(Dallas Ebola patient) Thomas Eric Duncan has died

[Scairp]

Source: MSNBC

Dallas Ebola patient has died, according to the hospital.

Read more: Link to source

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This shows how very, very important it is to diagnose this disease immediately and begin treatment as was the case with the American missionaries who were infected in Africa but brought back here for treatment. This man might have lived had the hospital not dropped the ball. His family must be so upset and afraid for themselves.

[jen63]

1. Just heard this on MSNBC also.

Very sad.

[calimary]

12. Oh brother...

[lovuian]

2. According to the Houston Chronicle

My condolences to the family and thank God to the relative who notified the CDC


it cost over 500,000 dollars to treat him and it doesn't look like he's paying the bill

Does our medical system of capitalism and insurance companies have a weak spot?

Ebola could wipe the hospitals out financially and the insurance companies

Our whole medical system won't work with a devastating plaque

[Scairp]

3. Ebola isn't like that

It isn't influenza or anything easily caught through the air. I don't foresee any kind of long term issue with this particular disease.

[lovuian]

4. It's 500,000 dollars for ONE CASE

we have now how many possible cases pending out there

all it takes is 50 cases we could be looking at MILLIONS

not many cases but catastrophic costs and very DEADLY

[ColesCountyDem]

5. Major trauma cases can easily cost that much.

The system survives, even though there are many, MANY more trauma cases than Ebola cases.

[hedgehog]

6. A man dies and your first concern is the money spent to save him?

You do know where you're posting, right?

[AZ Progressive]

10. That's not unsurprising in America nowadays

[lovuian]

18. I wrote my condolences to his family

I was pointing to the weakness of not having a one payer system

I'm very sad for his family and pray none of them get sick

[hedgehog]

22. OK

[candelista]

37. Glad to know his moral priorities meet with your approval!

[harun]

29. Money is not a major concern in these cases or others.

Just because that is the bill doesn't mean the hospital will get that much. By the time insurance companies and the state get done fighting it out the hospital will be lucky to get 40K. It's how our fucked up system works.

[WinkyDink]

13. Let me think..How DOES a sneeze work? Hmmmmmm........

[LynneSin]

40. Are you kidding me? Do you even know how it's transmitted?

http://www.cdc.gov/vhf/ebola/transmission/index.html

•blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola

Sure, not being airborne is pretty good for us. But that doesn't mean it is safer.

Do you know what happens to a patient when Ebola is raging thru them - they are puking, pooping, sweating and bleeding from every open pore and hole in their body and all that discharge makes nuclear waste look like safe drinking water. All that stuff coming out of the patient is filled with live Ebola virus looking for a new host. Why do you think this thing spread as rapidly has it has thru Gambia, Sierra Leona and Liberia - because sanitation is poor there plus relatives want to help their family members and they get near these hot waste. Why do you think so many health workers helping with this outbreak are getting sick and dying - because they are surrounded by this mess and they are exhausted. It's almost impossible to not get the Ebola. In BSL4 research labs the scientists wear spacesuits to research Ebola. In the field the doctors wear hazmat suits and masks and hope they don't tear. And they practically drown themselves in clorox, those hazmat suits aren't removed until they get a good dousing of it.

Nigeria was smart - they isolated those that were sick from everyone and things down until they were in the clear.

Our biggest mistake - we are letting these Ministries send their health workers over to help out with the situation and now one of them brought the virus into the country. These people have no clue how to work around a Biosafety Level 4 virus. SARS and H1N1 - those were only BSL3 virus which meant there was a treatment available and if I wear a gas mask I probably won't inhale the virus. BSL4 are nasty motherfucker virus that have high kill rates and no known treatments. Usually the best bet is to isolate the sick and wait for the virus to die out from lack of any fresh hosts. I know that sounds sick but that's about all you can do with something like Ebola.

Until we shut down the airports from the 3 West African Countries with the greatest infection this thing is going to go crazy. And we need to stop all the do-gooders from sending volunteers into the country, let WHO and the CDC handle this with people who have training (or have been provided training thru them) to go into the area and work with the sick.

[Blackballed45]

49. Friggin' common sense!

Agree! Agree! Agree! I cannot understand why we are sending military troops there...why we are constantly and daily accepting plane loads of people from these Ebola stricken places! And why UNTRAINED do-gooders would even want to go near this?? Stop the insanity!

