Duncan’s family and Texas Health Resources reach a confidential settlement. As a part of the settlement, a memorial fund is set up in Duncan’s name to raise money to help victims of Ebola in South Africa. Texas Health Presbyterian statement:
We know that this has been a terribly sad, difficult and trying time for Mr. Duncan’s family and friends, and they will continue to be in the hearts and prayers of the entire Texas Health Presbyterian family.
Medical records show that Duncan received the experimental drug six days after doctors first suspected he had the virus, but it was unable to prevent his death. Mukpo also received the drug, and survived.
The ER nurse says that Duncan denied contact with patients on his second visit to Texas Health Presbyterian:
I explained to him, ‘We are under the impression that you may have been exposed to Ebola.’ And I said, ‘Where are you from?’ And he told me Liberia. And I asked ‘Have you been in contact with anyone who’s been sick?’ No. He said no.
Crowl describes the scene when hazmat teams arrived at the apartments where he lived next door to Duncan:
People were freaking out. People were looking at them like they were zombies.
The Texas state health department says 43 people who had contact with Duncan are cleared of twice-daily monitoring after 21 days of showing no symptoms. Another 120 are still on watchlists.
Officials say monitoring of the virus’s potential spread has been inconsistent. In one example, Dallas County chief executive Judge Jenkins told Texas Health Presbyterian to change its system so that workers who had treated Duncan were to stop seeing any patients other than Pham. The next day, the CDC allowed Vinson to fly on a commercial airliner. Rep. Michael Burgess, R-Texas, a doctor who did his residency in Dallas:
I don’t think the directions provided to people at first were as clear as they needed to be, and there have been changes in the instructions given to people over time.
Texas Health Presbyterian apologizes to the House Energy and Commerce Committee for mishandling Duncan’s case (written testimony here.) Chief clinical officer:
Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes. We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry.
The Texas Department of State Health Services says a second worker at Texas Health Presbyterian who treated Duncan has contracted the virus. Tests to confirm the result of the local test are being conducted at the CDC in Atlanta. The person isn’t identified but authorities say interviews have been done to allow contact tracing. CDC statement:
An additional health care worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimize the risk to health care workers and the patient
Texas Health Presbyterian had to adapt its Ebola protocols on the fly as it treated Duncan, adding more layers of protective gear. CDC epidemiologist Pierre Rollin:
They kept adding more protective equipment as the patient [Duncan] deteriorated. They had masks first, then face shields, then the positive-pressure respirator. They added a second pair of gloves.
National Nurses United says Duncan was kept in a non-isolated area of the ECU for several hours and potentially exposed up to seven other patients to Ebola. Among other claims about the protocols used are that nurses did not have proper protective gear, were treating Duncan as well as other patients, and that preparation for the virus was limited to an optional seminar for staff. Union official Deborah Burger:
There was no advance preparedness on what to do with the patient, there was no protocol, there was no system
The CDC is monitoring 11 people who had contact with Duncan and 114 people who may have had contact. None of the people are showing signs of Ebola. It says that 48 have been monitored since before Duncan was admitted to Texas Health Presbyterian, 75 are people who worked in the hospital, and one is someone who had contact with Pham.
Medical records show that around 70 Texas Health Presbyterian staffers cared for Duncan, and some of them may have had direct contact with his body or fluids. The CDC says there were breaches in protection protocol at the hospital, and is investigating to identify them. WHO doctor Aileen Marty says no amount of protection will help if hospital workers do not put on and take off their protective layers carefully:
The first thing in caring for someone with Ebola is to do everything in your power to never become a victim
State Attorney General Buddy Caldwell is seeking a temporary restraining order to block the disposal of incinerated waste from Duncan’s apartment at a Louisiana landfill:
We certainly share sadness and compassion for those who have lost their lives and loved ones to this terrible virus, but the health and safety of our Louisiana citizens is our top priority. There are too many unknowns at this point, and it is absurd to transport potentially hazardous Ebola waste across state lines.This situation is certainly unprecedented and we want to approach it with the utmost caution. We just can’t afford to take any risks when it comes to this deadly virus.
Duncan’s medical records show that he had a fever of 103 degrees when he presented at Texas Health Presbyterian. He complained of abdominal pain, dizziness, a headache and decreased urination, and reported severe pain – rating it an eight on a scale of 10. Doctors gave him CT scans to rule out appendicitis, stroke and other serious ailments. He was then prescribed antibiotics and told to take Tylenol and return home.
Duncan is pronounced dead at 7:51 a.m. at Texas Health Presbyterian Hospital Dallas, where he was admitted Sept. 28 and has been kept in isolation. Texas officials are monitoring 10 people who had direct contact with him while he was symptomatic, as well as 38 others who may have had contact. None have shown symptoms of the disease to this point. They will be monitored for 21 days, the normal incubation period for the disease. Hospital:
Mr. Duncan succumbed to an insidious disease, Ebola. He fought courageously in this battle. Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time.
Monnig, a sheriff’s deputy who served a quarantine order to the apartment where Thomas Eric Duncan was staying, is being examined at Texas Health Presbyterian Hospital for possible exposure to Ebola. Monnig, although not in direct contact with Duncan, exhibits symptoms and history that warrant testing. Dallas County Sheriff’s Office:
The deputy expressed concern and we directed that deputy to the Dallas County Health & Human Services for care. We now wait for further information as medical staff attends to the deputy.
