Texas Health Presbyterian Hospital officials said they discovered the error that allowed a Dallas Ebola patient to be released from the hospital despite telling medical staff he had been in West Africa.
Hospital officials said Thomas Eric Duncan's symptoms weren't severe during his initial hospital visit Sept. 25. He complained of headache, abdominal pain and fever. He told nurses that he had been in Africa, but that he didn't come into contact with anyone who was sick.
“We have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR) interacted in this specific case,” a statement released by the hospital read.
The nurses' and doctors' workflows were separated in patient electronic health records, hospital officials said. Even though the nurse noted that Duncan was in Africa in the nurses' section of his chart, doctors didn't see the note in the doctor's section.
“The documentation of the travel history was located in the nursing workflow portion of the EHR, and was designed to provide a high reliability nursing process to allow for the administration of influenza vaccine under a physician-delegated standing order,' the statement added. "As designed, the travel history would not automatically appear in the physician's standard workflow.”
Hospital officials said they are now using a new process to record and share patient information that will prevent such issues.
Duncan remains at the hospital in serious condition.
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Family Locked Down
A hazardous material crew is scheduled Friday to decontaminate the apartment where Duncan's family is under a legal isolation order.
Officials said crews will try to clean any sign of the virus, including sheets and towels that Duncan used.
CDC director Dr. Tom Frieden was asked on NBC's "Today" show why the apartment wasn't immediately cleaned.
"The details of that you'd have to refer to the folks in Dallas," Frieden said Friday. "But this is, after all, the first time we've ever had a case of Ebola in the U.S. and there are issues to make sure that when things are removed that it is not going to be disposed of in any way that could potentially be a risk."
The crew went to the apartment Thursday evening, but didn't have the required permits to clean and remove hazardous waste, city spokesman Richard Hill said. The family must be relocated before the cleanup can begin.
Police said they're constantly watching the family after they ignored initial requests to remain in the apartment and sent a child to school Wednesday.
Patient Faces Prosecution
Liberian authorities announced plans to prosecute Duncan when he returns, accusing him of lying about not having any contact with an infected person.
Duncan filled out a form Sept. 19 about his health and activities before leaving for Dallas. Among the questions on the form, obtained by The Associated Press, one asked whether Duncan had cared for an Ebola patient or touched the body of anyone who had died in an area affected by Ebola. He answered no to all the questions.
"We expect people to do the honorable thing," said Binyah Kesselly, chairman of the board of directors of the Liberia Airport Authority in Monrovia.
Duncan's neighbors in the Liberian capital believe he become infected when he helped a sick pregnant neighbor a few weeks ago. It was not clear if he had learned of the woman's diagnosis before traveling.