If people knew all the facts, like while your bleeding and oozing fluid from every hole in your face & body and getting blood clots one minute and then bleeding out the next...All while in EXCRUCIATING pain and you cannot be given pain medicine because your veins withstand an IV and you can't keep anything down, much less swallow because you're spewing your guts out.....I think much of America would change their mind!!!!!!

[LynneSin]

50. I think troops can help but not within the heart of the hot zone

We need to secure the area where the infected are and not let anyone get in or out. The military could be at the airport making sure that sick people aren't getting on planes and healthy people aren't coming in from other countries trying to be helpful when in reality they could just be making it worse.

I would not let the troops near the sick - that's just plain stupidity.

Do-gooders want to do good. They go where sick people are. But this isn't a Katrina or even a Darfur. A BSL4 Hot Zone is the purest definition of hell on earth because in the heart of it there isn't much you can do but just watch these people die although I have heard this Ebola has a death rate of only 50%. There have been some with 90%.

[gopiscrap]

59. Welcome to DU!

[kestrel91316]

43. Tell that to Liberia or Sierra Leone or Guinea.

[jwirr]

8. That is why we need a single payer universal system. But would that cover uninsured visitors to ones

country? Anyone know if the systems in other countries cover this kind of situation?

[WinkyDink]

17. I've been to hospitals (out-patient) in France, Portugal, England, the Netherlands: Free of charge.

[jwirr]

24. Thank you. More than likely our current system does not have anything like that.

[logosoco]

9. That seems like a very large amount, considering I had read they weren't really

treating him with any specialized drugs. Or maybe that shows that "just walking in the door" is very expensive in a hospital.

I am guessing that the hospital and the "system" learned a lot from this case and that more than offsets the costs.

I am sorry to hear he passed on. I was really hoping that he would make it.

[LisaL]

20. He was put on an experimental drug.

[VA_Jill]

31. Way too late n/t

[logosoco]

36. That is good to hear, I did not know about that.

I hoped they learned something from that. That would be invaluable to the researchers.

[Ms. Toad]

26. I am actually surprised it is so low.

Given his condition, he would have been in ICU, and given his illness anyone caring for him would have needed to be in full protective gear. He was also on dialysis - not a cheap process.

[kmlisle]

21. Interesting prediction when Insurance companies profits are sky rocketing

And CEO pay is going through the roof. This is after Obama care has been instituted:
http://www.publicintegrity.org/2014/06/09/14912/skyrocketing-salaries-health-insurance-ceos

Almost all of the publicly traded health insurers reported big increases in revenue and profits last year. The big winners have been the top executives of those companies, led by Mark Bertolini, CEO of Aetna, the nation’s third largest health insurer. Bertolini’s total compensation of $30.7 million in 2013 was 131 percent higher than in 2012.

Insurance companies can't pay to save lives unless they are forced to but we can pay one already rich man 30 million for what?

Profits over people continues!

[otohara]

27. Some Condolences

Funny thing happened when I was 19 mos old. Fever, leg pain, hospital said I had the flu and wanted to send me home.
Thank GOD my mother insisted they test me for Polio. In 1952 58,000 Americans were infected with the Polio virus.
All those iron lungs and sick children didn't ruin our hospital system then and neither will Ebola now.



RIP Mr. Duncan

[jwirr]

7. Early detection makes all the difference. He may still have died because we do not have the right

drugs for this yet but he would have had a better chance. Now I hope none of his family gets sick.

[me b zola]

41. Yes, early treatment is key

So I still wonder, was he initially sent home from the hospital because he didn't have health insurance?

[LynneSin]

51. What treatment?

By there is no treatment for Ebola. This is a Biosafety Level 4 virus. There are a few things they have tried that might work but they are purely experimental. Unless they have found the host animal of the virus (which is highly unlikely) there probably won't find a treatment for Ebola. The only way to 'cure' Ebola is to isolate the sick from the healthy and let it run it's course. Ebola can't spread if there are no more healthy host to infect.

BTW SARS was only BSL3 which means there is a treatment available.

[magical thyme]

63. they don't need to identify the host animal for ebola to develop treatments

The experimental treatments attack the virus, and there are numerous antiviral Ebola treatments in development. Due to the epidemic they are being fast tracked, but won't be broadly available for months.

Zmapp delivers synthesized antibodies and has been 100% successful in its limited animal trials. Iirc, it was easily tolerated in human trials. 3 out of 4 human patients that received it have survived, but they also received transfused plasma from from recovered patients. Brantly's condition started improving within a few hours of receiving his 1st dose of Zmapp. The patient that died after receiving it was very late stage and his organs and vascular integrity were probably too compromised for any chance of recovery.