Duncan has worsened and is in critical condition, Texas Health Presbyterian says. The hospital doesn’t provide other details.
The office of Dallas County DA Craig Watkins is considering state charges of aggravated assault against Duncan:
We’re dealing with the issue that he may have knowingly exposed individuals in Dallas County to the Ebola virus. We’ve prosecuted individuals, for knowingly exposing individuals to HIV – which is aggravated assault.
United is contacting passengers who flew in and out of Dulles with Duncan and telling them how to contact health officials. United officials decline to say how many passengers were on the flights. The Brussels-to-Dulles flight used a Boeing 777 with 266 seats and the flight to Dallas used an Airbus A320 with 138 seats. United did a routine overnight ‘thorough cleaning’ after the flights:
Including cleaning of lavatories and galleys with heavy-duty all-purpose cleaners and wiping tray tables and armrests with disinfectant … We continue to clean and route the planes throughout our network as usual.
The number of people being screened in Dallas increases to around 100. CDC Director Frieden says only a ‘handful’ of people who had contact with Duncan have been identified. Most of the 100 people haven’t been ordered to stay home however officials say they ordered four of Duncan’s family members to remain in their home as the family disobeyed their request to stay there. The family was examined Thursday and hadn’t developed symptoms. A law enforcement official is stationed outside their apartment to make sure they don’t leave.
Liberia will prosecute Duncan for allegedly lying on an airport questionnaire about not having any contact with an infected person. He filled out a series of questions about his health and activities on Sept. 19, answering no to all of them. The form asked whether he had cared for an Ebola patient or touched the body of anyone who had died in an area affected by Ebola.Binyah Kesselly, chairman of the board of directors of the Liberia Airport Authority in Monrovia:
We expect people to do the honorable thing.
The agency obtained permission from the Ministry of Justice to pursue the matter.
National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci tells CNN’s The Lead with Jake Tapper that Texas Health Presbyterian made a mistake by releasing Duncan:
A travel history was taken, but it wasn’t communicated to the people who were making the decision. … It was a mistake. They dropped the ball. You don’t want to pile on them, but hopefully this will never happen again. … The CDC has been vigorously emphasizing the need for a travel history.
The CDC has issued a nationwide alert to hospitals updating them on how to appropriately respond to possible Ebola cases after Duncan was sent home after contracting the virus. CDC director Frieden:
It’s a teachable moment.
The guidance includes a poster with quick rules for evaluating returned travelers and a checklist.
Duncan won’t be given ZMapp, as all the dosages currently in existence have already been used. ZMapp is manufacturing more supplies, but the drug takes months to produce.
A friend who speaks with Duncan says he is ‘all right’ but hasn’t eaten in a week:
He is in pain.
Health Presbyterian says he remains in serious condition.
Dallas Independent School District Superintendent Mike Miles says five children from four of the district’s campuses were possibly exposed to the virus:
- Conrad High School
- Tasby Middle School
- Hotchkiss Elementary School
- Dan D. Rogers Elementary School
Tasby Middle School shares a campus with Jack Lowe Sr. Elementary School, but DISD officials say no students at Lowe Elementary were directly exposed. The students who may have had contact with Thomas Eric Duncan attended classes earlier in the week, but none have exhibited symptoms. Miles:
So, the odds of them passing on any sort of virus is very low
The children are at home and being monitored by Dallas County Health and Human Services, while the schools have been staffed with additional health employees and more sanitation staff.
Vinson is one of the nurses who cares for Duncan. She draws his blood, inserts catheters, and deals with his bodily fluids, according to Duncan’s medical records obtained by the Associated Press.
Duncan arrives at Texas Health Presbyterian by ambulance and is admitted. A friend says that he called the CDC after Duncan was sent home from the hospital, who told him to call the Texas Board of Health and the message eventually got to the hospital. Health Presbyterian says by the time Duncan arrived:
EMS had already identified potential need for isolation. The hospital followed all suggested CDC protocols at that time.
Duncan presents at Texas Health Presbyterian after 10 p.m. local time. He undergoes basic blood tests but isn’t screened for Ebola, and is given antibiotics and a pain killer. Dr. Edward Goodman:
His condition did not warrant admission. He also was not exhibiting symptoms specific to Ebola.
Although Duncan informs a nurse that he has traveled from Liberia. Staff say this is not ‘fully communicated’ to the hospital’s medical team.
Duncan comes into contact with 12 to 18 people in Dallas over a period of several days after he starts developing symptoms. Five of them are his girlfriend’s children. An ambulance crew that takes him to hospital are also among those identified.
CDC director Frieden says Duncan developed symptoms ‘four or five days” after traveling to the U.S. The incubation period is two to 21 days.
Duncan leaves Liberia for the U.S. He boards an SN Brussels Airlines flight to Brussels. He then boards United Airlines Flight 951 to Washington Dulles and Flight 822 to Dallas-Fort Worth.
Duncan is tested at Roberts International Airport, 35 miles east of Monrovia before boarding his flight to the U.S. via Belgium. He does not have high fever, sweating, vomiting or weakness. Jay Nagbe Sloh, the director-general of the state-run Liberia News Agency:
He showed no Ebola signs.
Thomas Eric Duncan is born in Monrovia, Liberia to Nowai Korkoya. He has one sister, Mai.