Ebola Patient’s ER Discharge Was Classic Malpractice

New details have emerged about Ebola victim Thomas Duncan’s first treatment at a Dallas hospital emergency room. High fever, severe pain, a recent trip from a foreign country: classic markers of a patient who needs to stay in the hospital and not be ushered out the door. Yet he was sent home, and came back three days later when he was much sicker, and ultimately died.

Whether the mistreatment of Mr. Duncan had to do with his skin color, as his family alleges, might be questionable. Plenty of people of all races fall victim regularly to medical malpractice. Yet the emergency staff’s first interaction with the patient gave them plenty of clues.

He showed up in the ER complaining of abdominal pain and a headache but no fever, according to records obtained by the family and turned over to the Associated Press. Then, three hours into his four-hour stay, his temperature spiked to 103 degrees. Why? Doctors had no explanation for that, nor for his report of 8-out-of-10 pain. Pain out of proportion to the patient’s appearance — no obvious trauma or other apparent reason — is well known to skilled doctors as a reason to proceed with care and caution, and do further tests and observations. That didn’t happen on September 25, the day Mr. Duncan showed up at the ER of Texas Health Presbyterian Hospital. Instead he got a diagnosis of sinus infection, another head scratcher in light of his normal head CT scan and unexplained abdominal pain.

The hospital’s story about why he wasn’t admitted that day is also growing sketchier by the day. Its initial excuse was:

* His fever only got to 100.3, not enough to set off alarm bells.

* His symptoms were not severe.

* The doctors treating him were not told of his trip from Liberia, due to some snafu in the hospital’s electronic record system.

Now we know all three of those reasons are wrong. The bit about the records glitch was first to fall, when hospital administrators admitted that Mr. Duncan had told the staff of his trip from Africa and that it appeared in all of his electronic records that treaters saw.

Now the real number on his fever – 103 – and his severe pain have been revealed, and it all adds up to a patient who most independent doctors would say should have never been sent home. Would that have saved his life? Hard to say, but the odds would have definitely improved, as early diagnosis has saved some other Ebola victims.

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