Ebola patient's temperature spiked to 103 degrees
Source: AP-EXCITE
By EMILY SCHMALL, HOLBROOK MOHR and NOMAAN MERCHANT
DALLAS (AP) Thomas Eric Duncan's temperature spiked to 103 degrees during the hours of his initial visit to an emergency room a fever that was flagged with an exclamation point in the hospital's record-keeping system, his medical records show.
Despite telling a nurse that he had recently been in Africa and displaying other symptoms that could indicate Ebola, the man who would become the only person to die from the disease in the U.S. underwent a battery of tests and was eventually sent home.
Duncan's family provided his medical records to The Associated Press more than 1,400 pages in all. They encompass his time in the ER, his urgent return to the hospital two days later and chronicle his steep decline as his organs began to fail.
Duncan carried the deadly virus with him from his home in Liberia, though he showed no symptoms when he left for the United States. He arrived in Dallas on Sept. 20 and fell ill several days later.
FULL story at link.
This Friday, Oct. 10, 2014 photo shows a copy of Thomas Eric Duncan's medical records from Texas Health Presbyterian Hospital, provided by Duncan{2019}s family to The Associated Press. The records encompass his time in the emergency room, his urgent return to the hospital two days later and a chronicle of his steep decline as his organs began to fail. Duncan carried the deadly Ebola virus with him from his home in Liberia, though he showed no symptoms when he left for the United States. He arrived in Dallas on Sept. 20 and fell ill several days later. (AP Photo/Kiichiro Sato)
Read more: http://apnews.excite.com/article/20141010/us-ebola-medical-records-f268d6fdd1.html
femmocrat
(28,394 posts)I'll bet their phone has been ringing off the hook with calls from personal injury lawyers.
Response to femmocrat (Reply #1)
ann--- This message was self-deleted by its author.
herding cats
(19,558 posts)Dallas lawyer Michael Sawicki, who takes medical malpractice cases, said a lawsuit against the hospital or the doctor in the Duncan case is likely to fail because Texas law makes specific exemptions for emergency care.
He quoted a 2003 Texas legal rule that essentially says someone has to intentionally cause harm to be liable for civil damages. There has been no case in Texas where a plaintiff has proved a case under that rule, Sawicki said. The law is written so in emergency care youre not responsible for anything, he said.
Read more here: http://www.star-telegram.com/2014/10/09/6188006/deputy-showing-no-signs-of-ebola.html#storylink=cpy
There's some speculation as to if the hospital may be guilty of patient dumping by Dallas County Commissioner John Wiley Price.
"The fact that they turned him away the first time should be the basis for a CMS review," Price said. "It's tantamount to patient dumping they changed their story at least three times. I stand by my position that the reason they basically dumped him was because he was black and didn't have insurance."
Even if that wasn't the case, Price said, "the bottom line is they missed the protocol" for dealing with potential Ebola patients.
http://www.freep.com/story/news/nation/2014/10/10/dallas-hospital-defends-care-ebola-victim-thomas-eric-duncan/17024985/
Dustlawyer
(10,494 posts)frivolous lawsuits all of the time. Think about it, we only get paid if we win a recovery and we have to front all expenses and only get those back out of a recovery if there is one. Now you pretty much have to prove your med mal case up front, post a bond, have expert reports and damages are capped. With the cost of litigation and the experts, few cases are worth taking. If you are a minor, unemployed, or retired you probably cannot find a lawyer in Texas to take your case.
When RW potential clients come to me with a med mal and I turn them down I usually hear, "But my case is legit, not like the others you get!" I almost enjoy telling them they shouldn't have voted for the tort reform, they were lied to.
Sunlei
(22,651 posts)Or 'listen' to what 'they' had to say. "the bottom line is they missed the protocol", yes, probably the biggest fail in that Doctors lifetime.
rainbow4321
(9,974 posts)Adding that there are multiple obstacles for the family.
1) State law limits awards to $250,000
2) Another law gives protection to ER workers
3) 3rd law says it would have to be proven that had a person been given a different treatment, would they have had more then a 50% chance of survival...given how high the death rate is for Ebola this probably would work against the family.
