EbolaNews - Dallas: Dallas hospital retracts explanation for missed Ebola diagnosis. Texas Health Presbyterian has not addressed how it overlooked Thomas Eric Duncan as likely having Ebola. The Texas hospital that failed to initially identify and isolate the country’s first Ebola patient in its emergency room is now backtracking on its explanation for the error. Texas Health Presbyterian Hospital in Dallas first said they had “thoroughly reviewed the chain of events” and blamed a flawed computer system for its staff not recognizing that Liberian native Thomas Duncan was at high-risk for having the deadly disease. U.S. Ebola patient Thomas Eric Duncan. Late Friday – 24 hours after releasing the details in “in the interest of transparency” – the hospital reversed part of its account. Unlike before, they said Duncan’s travel history was visible to all in the hospital’s electronic health record (EHR) system. “There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event,” the hospital said in a written statement. But as of Saturday afternoon, no other explanation for the oversight has been given. Emails to the hospital with specific questions from Yahoo News have not been returned for days. The orginal statement detailed how the hospital had been proactive in fixing the alleged flaw. “Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows,” the hospital stated on Thursday. “It also has been modified to specifically reference Ebola-endemic regions in Africa. We have made this change to increase the visibility and documentation of the travel question in order to alert all providers. We feel that this change will improve the early identification of patients who may be at risk for communicable diseases, including Ebola.” Duncans condition was downgraded on Saturday afternoon from serious to critical. Officials in charge of the Dallas investigation and public health response also had no answers when asked about the hospital’s retraction during a Saturday news conference. “There are a lot of issues that have come forward with the first case in the U.S.,” said Dr. Thomas Frieden, CDC director. “It’s definitely possible to take care of patients with Ebola safely, but it’s not easy and there are lots of issues.” Hospitals original statement faulted its computer system. Click image to read entire document. Federal guidelines published in August advised someone in Duncan’s condition and who was known to be in diseased-ravaged West Africa to be placed in isolation and tested. Instead, Duncan was prescribed antibiotics and sent home. The decision may have put others at risk for exposure to Ebola before an ambulance rushed Duncan back to the ER two days later when his condition worsened. Dr. David Lakey, commissioner of the Texas Department of State Health Service, pleaded for the country’s medical professionals to learn from Texas Health Presbyterian’s lapse. “The travel history is very, very important to take right now and it has to be communicated,” Lakey said on Saturday. “If you have a patient with a fever or symptoms that could possibly be related to Ebola, youve got to ask that travel history and take it seriously.” Duncan, 42, showed up at the hospital with what officials described as fever of 100.1 degrees, abdominal pain for two days, a sharp headache, and decreased urination. The hospital said Duncan told them he hadnt experienced nausea, vomiting, or diarrhea — strong indicators of Ebola. [Related: U.S. officials acknowledge ‘missteps’ in Ebola case] Texas Health Presbyterian admits that Duncan, who had just moved to Dallas from Liberia on Sept. 20, acknowledged that he had been in Africa in the past four weeks. “The nurse entered that information in the nursing portion of the electronic medical record,” the hospital said in the original statement. However, “when Mr. Duncan was asked if he had been around anyone who had been ill, he said that he had not.” The retraction late Friday did not address how Duncan answered the questions or the hospital’s stance that it followed protocol. Officials said public health investigators are monitoring 46 people for Ebola symptoms, including nine who are considered to be at higher risk because they had definite contact with Duncan. None have shown any symptoms, but will be tested through late October. Dallas resident Don Petty said he has grown weary of the “mixed signals” and lack of answers. “The computers at Presbyterian do not prevent or preclude intake personnel, nurses and doctors from talking to each other about the cases they observe,” Petty told Yahoo News. “I don’t know if we know what we have going on here in Dallas. We’re kind of like the dog that caught the car – what are we going to do with it now?”
Posted on: Sun, 05 Oct 2014 03:46:09 +0000
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