TKM-Ebola has been in human trials for other viruses and at high doses causes some immune system reactions. Since Ebola already causes a cytokine storm and mass lymphocide, they probably felt it was too risky to try.

The drug they gave Duncan has been in human trials for other diseases and is easy on the human, but it doesn't destroy the virions, but stops them from replicating. It probably will be most effective in the early stages.

There are other anti-virals being tested against Ebola as we type. On a case-by-case basis, the attending doctors have to review their options and, with the patients, decide on the best choice. In every case, there is no way at this point to know whether the treatments help, hinder or are irrelevent.

[LynneSin]

64. How did it work on Duncan

They have no known treatment - everything is experimental.

[magical thyme]

65. I didn't say there were proven treatments. I said identifying the host is irrelevent.

It doesn't matter whether the reservoir is fruit bats or they are a vector.

Obviously it didn't work out for Duncan. Zmapp didn't work out for the Spanish priest who got that one, either.

At this point, they don't even know whether the experimental drugs help, hinder or are irrelevent. Anecdotal evidence suggests Zmapp may help, as Brantly began to improve within a few hours of receiving it.

[uppityperson]

11. RIP Mr Duncan, my condolences to his family and friends.

[calimary]

14. I hope they're not afflicted yet - preferably NOT AT ALL, I hope.

[WinkyDink]

19. Have you seen this photo from Dulles Airport?

[mainer]

23. where he looked perfectly happy and healthy

I feel so sorry for him. He had no idea he was going to be dead within a few weeks.

[WinkyDink]

28. Except he was deathly ill. And I REALLY don't think the CDC knows all there is to know about

transmission: methodologies; time-frames.

[TheNutcracker]

48. Yes, but they said before he passed they did not want to show what he looked like sick, it's ugly.

[erpowers]

54. Maybe He Did

Supposedly he lived in a village that is being ravaged by Ebola. That village happens to be in the country, Liberia, that has been most devestated by Ebola. Before he came to America he had helped a young woman who was extremely sick. It was later discovered that the young woman had Ebola.
Mr. Duncan and his family claimed he did not know he had contacted Ebola, or that he had come into contact with Ebola, but I think he could have guessed that there was a chance that he had been exposed to Ebola. He may have come to the United States in the hopes of getting better treatment and better results.

[calimary]

25. Hope she isn't a walking dead woman by now.

I feel bad for her, too.

[AZ Progressive]

15. Thomas Eric Duncan tried to help a sick pregnant woman and got punished with death

Talk about a grim and cold message.

[Wait Wut]

33. That's not important.

What's important is that the bills won't get paid, that he was in denial and the hospital quite possibly dropped the ball, that he's not a real American, that he's not white.

Sorry. After reading the comments here and on RW sites I'm a little depressed over this. He apparently didn't know that woman had ebola. They said she had the flu. He carried her...carried her. How many freakin' people in this world would carry a sick, possibly dying, woman? Most people would cover their faces and run in the opposite direction. We've lost site of the tragedy of all the ebola victims and made it into another terrorist threat. These are freakin' humans.

I wish the best for his family. I'm hoping some news comes out on them soon.

P.S. Thanks for being one of the few that still sees the humanity in all of this.

[Rozlee]

16. How long ago was he infected? Ebola has a 2-21 day incubation period.

These talking heads in the conservative blogosphere already have the disease incubating in a fifth of the country, just waiting to infect the rest of us, kill us and make us rise from the dead in a coming Zombocalypse. Their hysteria would be funny if so many people didn't take it so seriously. I have a teabagger in my family who has already bought surgical face masks and latex gloves.

[WinkyDink]

30. Here ya go:

Mr. Duncan — a Liberian national in his mid-40s who had come to America to visit relatives in Dallas — had direct contact with a woman stricken by Ebola in Monrovia, the Liberian capital, on Sept. 15, days before he left Liberia for the United States, the woman’s parents and Mr. Duncan’s neighbors said.....

Mr. Duncan flew on Sept. 19 from Monrovia to Brussels, where, according to United Airlines, he took Flight 951 to Washington Dulles Airport and continued to Dallas/Fort Worth on Flight 822, arriving Sept. 20.......