MADem
(135,425 posts)The patient lied at every step of the process to get into the country. He misstated his associations with people who were infected, and by doing that he interfered with the ability of medical personnel to diagnose him. The medical personnel may have screwed up but when the patient lies to the doctor it can be a challenge. If he'd said "I was recently in the part of Africa where Ebola is rampant and I hauled a woman with Ebola to and from a hospital and then she died," people may have taken him more seriously.
Africa is a big continent, the disease is not everywhere, and he was one of the earlier Ebola cases in USA. This guy was an early victim who didn't help himself with an incomplete medical history, but he did do a great service to those who might come after him in that his case has sensitized ERs across the country to the nuances of the disease in earlier stages.
hedgehog
(36,286 posts)Why would anyone go to an ER and then deny any connection to Ebola?
Wellstone ruled
(34,661 posts)You just knew someone or circumstances got out of control. When we see the Judge from Dallas County do a press conference at this Hospital,pretty much sunk this man's fate. Only in Texass.
bullwinkle428
(20,628 posts)Chemisse
(30,802 posts)And that is with no diagnosis and certainly no antibiotics (a few years ago).
After a few more days I went to the local ER and found out I had pneumonia. That time I was sent home - again with a very high fever - but this time with antibiotics. I improved slowly after that.
So to say that someone with a high fever is or should be automatically admitted to the hospital is not right.
RobinA
(9,884 posts)It's not that easy to get admitted to a hospital these days. I'd be willing to bet that hospitals turn away 103 fevers every day. They sure as heck don't admit them all. In fact, they discharge way worse than this. If this guy hadn't turned out to have Ebola he would be just another feeling-crappy schmoo who got hustled out of the ER with an antibiotic prescription. One of hundreds who received the same treatment that day.
I wish the take home from this episode would be less about Ebola and scapegoating this particular hospital and more about the slap dash way medicine has to be practiced these days.
magical thyme
(14,881 posts)thousands of people/year get sent home w/a prescription jic.
Short-staffed, overworked "quacks" do this all the time. This Dr. just drew the short straw on the first Ebola patient.
TwilightGardener
(46,416 posts)about. I've never had a patient complain about not producing enough urine. The staff probably assumed it was dehydration related to his general illness, although he didn't complain about recurrent vomiting or severe diarrhea--and even then, your kidneys still produce urine, even if concentrated. I wonder if he was given IV fluids and had his output monitored?
TwilightGardener
(46,416 posts)people with fevers. 103 is high and indicative of acute illness/infection, but it isn't crazy-high, and that in itself wouldn't be grounds for hospital admission or a diagnosis of something like ebola. It's just another piece of the puzzle they missed--the low urine production, the abdominal pain, and the travel history and the fever COMBINED is what should have gotten him immediately isolated and admitted.
Iliyah
(25,111 posts)ER will keep you until the temp breaks. Texas may be different, especially if patient has no health insurance.
California regardless of no insurance will keep the patient to monitor and until the fever breaks.
Yo_Mama
(8,303 posts)It depends on how stable the patient is. I had insurance, btw. And it was a good hospital, and the right thing to do. I was much better off at home. That doesn't mean Duncan was, or should reasonably have been discharged.
But if his fever rose to 103 in the ER, given the recent African connection you would think they would have been more cautious - unless, of course, they thought they had it connected to typhoid fever or malaria.
http://en.wikipedia.org/wiki/Typhoid_fever
Well, now that the family has released the records, everyone can take a look at them and make up their own minds.
I don't think the family members are looking for money - I think they are honestly trying to prevent this from happening to someone else.
Does anyone know what abx they prescribed?
Judi Lynn
(160,420 posts)maynard
(657 posts)Haven't been following threads, but since Texas does not believe in people having health insurance, was he sent home for insurance reasons?
Omaha Steve
(99,487 posts)Isn't that Governor getting ready to run for POTUS. He did say Texas was the best state for this to happen in, before the patient died.
freshwest
(53,661 posts)redruddyred
(1,615 posts)had he meant that ironically.
Yo_Mama
(8,303 posts)The ins cos can make it very hard to hospitalize a patient.
