Was the care given Mr. Duncan as good as that given the other patients who have been

[cali]

treated for ebola in this country?

He didn't get the experimental drug brincidofovir until he'd been in the hospital for 4 days. Ashoka Mukpo was put on it immediately. Mukpo also got a blood transfusion from Dr. Brantley. I know that Mr. Duncan was sicker when he was finally admitted to the hospital, but wouldn't that be even more of a reason to try and get him on one of the experimental drugs expeditiously.

Mr. Duncan was a black Liberian national. Mr. Mukpo is an American, white and the son of a prominent U.S. physician. (his father is head of critical care at R.I. Hospital).

[lunasun]

1. This is what I read but maybe someone can prove it wrong . That dr. Brantley called the Dallas

Hospital to offer the victim a blood transfusion in hopes of helping but he was never called back!!!

[cali]

3. wow. I didn't see that. do you have a link?

[gvstn]

5. From Daily Mail so you be the judge.

Unlike Ebola victims Dr Rick Sacra and NBC cameraman Ashoka Mukpo, Duncan did not receive a transfusion of blood from American Ebola survivor Dr Kent Brantly after he was finally diagnosed.

Weeks (Duncan's nephew) says doctors told the family 'that the blood wasn’t a match

Read more: http://www.dailymail.co.uk/news/article-2785923/No-one-died-Ebola-U-S-Outraged-family-eyes-lawsuit-America-s-patient-zero-succumbs-initially-turned-away-doctors-later-refused-blood-transfusion.html#ixzz3FfA3t2Py
Follow us: @MailOnline on Twitter | DailyMail on Facebook

[bullwinkle428]

9. Rachel did a segment on this topic last night, and brought up this

part of the story (Brantley's offer of a transfusion) as well. She sounded genuinely pissed - well beyond standard "reporting".

[B2G]

10. Their blood types didn't match

Had they proceeded with a transfusion, that alone would have killed him.

[hack89]

15. The doctors told the family that the blood types didn't match

a transfusion would have killed him.

[lunasun]

16. thanks everyone dont know why some outlets were playing this info up if no match on blood type.

[Avalux]

2. Well for starters, it would have helped if he had received care after first ER presentation.

That was what did him in, I think. If he had been caught earlier and treated earlier, he may have survived. But your point that it took 4 days to give him brindcidofovir is noted. I have this question as well - why didn't they track down Brantly and get his blood for Duncan as they did Mukpo?

[IphengeniaBlumgarten]

6. Brincidofovir has JUST been approved by the FDA

I THINK they started him on as soon as the FDA approved it on an emergency basis. AS for blood transfusions, donor must be same type as recipient. No idea if there were donors compatible with Duncan.

If he had been treated appropriately from his first hospital visit on, it may have helped.

[cali]

8. doctors have to ask for permission from the FDA to use the drug

it's my understanding that the hospital in Dallas didn't do so for several days.

[B2G]

12. And he was improving in the first few days

from critical to stable.

Any experimental drug has the potential to upset things and make a patient worse. It sounds to me like they were taking a wait and see approach before administering it.

If they had administered it when he was stable and he crashed and died shortly after, everyone would be accusing them of treating him like a human lab rat.

Because, you know...he's black and didn't have insurance.

[Tatiana]

4. No, it wasn't.

They saw him as an uninsured patient that didn't have the means to pay for services rendered. They were so ignorant that it never entered their minds that they could have a public health emergency on their hands. They just saw $$$, in my opinion.

I see this as more of a class than a race issue. I believe if he was uninsured and white, they likely would have still turned him away. But I don't deny that race could have also played a factor.

The initial lack of care is what really did him in, I think. The virus had additional time to replicate and overwhelm his system. If they had gotten to it earlier, he might have been able to fight it off.

