan with the experimental antiviral drug brincidofovir. On Wednesday, Duncan died.Over the weekend, Duncan’s liver function declined, he was placed on dialysis and was breathing through a respirator. The hospital began treating Duncan with the experimental antiviral drug brincidofovir. On Wednesday, Duncan died.
It is still not clear why the hospital did not test Duncan for Ebola on his first visit, based on his travel history and symptoms. The hospital initially said Duncan had not told them of his travel history, and then later said he had, but the nurse had not shared that information with the entire medical team. The following day, the hospital changed its story again, attributing the error to a “flaw” in its online health records system, but then corrected its statement and said their was “no flaw” and Duncan’s travel history had been available to the entire medical team.It is still not clear why the hospital did not test Duncan for Ebola on his first visit, based on his travel history and symptoms. The hospital initially said Duncan had not told them of his travel history, and then later said he had, but the nurse had not shared that information with the entire medical team. The following day, the hospital changed its story again, attributing the error to a “flaw” in its online health records system, but then corrected its statement and said their was “no flaw” and Duncan’s travel history had been available to the entire medical team.
Many in the community are raising questions about the standard of care Duncan received, and some believe his race and lack of insurance played a role in the hospital’s decision to send Duncan home, feverishly ill with a course of antibiotics.Many in the community are raising questions about the standard of care Duncan received, and some believe his race and lack of insurance played a role in the hospital’s decision to send Duncan home, feverishly ill with a course of antibiotics.
The hospital defended itself in a statement on Thursday saying, “Our care team provided Mr Duncan with the same high level of attention and care that would be given any patient, regardless of nationality or ability to pay for care. In this case that included a four-hour evaluation and numerous tests. We have a long history of treating a multicultural community in this area.” Duncan’s nephew, Josephus Weeks, issued a statement on Thursday in which he alleged that his uncle may have been given inadequate treatment because of his skin colour: “Eric Duncan was treated unfairly. Eric walked into the hospital, the other patients were carried in after an 18-hour flight. It is suspicious to us that all the white patients survived and this one black patient passed away. It took eight days to get him medicine. He didn’t begin treatment in Africa, he began treatment here, but he wasn’t given a chance.”
The hospital responded to similar claims in a statement it released on Thursday, saying that it has “a long history of treating a multicultural community” and provided Duncan with “the same level of attention and care that would be given any patient, regardless of nationality or ability to pay for care.”
Mark Wingfield, associate pastor at the church attended by Louise Troh, Duncan’s partner, said that Troh, her teenaged son and two nephews are still in quarantine and not showing any symptoms. They are expected to remain isolated until 19 October when the maximum 21-day incubation period is over.
Wingfield said that the family has not yet decided whether to sue the hospital. “That’s still an underlying current. I don’t know that Louise has come to any resolution on that,” he said.
As well as the obstacle to any potentially successful legal action posed by the virus’s high mortality rate, Texas governor Rick Perry in 2003 signed into law one of the nation’s toughest statutes to limit liability for medical malpractice. The law caps “non-economic” damages payable by individuals and hospitals – such as payouts for suffering and mental trauma – to $250,000 per claimant.
None of the 48 people under observation in the Dallas area who may have had contact with Duncan are showing symptoms of the virus, David Lakey, the Texas health commissioner, told a congressional homeland security committee hearing on Ebola response coordination held at Dallas-Fort Worth international airport on Friday afternoon.
It is the 12th day of monitoring via daily contact with an epidemiologist and twice-daily temperature checks; the most common period for Ebola symptoms to reveal themselves, according to the CDC, is eight to 10 days after exposure.
“We remain confident that Ebola is not a significant public health threat to the United States,” Toby Merlin, director of the CDC’s division of preparedness and emerging infection, told the hearing. He reiterated the agency’s stance that restricting air travel between the US and the affected region in Africa would be a harmful step because it would hamper efforts to combat Ebola and worsen the economic situation there.
Dallas County judge Clay Jenkins, who has been criticised for driving the quarantined family from their north Dallas apartment to a temporary home in an undisclosed location without wearing protective clothes, defended his decision at the hearing.
Jenkins said it was “important that I not move that family wearing a Hazmat suit. It’s important for them to see me as a fellow human being, face to face, and for me to converse with them as equals. That is a basic tenet of leadership and it is in keeping with modern medicine. Louise Troh and those three young men have been handling an extraordinary scary, sad and difficult situation with grace.”
Still, a professional hazardous materials cleaning company decontaminated and stripped out the apartment last Saturday, removing the contents in 140 55-gallon drums and disposing of them.
Merlin said that dramatic images such as footage of a Dallas-area sheriff’s deputy being taken to hospital by officials wearing full protecting clothing were helping inflame public fears that were unwarranted, he said, given the limited ways in which the virus can be transmitted.
“I wince every time I see the TV images with people in space suits because it gives an impression about the infectivity of the virus that is not realistic, it is an overreaction,” he said.
This weekend is set to see an unusually large influx of visitors to Dallas, as there is a high-profile college American football game at the Cotton Bowl on Saturday and the annual state fair is ongoing.
Frank Librio, spokesman for the Dallas convention and visitors bureau, said that since the news broke they had only received two requests for information from organisations scheduled to visit Dallas. “The groups were not concerned or cancelling their meetings, an indication that people are paying attention to the medical facts. We have not received any calls from tourists to my knowledge,” he said.
As questions linger over Duncan’s death in the US, the World Health Organization (WHO) announced a grim milestone in the current Ebola outbreak – the disease has claimed more than 4,000 lives since the outbreak began in March 2014.As questions linger over Duncan’s death in the US, the World Health Organization (WHO) announced a grim milestone in the current Ebola outbreak – the disease has claimed more than 4,000 lives since the outbreak began in March 2014.
The WHO report noted that the exposure of health care workers to the virus “alarming feature of this outbreak”. More than 400 health care workers have developed Ebola since the outbreak began, including three American medical missionaries who contracted the virus while working at a hospital in Liberia and an American doctor with the WHO who contracted it in Sierra Leone and is still being treated in an Atlanta hospital. The WHO report noted that the exposure of health care workers to the virus is an “alarming feature of this outbreak”. More than 400 health care workers have developed Ebola since the outbreak began, including three American medical missionaries who contracted the virus while working at a hospital in Liberia and an American doctor with the WHO who contracted it in Sierra Leone and is still being treated in an Atlanta hospital.