Thursday, five days after he had arrived in America, he told a nurse that he had come from West Africa.....

http://www.nytimes.com/2014/10/02/us/after-ebola-case-in-dallas-health-officials-seek-those-who-had-contact-with-patient.html?_r=0

9/15---9/25 looks like 10 days from acquisition to needing hospitalization.

[harun]

35. Having an N95 mask and latex gloves on hand is cheap and a good idea

All preppers I know have them, including me and I'm not a tea bagger. I'm a super lib .

There's a lot of outbreak scenarios and pollution type scenarios where one would want to have them handy.

All over Asia people wear them (face masks) just because the diesel pollution and dust is so bad near major cities.

[Farmbrook]

32. RIP Mr. Duncan

Thank you for your bravery in innocently helping another human being. Your family and friends are in my prayers.

[Wait Wut]

34. ...

Ditto.

[Gothmog]

38. May he rest in peace

[MissKat]

39. Well, how will Fox handle this, with sincere sympathy? Or blaming Obama?

So, let's imagine how the Fox entertainers will deal with this.
1. Blame Obama
2. Blame Obama
3. Blame Obama
4. Blame Mr. Duncan
5. Blame Africa

This should be good for numerous news cycles for them.
One thing they won't do? Show sympathy for this man or his family.

[MBS]

42. This man might have lived had the hospital not dropped the ball. . . .

Exactly. The incompetence of staff at that Dallas hospital was beyond belief. Almost criminal-level malpractice.
I so much hope that that family is OK.

[Drayden]

44. He also might have lived

If he had been upfront with the hospital about his exposure. Yes there are people saying he didn't know, but I have a hard time believing that. He knew ebola was spreading all around him, to the point where the ebola ward he helped to take this lady to turned her away. He knew she died, with ebola symptoms that should be well known thanks to public service campaigns that have been going on in Liberia and other countries hit hard. If he had of pushed it and said "I am here from Liberia and my neighbor just recently died from ebola symptoms after I assisted her, I'm afraid I might have contracted it." Then the hospital may have woken up and taken it more seriously. Undoubtedly he was afraid and in denial but withholding that information coupled with the hospital's negligence may have cost him his life.

[erpowers]

57. I think He Told Them

From what I heard, he told the nurses at the hospital that he had just come from West Africa. I think the real problem is that the nurses may have thought he was another one of those people that always think they are sick and they always think they have the latest disease.

[Drayden]

58. I read he simply told them he recently traveled from Africa

But didn't specify where. No way this man was unaware of the ebola crisis all around him in his native Liberia. Let's put it this way:

Let's assume I live in Dallas and ebola cases start spreading around there. I decide to travel and see my dear great Aunt Constance in Ireland. I board a plane and head there, 5 days later I start exhibiting symptoms. You can be damn sure once I hit the hospital I am going to tell them, "Hey, I recently arrived from Dallas, which has had 1040 cases of ebola. I assisted my neighbor Mary into her apartment a few days before I left and she died the next day after being turned away from a hospital overfilled with ebola patients because they had no more room. I am greatly concerned I may have contracted it, could you please test me?"

[LynneSin]

52. How? It's Ebola. What I'd be worried about is if he infected others when he left

There is no treatment for Ebola. There have been some experimental treatments that some think might work but unless they find the host animal of this strain of Ebola it's doubtful they will find a treatment.

What is the criminal-level malpractice is if anyone else gets infected by Mr. Duncan because he left the hospital. Because no Ebola is not airborne. But it is in the semen, and urine, and blood, and feces, and vomit and SWEAT - it's oozing out of every pore of the person when the infection becomes fullblown. So not sure what Mr. Duncan's status was when he left the hospital but if the virus started to amplify in him and someone else got it - that's going to be a serious problem and one that would have been prevented if the hospital simply kept him quarantined when he first arrived.

[MBS]

56. that, too, of course!

but I agree with the OP that speed of diagnosis is essential if there is to be any hope of survival at all.

[Drayden]

45. And also

That hospital I guarantee you sees patients by the thousands that show up with the type of vague symptoms Duncan did the first time. And they have never seen a case of ebola before and have no experience with it. Duncan on the other hand has lived through the outbreak in Liberia and had to have been aware of the toll the disease was taken on his country. They had no way of knowing what he was exposed to, he had to at minimum have a damn good guess.

[aceofblades]

62. Couple things I would mention

My ID attending constantly stressed to us to ask a travel history for anyone with an acute febrile illness(or where you suspect it) and it's a part of any complete History & Physical as laid out in Bates. Yes, I wish the patient had been more helpful in providing information on his own, but the hospital and particularly the physician have an independent responsibility.

