Thomas Eric Duncan died from Ebola at 7:51 a.m. on Wednesday, Oct. 8, less than two weeks after he was diagnosed with Ebola at Texas Presbyterian Hospital.
Duncan’s family is now questioning whether a series of alleged mistakes by the hospital contributed to a death that might have been prevented. Meanwhile, hospital officials have admitted his care differed from that of others in the US who survived Ebola, in some ways that couldn’t have been prevented.
Duncan’s nephew, Josephus Weeks, wrote in the Dallas Morning News this week that his uncle’s death was the direct result of a series of hospital mistakes. “From his botched release from the emergency room to his delayed testing and delayed treatment… the hospital invited death every step of the way.”
Centres for Disease Control and Prevention Director Tom Frieden’s recent statement to the press implies that Duncan’s chances of survival may have been higher had the hospital treated him earlier. “Ebola, even with the best of treatment, is fatal in a high proportion of cases,” he said. “We encourage rapid and early diagnosis because the earlier someone is diagnosed, the more likely they will be to survive.”
It is well-known by now that the hospital released Duncan from its care after his initial visit, during which he complained of headaches and severe abdominal pain as his temperature spiked to 103 degrees. This is according to medical records obtained by the Associated Press, which contradict the hospital’s initial statement that at his first visit Duncan had a
100.1-degree fever and no severe symptoms.
After ruling out appendicitis, the hospital diagnosed Duncan with a sinus infection and sent him home with some Tylenol and antibiotics, according to the AP. Duncan’s condition worsened and he returned to the hospital on Sept. 28. This time, he was diagnosed with Ebola. He died less than two weeks later.
Dr. Daniel Varga, chief clinical officer at Texas Health Resources, has apologised on behalf of the hospital for initially failing to diagnose Duncan. Since his death, two nurses at Texas Presbyterian Hospital who cared for Duncan have been diagnosed with Ebola.
“Unfortunately, in our initial treatment of Mr Duncan, despite our best intentions and highly skilled medical team, we made mistakes,” Varga wrote in testimony to the US Congress. “We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry.”
In this testimony, Dr. Varga also expressed regret for providing the public with inaccurate information. The hospital initially reported that doctors were never made aware of Duncan’s travel history, and this is why they did not test him for Ebola. But medical records released shortly thereafter showed that a nurse in fact recorded during Duncan’s first visit that he had come to the US from West Africa. The hospital subsequently retracted its statement.
Duncan’s late diagnosis and the mistakes allegedly made by hospital staff are only some examples of how his treatment differed from other Ebola patients receiving American care. For one thing, the Nebraska Medical Center and Emory University Hospital, which received American patients who had been evacuated from the Ebola zone, are specifically set up to deal with such patients and were fully prepared to receive them. Texas Presbyterian Hospital had an Ebola patient thrust upon them with no warning.
Ashoka Mukpo, an NBC cameraman currently being treated in Nebraska, and Nina Pham, the nurse who contracted Ebola after caring for Duncan, both received potentially life-saving blood transfusions from fellow Ebola patient Dr. Kent Brantly, though that treatment remains largely unproven. This was, according to the hospital, not an option for Duncan as his blood type did not match Brantly’s.
Dr. Kent Brantly and Nancy Writebol, both flown to the US for treatment after contracting Ebola while in Liberia, received the experimental drug ZMapp and recovered soon thereafter, though it is unknown whether the drug played a role in their recovery. (Others who received it did not recover.) Duncan received Brincidofovir, the same experimental drug given to NBC cameraman Ashoka Mukpo, who is being treated in Nebraska. Duncan did not receive ZMapp because, according to the hospital, there was none left.
The day of Duncan’s death, Oct. 8, Tom Friedan backed that assertion, stating in a press call that “unfortunately ZMapp, which is a promising, but unproven experimental treatment for Ebola, is not available. There is, as far as we understand, no more of it in the world.” He went on to say that “while people are working hard to manufacture more, it takes a long time to develop.”
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