[Little Star]

7. No but not due to....

racism. There is a big difference in being treated at the Nebraska Medical Center as opposed to Dallas Texas Health Presbyterian.
jmho

[Johonny]

11. I haven't seen enough information to know

I was reading about his care last night. I'm not even sure how accurate things in the news cycle are. Apparently he couldn't get a blood transfusion because of blood type. Some of the experimental drugs weren't available. Other drugs were given but possibly later than other patients. Basically the only thing we know is had he gotten care earlier it could have increased his odds of surviving, but that is based on basic care philosophy. Still the disease has a 60-80 % casualty rate and none of the experimental drugs or blood transfusions are known for sure to actually "work." Which is to say it is hard to define good care. All we know is his care was different than other patients and he died and some of the other patients recovered. It is hard to know if the care given made the result more certain or simply the roll of the dice. I'm not sure we will know for sure for years how effective different treatments are. About the only thing we know for sure is that it would have been better had he started getting medical care 2 days earlier.

[Yo_Mama]

13. Brincidofovir was just approved on an emergency basis, which is why he didn't get it earlier

The journalist got it at an earlier stage of illness, but that's because he got sick later.

Brincidofovir has been used in humans before in trials against other viral infections, so its safety profile is somewhat known. But it has only shown efficacy against Ebola in the test tube. It's an utterly speculative treatment, and some felt it was too early.

Duncan's doctors asked the company for it:
http://www.nbcnews.com/storyline/ebola-virus-outbreak/dallas-ebola-patient-gets-experimental-drug-n219566
The company called the FDA for authorization. They got it.

As for the blood (I think antibody?) transfusion, it's not like we have that stocked. We have only a couple of recovered patients who could donate, and they can't donate all the time. I think Sacra got some. But these patients' bodies' are manufacturing the antibody because they need it - you can't keep pulling units and stripping all the WBCs out even if you put the rest back into their bodies. Testing seems to show that patients have some live virus in their bodies for weeks to months after "recovery". Well, Sacra was back sick in the hospital last week, so they couldn't get any from him.

I don't know whether Duncan's doctors asked for the antibodies. I think this is being done at the Nebraska hospital. The ethics of trying to take antibodies from African patients for use in the US is horrific, and won't be done for obvious reasons. If they have any, they need to use it there. Big problem there anyway that WHO has discussed:
http://www.nydailynews.com/news/national/blood-ebola-survivors-black-market-article-1.1944582

Eventually, if we get enough recovered patients this might be more generally available if we keep having just a few sporadic cases.

The journalist and Brantley have the same blood type, and Brantley donated blood to him.
http://abcnews.go.com/Health/ebola-patient-kent-brantly-donates-blood-fight-virus/story?id=26038565

[librechik]

14. considering the fact that medical errors are the third most common cause of death here

it wouldn't surprise me if caregivers botched the treatment. And that's an equal opportunity cause of death.

The fact is hospital bureaucracy is riddled with incompetence and staffing in hospitals is atrocious, if not criminal. Especially in backward former slaveholding places where the government has refused to sign on to ACA, like Texas. They want chaos. it makes a good excuse for all the inevitable fuckups.

If there was color bias against Mr Duncan, that would actually surprise me. Lots of hospitals have mostly black staffers, especially in caregiving positions. Also I believe it was a Catholic hospital with nun-nurses, and I assure you very few of those are racist.

The fact that he was a foreigner from Africa seems a more likely source of prejudicial treatment, if any.

Being Texas, though, only just barely.

Actually, given the high mortality rate for Africa-acquired ebola (70%) not sure what they could have done to stop his demise.The antiviral may not have helped. And I'm shocked we know everything about this case, even though there is HIPAA.

Of course they give the experimental drug to the white elites. That's who we are on the globe these days. And that's why a massive global effort to stop the disease in Africa won't happen. Ironic this may all blow up in "their" faces because they refused to be truly compassionate and are afraid they might have to open their wallets. I don't think of myself as a white elite because I am not part of the .1% or even the 1%.We should all be grabbing our pitchforks and mobbing the pillared halls to make them do the right thing for the poor.