Dallas Hospital Apologizes for "Mistakes" in Ebola Care

Ebola virus virion. Created by CDC microbiologist Cynthia Goldsmith, this colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion.
Ebola virus virion. Created by CDC microbiologist Cynthia Goldsmith, this colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion.

A representative of the Dallas hospital under scrutiny for its handling of the first Ebola case in the United States apologized on Thursday for mistakes he said the facility made when it initially misdiagnosed the patient.

During a congressional hearing, Daniel Varga, chief clinical officer of Texas Health Presbyterian Hospital's parent organization, said the hospital erred when it released Thomas Duncan, the first Ebola patient, on Sept. 26. Duncan was sent home from his first visit to the hospital with a prescription for antibiotics despite showing symptoms of the virus and reporting that he had traveled to an Ebola-stricken area of West Africa.

“We made mistakes," said Varga, who works for Texas Health Resources. "We did not correctly diagnose his symptoms as those of Ebola, and we are deeply sorry."

The Dallas hospital has come under fire for misdiagnosing Duncan, who came in contact with dozens of people after becoming infectious. Duncan returned to the hospital two days later in an ambulance and was placed in isolation for intensive care. He died on Oct. 8. Since then, two nurses who treated him have been diagnosed with Ebola. 

The congressional panel convened to examine the public health response to the Ebola outbreak that has killed thousands in West Africa.

 

Varga also apologized for the hospital’s release of inaccurate information about what led to the misdiagnosis of Duncan. He said the hospital rushed to release information in an effort to help other health institutions learn from the facility's response, but that the information ended up being wrong.

The hospital first said a glitch in its electronic medical record system had led to the misdiagnosis. In its original statement, the hospital said Duncan had informed a nurse about his travel history but that information had not been relayed to the physician overseeing Duncan’s care during his initial visit. It then revised this information, confirming that all members of the health care team that treated Duncan in the emergency room knew he had recently been in Africa.

Despite the mistakes the hospital said it made, lawmakers were much more critical of federal health officials. U.S. Rep. Tim Murphy of Pennsylvania, the panel's chairman, commended Varga’s “statement of honesty” about the hospital’s mistakes, but he said the "trust and credibility" of the government's response to the Ebola cases are "waning."

"Errors in judgment have been made to be sure," Murphy said.

The hearing came a day after Amber Vinson, a nurse who treated Duncan in the hospital, tested positive for Ebola. Nina Pham, another nurse who treated Duncan, also contracted the virus. Pham will be transferred from Dallas to a National Institutes of Health facility in Bethesda, Md., federal health officials told lawmakers. Vinson was transferred to Emory University Hospital in Atlanta on Wednesday.  

Varga told members of Congress that the hospital had yet to pinpoint how the two intensive-care nurses were exposed to the virus despite “using full protective measures” and personal protective equipment recommended by the U.S. Centers for Disease Control and Prevention.

“It’s clear there was an exposure somewhere,” Varga said. “We are poring over records and observations to find the answers.”

CDC director Tom Frieden said during the hearing that its investigation into the nurses’ exposure to the virus is “ongoing.” He has said a breach of protocol led to the health care workers’ infections. 

 

Ebola is not easily spread because it can only be transmitted through direct exposure to the bodily fluids — including blood, sweat, saliva, vomit and diarrhea — of someone who is carrying the virus and is showing symptoms.

Frieden was grilled over the fact that Vinson was granted permission from the CDC to board a commercial flight despite having a low-grade temperature. 

"My understanding is that she reported no symptoms to us," Frieden said.

Lawmakers also asked federal health officials whether a ban on incoming flights from Ebola-stricken areas may be necessary.

U.S. Rep. Michael Burgess of Texas, who indicated he supported the travel ban, suggested that the full U.S. House of Representatives take the matter up for a vote.

But Frieden said a travel ban may not help given the "porous border" between West African countries, which could allow entry from a nearby area that has not been affected by the Ebola outbreak.

Pham released a statement Thursday afternoon, saying she was doing well thanks to the care she had received at Texas Health Presbyterian Hospital.

“I’m so thankful for the outpouring of love and support from friends and family, my coworkers and complete strangers," Pham said. "I feel very blessed, and have gained strength from their support."

The hospital is currently monitoring 75 other health care workers who might have come in contact with Duncan. The medical professionals have been "sidelined" from staffing its intensive care unit while under observation, the hospital said.

As health officials continue to investigate how the nurses were exposed to the virus, state officials have asked the University of Texas Medical Branch at Galveston to prepare to treat Ebola patients in case a patient must be transported there.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

Disclosure: The University of Texas Medical Branch at Galveston was a corporate sponsor of The Texas Tribune in 2012. A complete list of Tribune donors and sponsors can be viewed here.

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