Dallas Hospital Says Ebola Patient Was Treated Well

by | October 10, 2014

By Molly Hennessy-Fiske and Michael Muskal

Ebola victim Thomas Eric Duncan was treated professionally and compassionately without regard for his nationality or ability to pay, the hospital that treated him said Thursday, one day after he died.

Texas Health Presbyterian Hospital in Dallas was responding to complaints from those close to the victim that Duncan, the first person diagnosed with Ebola on U.S. soil, was not treated as well as three white American missionaries who contracted the deadly virus in West Africa but recovered after treatment in Atlanta and Omaha, Neb.

Duncan, who was Liberian, arrived in Dallas on Sept. 20 and sought help in the hospital emergency room the night of Sept. 25, complaining of a headache and a fever that was just over 100 degrees. He was sent home with a prescription for antibiotics but was not diagnosed as a possible Ebola patient, even though he told the health care team that he had been in West Africa, where more than 3,800 people are suspected to have died from Ebola.

Three days later, Duncan was rushed back to the hospital by ambulance and placed in isolation until he died.

"We'd like to correct some misconceptions that have been reported about Mr. Duncan's first visit," the hospital said in an emailed statement. "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."

The hospital said that Duncan's physicians treated him with "the most appropriate and available medical interventions, including the investigative antiviral drug brincidofovir. ... Mr. Duncan was the first Ebola patient to receive this drug," the hospital said.

Two of the missionaries received the experimental drug ZMapp, but its limited supply has been exhausted, and making more takes months.

"The drug ZMapp was not administered to Mr. Duncan because it was not available," the hospital said. "According to the CDC and the drug manufacturer, it has not been available since Aug. 12."

Another of the missionaries received a transfusion with the blood of a recovered Ebola patient _ one of the missionaries who received ZMapp. But the hospital said that experimental technique could not be used for Duncan "because his blood type was not compatible with the serum donors."

Duncan was treated by more than 50 people in a secure 24-bed intensive care unit, the hospital said. "The treatment area remains sealed and is being aggressively decontaminated."

Youngor Jallah, daughter of Duncan's fiancee, disputed the hospital's assurances that he had received the quality of care that anyone else would have. "That's the way they feel, but for me, I don't think so," she said. Duncan was treated differently, she believes, because he was African and lacked health insurance.

There was no independent tally for the cost of treating Duncan in the hospital, nor for cleaning up the apartment where he stayed with his fiancee and relatives. But Dallas County Commissioner John Wiley Price said the county purchasing staff told him that the cost of responding to the case was $500,000.

Price, who is black, was among those who questioned the quality of Duncan's care. He called on the U.S. Centers for Medicare & Medicaid Services to investigate the hospital's response, alleging that it may have violated federal laws that bar patient dumping.

"The fact that they turned him away the first time should be the basis for a CMS review," Price said. "It's tantamount to patient dumping _ they changed their story at least three times. I stand by my position that the reason they basically dumped him was because he was black and didn't have insurance."

Even if that wasn't the case, Price said, "the bottom line is they missed the protocol" for dealing with potential Ebola patients.

Texas officials continue to monitor people who came in contact with Duncan during the period he had symptoms. The high-risk group of 10 includes Duncan's fiancee and three relatives. Thirty-eight others form a low-risk group that is also being checked for fevers.

No symptoms have been reported in either group.

Jallah said county officials had allowed her to leave home Thursday to see her mother _ her first chance since Duncan's Ebola diagnosis.

Also Thursday, a Dallas County sheriff's deputy who had become ill after entering the apartment where Duncan stayed was released from the hospital after tests determined that he did not have Ebola, the Texas Department of State Health Services announced.

(Hennessy-Fiske reported from Dallas, Muskal from Los Angeles.)

(c)2014 Los Angeles Times