Liberian Com­mu­nity in Texas Raises Con­cerns About Dal­las Ebola Pa­tient’s Treat­ment


The death of Thomas Eric Dun­can, a Liberian man who was the first pa­tient in the U.S. to die of Ebola, is stir­ring de­bate in the Dal­las Liberian com­mu­nity about whether there has been a dif­fer­ence in the qual­ity of treat­ment be­tween Amer­i­can and African pa­tients with Ebola at U.S. hos­pi­tals.

Stan­ley Gaye, pres­i­dent of the Liberia Com­mu­nity As­so­ci­a­tion in Dal­las, said peo­ple have con­tacted him about con­cerns that Dun­can was treated dif­fer­ently “be­cause he was African and not only that, he was Liberian.”

Texas Health Pres­by­te­rian Hos­pi­tal ex­plained to­day in de­tail how they cared for Dun­can, in­clud­ing as­sign­ing 50 peo­ple to help with Dun­can’s care and se­cur­ing an en­tire in­ten­sive care unit for Dun­can.

How­ever, Gaye told ABC News that one of the big­gest con­cerns ex­pressed by the Liberian com­mu­nity was that Dun­can was al­lowed to leave that hos­pi­tal on Septem­ber 25 even though he had early Ebola symp­toms and had told a nurse there that he had re­cently trav­eled from West Africa.

Hos­pi­tal of­fi­cials ini­tially said that there was a lapse in the record keep­ing sys­tem that al­lowed Dun­can to leave even though he met cri­te­ria from the U.S. Cen­ters for Dis­ease Con­trol and Preven­tion in­di­cat­ing he should be quar­an­tined for pos­si­ble Ebola in­fec­tion. But they later said the sys­tem was func­tion­ing prop­erly and have yet to give a fur­ther rea­son for the er­ror.

In to­day’s state­ment, the hos­pi­tal de­nied Dun­can had re­ceived sub­stan­dard care dur­ing his first visit to the emer­gency room.

“Our care team pro­vided Mr. Dun­can with the same high level of at­ten­tion and care that would be given any pa­tient, re­gard­less of na­tion­al­ity or abil­ity to pay for care,” read the state­ment, which clar­i­fied Dun­can had a four-hour eval­u­a­tion and nu­mer­ous tests.

Three days later, on Sept. 28, Dun­can was taken back to the hos­pi­tal in an am­bu­lance and put into an iso­la­tion ward at the hos­pi­tal, health of­fi­cials said.

Liberian com­mu­nity mem­bers have voiced con­cern that by not be­ing ad­mit­ted to the hos­pi­tal im­me­di­ately, the ill­ness had time to make Dun­can sicker and that “he was not prop­erly taken care of,” Gaye said.

Dun­can died from the Ebola virus on Wed­nes­day, more than a week after be­ing ad­mit­ted to Texas Health Pres­by­te­rian Hos­pi­tal. The day be­fore his death, hos­pi­tal of­fi­cials said he was on a res­pi­ra­tor and be­ing given kid­ney dial­y­sis.

He was also be­ing given the ex­per­i­men­tal drug brin­cid­o­fovir. Another Ebola pa­tient, an Amer­i­can jour­nal­ist be­ing treated in Ne­braska, has also started the same med­i­ca­tion, health of­fi­cials said. Texas Health Pres­by­te­rian Hos­pi­tal of­fi­cials re­vealed new de­tails to­day about Dun­can’s death and ex­plained he had asked not to re­ceive cer­tain ex­tra­or­di­nary mea­sures, in­clud­ing chest com­pres­sions and de­fib­ril­la­tion.

“In spite of the in­ten­sive care he was re­ceiv­ing, his heart stopped,” the hos­pi­tal said in its state­ment.

The hos­pi­tal also adamantly de­fended its treat­ment of Dun­can and ex­plained why he had not re­ceived some of the same med­i­ca­tions other Ebola pa­tients had been given. Dun­can’s fam­ily told re­porters on Wed­nes­day that Dun­can had re­ceived “un­fair” treat­ment com­pared to other pa­tients who had been cared for in the U.S. “No one has died of Ebola in the U.S. be­fore. This is the first time,” Weeks told ABC News. Weeks said the fam­ily asked doc­tors at Texas Health Pres­by­te­rian Hos­pi­tal why Dun­can was not moved to Emory Univer­sity Med­i­cal Cen­ter, where two mis­sion­ar­ies were treated for Ebola ear­lier this year. Weeks said doc­tors told the fam­ily they had ev­ery­thing nec­es­sary to treat Dun­can in Dal­las.

The CDC has not rec­om­mended that Ebola pa­tients be trans­ferred to a spe­cial­ized iso­la­tion fa­cil­ity like the one at Emory Univer­sity. Weeks also said doc­tors told the fam­ily Dun­can was not given any do­nated plasma, called con­va­les­cent serum, from for­mer Ebola pa­tients. The hos­pi­tal stated to­day that Dun­can’s blood type was not com­pat­i­ble with con­va­les­cent serum donors.

The hos­pi­tal also af­firmed that Dun­can was not given ZMapp, a serum used on two U.S. health­care work­ers, be­cause the sup­ply had been ex­hausted.

At least one ex­pert said this in­for­ma­tion is cru­cial to re­build­ing trust be­tween ner­vous com­mu­nity mem­bers and med­i­cal in­sti­tu­tions. Art Ca­plan, a med­i­cal ethi­cist and di­rec­tor for Di­vi­sion of Med­i­cal Ethics at the New York Univer­sity Lan­gone Med­i­cal Cen­ter, said just the ap­pear­ance of a hos­pi­tal or med­i­cal in­sti­tu­tion treat­ing pa­tients dif­fer­ently can have se­vere neg­a­tive con­se­quences for pub­lic health dur­ing an epi­demic.

Ca­plan said if peo­ple don’t trust health au­thor­i­ties then they might not seek help when they’re sick and in­ad­ver­tently in­fect oth­ers.

Thomas Eric Dun­can Suc­cumbed to the Deadly Ebola Virus:

Was evey­thing pos­si­ble done to save his life?

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