Also, new CDC recommendations disseminated prior to Mr. Duncan's case provide a guide for those hospitals that are inexperienced with ebola cases, and the travel history is so important(again something that should be asked by the physician independently)

http://www.cdc.gov/vhf/ebola/pdf/checklist-patients-evaluated-us-evd.pdf. Regardless of the hospital's specific experience with treating ebola patients, positive travel history (if asked and provided truthfully) combined with other symptoms as listed in the checklist warrant ,at the very least, isolation and follow-up testing.


If the patient says "Africa" ask where in africa(also interested in any sources you may have about whether Duncan said 'Africa'(in general) to the nurse or 'Liberia' specifically). If the patient lies, then you as a physician have asked all that you can, if you haven't, then you simply have an incomplete history

[herding cats]

46. Peace to his family and loved ones.

I cannot honestly imagine what they must be going through right now. They've lost a loved one, others they love, or even themselves, are still being watched for the same disease which killed their loved one, and they're being scrutinized by the media on a daily basis. I hope they somehow manage to avoid the renewed barrage of hate talk that's going to be spreading. I know those close to him here have already been feeling ostracized according to their accounts. Let's all hope they remain safe and their lives can soon regain a level of normalcy again. It's looking more likely each passing day they're going to avoid the virus, so at least there's that bit of comfort for them.

[Rhiannon12866]

47. Such sad news!!! You need a link in the OP. Here you go:

Thomas Eric Duncan, Ebola victim in Texas, has died
http://www.cbsnews.com/news/thomas-eric-duncan-ebola-victim-in-texas-has-died/

Thomas Duncan, the Texas Ebola patient, has died
http://www.washingtonpost.com/news/post-nation/wp/2014/10/08/texas-ebola-patient-has-died-from-ebola/

Dallas Ebola patient Thomas Eric Duncan dies
http://www.chicagotribune.com/lifestyles/health/chi-dallas-ebola-patient-dead-20141008-story.html

[erpowers]

53. Lawsuit

Does the family have any chance at winning a lawsuit? Maybe it was too late for him when he first went to the hospital, but they sent him home. Maybe the results would have been different if the hospital had admitted him when he first went to the hospital.

[branford]

61. I think any lawsuit would primarily have a serious causation problem.

There is no cure for Ebola and it is deadly. Once stricken, it's usually a matter of luck, with only some very experimental (and some currently unavailable, like Zmapp) treatments that cannot be considered "established practices within the medical community. It would be impossible to prove that the patient would have survived but for not admitting him immediately, or even that he would have suffered less.

As a practical matter, the issue of whether he was honest and forthcoming in his questionnaire before entering the USA (recall that Liberia was considering criminal charges against him if he survived) and if he disclosed all relevant information to the hospital, will be very material. Many jurors might also find his status as a visitor, rather than a citizen or resident, to be important. Any recovery might additionally have first pay-off his significant treatment and related expenses, such as the experimental medication, from any source not found to have been negligent, a likely significant number of individual and groups.

I would lastly note that his girlfriend referenced in by the press would not have standing for her own damages as she is not a relative. Girlfriends, even a fiance, does not normally have standing to sue. If she is the executor or administrator of his estate, she could seek to recover for his pain, but no her own damages, but the amounts would be distributed pursuant to any legal will or be intestate succession, which would not include her. I believe, however, that he has children that are US citizens or legal residents, and they may be able to bring suit with the same problems noted above..

[Iamthetruth]

66. Pretty sure

Him not being an American citizen could hamper that.

[Yo_Mama]

55. It's very unlikely that a delay in treatment caused his death

Because right now, we do absolutely nothing until symptoms get dire. The new experimental early treatment in the US is now apparently brincidofovir, but that's just been approved. Until patients get very ill and need acute care, the standard has been nothing.

We are out of the early stuff that was used, but some of those who got that early stuff died too. And quite a few patients who get not even the care he did have lived.

A bunch of others who were exposed with are dead too.

The US has no miracle treatment. Maybe eventually ZMapp will turn out to be a strong therapy, but we're out and at least one of the patients who got it died. I don't think your statement should stand unchallenged.

[NutmegYankee]

60. I'm really saddened that he didn't make it.

I'm not convinced at all that he knew he was exposed prior to coming to the US. I was really hoping he's pull through.