In written testimony to the House Energy and Commerce Committee on Thursday, Daniel Varga, chief clinical officer of Texas Health Resources (THR), said he is "deeply sorry" for how THR's Texas Health Presbyterian Hospital handled the treatment of the first Ebola case in the United States.
Our timeline: How the deadliest Ebola outbreak in history spread
Background on the three Dallas Ebola cases
Thomas Eric Duncan flew from Liberia on Sept. 19 and arrived in the United States on Sept. 20 to visit relatives. He first became ill on Sept. 24 and went to Texas Health on Sept. 25. However, health workers did not suspect Ebola and he was discharged.
'People make mistakes.' Why a patient with Ebola was sent home
According to hospital officials, one of the nurses asked the man about his travel history, and he volunteered that he had been in Liberia days before. The hospital initially blamed a flaw in the hospital's electronic health record (EHR) system, claiming it prevented Duncan's doctors from seeing his travel history, which led them to discharge him from the hospital. However, the hospital later said that the EHR was not to blame and said a miscommunication between members of Duncan's care team led workers to lower his risk status approve his discharge.
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When the patient's health worsened on Sept. 28, he returned to the hospital via ambulance. On Oct. 7, hospital officials announced that Duncan had been put on a ventilator and a kidney dialysis machine and that he was fighting for his life. And at 7:51 a.m. on Oct. 8, he succumbed to the viral infection that has killed nearly 5,000 people in West Africa.
This past weekend, Nina Pham, a 26-year-old nurse who was part of Duncan's care team, tested positive for the deadly virus, marking the first known Ebola transmission on U.S. soil and heightening concerns about the health system's ability to contain its spread.
A second Dallas nurse has contracted Ebola. Are more cases to come?
Three days after Pham's diagnosis was announced, a second member of Duncan's care team, 29-year-old nurse Amber Vinson, was also diagnosed with the virus. Vinson was transported to Emory University Hospital in Atlanta to receive care, while Pham will continue receiving treatment at Texas Health Presbyterian.
First Ebola patient was not isolated until two days after hospital admission
According to medical records released by the Associated Press, Duncan was not put in an isolation unit and medical personnel treating Duncan did not wear protective hazardous-material suits until two days after he was admitted to the hospital with Ebola-like symptoms. These two days may have exposed dozens of staff members to the virus.
Officials are now looking at the three-day window between Sept. 28 and Sept. 30 as the key time when one or more of the 70 health care workers who were exposed to Duncan may have contracted the virus.
Varga issues apologies
According to The Hill, Varga will not attend a Congressional hearing Thursday on Ebola, although CDC Director Thomas Frieden and other health officials will be in attendance. Instead, Varga has issued written testimony apologizing to lawmakers on behalf of the hospital.
In the testimony, Varga writes, "Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes [and] did not correctly diagnose his symptoms as those of Ebola," adding, "We are deeply sorry."
He also apologizes for "inadvertently provid[ing] some information [to the public] that was inaccurate and had to be corrected."
However, Varga does note that the hospital had conducted training over the summer and employees were given guidance several times on how to spot Ebola symptoms.
What CDC is doing to improve safety for Ebola workers in Dallas
Varga touts Pham as an "extremely skilled" nurse who used "full protective measures under the CDC protocols." He said that THR is "poring over records and observations" to determine how she and Vinson became infected. Earlier this week, Varga acknowledged that "there was an exposure somewhere, some time during the treatment of Mr. Duncan," but that he did not think the hospital had "a symptomatic, institutional problem."
Varga says that the facility has made several procedural changes, such as immediately asking ED patients about their travel history and implementing "proactive, intensive, and focused training" related to spotting and diagnosing the virus (Wolfe/Kenen, Politico, 10/15; Byrnes, The Hill, 10/16; Yan et al., CNN, 10/16; Sack, New York Times, 10/15; Hunt, "The Scoop Blog," Dallas Morning News, 10/15).
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