My husband was discharged from the ER with a diagnosis of pneumonia, diarrhea, and a fever of 104 with nothing but two prescriptions - one for penicillin and one for something to treat the diarrhea. I was states away with my mother who had been in intensive care. I spoke to him, took her home, got on the first plane and made it back in time to take him into the hospital to save his life (a day and a half later!, but insurance companies aren't necessarily going to authorize decent care either. I called for an ambulance and they wouldn't send it. I had to carry him to the car myself. His fever was over 105 and he was grey.
My husband was in intensive care for a week, so that particular episode of "managed" care didn't save the ins co any money, but don't assume that this man's fate would have been different if he had insurance.
The US health care system is not what it was, and insurance companies are one of the main reasons for it. Remember "drive by" births?
Response to Omaha Steve (Original post)
maynard This message was self-deleted by its author.
Erose999
(5,624 posts)that was 5 years ago.
jeff47
(26,549 posts)Fever + other symptoms + recently from Africa is.
Previously, the story was that he only had a low fever on his first visit, as an excuse for why they missed it on the first visit.
cstanleytech
(26,222 posts)flag you would think for the hospital.
colorado_ufo
(5,730 posts)I was in the doc's office with 104 degrees and he said, "You're the sickest patient I've seen in years!" And then sent me home, without even a question about whether or not there would be someone there to help take care of me. Doesn't matter if I had a huge infiltrate in my lung with pneumonia, severe anemia, blistered burns over half my body, wrecked knee swollen like small cantaloupe, or anything else - they ALWAYS send me home! It's like I have a tattoo that says, "inhospitable." And it wasn't the same doctors. And I had excellent insurance, so why?
At 105 degrees, they most definitely should have hospitalized you; your life was in danger.
pnwmom
(108,954 posts)Did you have health insurance?
Erose999
(5,624 posts)a clinic and not really a hospital. I rode the bus there and rode the bus home, delirious all the way.
Sunlei
(22,651 posts)His family couldn't even bare to view him, he was in such bad shape at the end. He never got a serum transfusion from a survivor because the hospital said, no blood match. Why couldn't they ship some serum from a survivor in Africa? That may have helped him survive.
We still have more than a week to go before all the other contacts are clear.
The family can not sue if the man went into emergency room as a uninsured or non-paying patient. I don't think Medicaid patients or medicare patients can sue any hospital or Doctor either. Maybe he had insurance or was a cash payer. Sue the heck out of that Doctor!
It was the family who called our Federal CDC and they/ CDC contacts the Texas hospital and sent the ambulance ASAP.
Iliyah
(25,111 posts)by your truly the GOP party.
azurnoir
(45,850 posts)was it low?
Sunlei
(22,651 posts)We have to wait another week or so longer to see if this Texas hospitals incompetence, caused a spread of ebola to any others.
TwilightGardener
(46,416 posts)How well did they clean the equipment? The stretchers, the exam tables, the floors?
LisaL
(44,972 posts)Chemisse
(30,802 posts)His symptoms, including a high fever, were not sufficient to hospitalize him.
In addition, I think hospital ER doctors miss things in the patient's background all the time. They are incredibly busy and they have to work fast.
While I agree the hospital is covering up in the aftermath, I don't think they acted in a way that is shockingly negligent, especially since there had never been an Ebola case diagnosed in this country before. Really, what were the chances somebody would walk in with Ebola? It had never happened before and it has not happened since.
George II
(67,782 posts)RobinA
(9,884 posts)when I had Lyme. Before I knew it was Lyme and thought it was the flu. Actually, I started to feel better before I knew it was Lyme.
George II
(67,782 posts)....and it's not like they see Ebola cases every day. In fact, this was the very first one diagnosed EVER in the United States. In hindsight everyone is implying "they should have known"!
Aerows
(39,961 posts)when I got chicken pox.
AngryAmish
(25,704 posts)Or is that 105? Either way that is really sick.
Aerows
(39,961 posts)So, yes, 103 or 104 should be where they start cooling. He didn't have insurance, though.
Aerows
(39,961 posts)get admitted. Don't have insurance, get sent home unless you are on the threshold of dying.