Tags: Ebola | confidence | Dallas | hospital

Ebola Mistakes Shake Confidence in Dallas Hospital

Friday, 17 October 2014 08:50 PM

Dallas security guard Joanna Richardson said she wouldn’t trust Texas Health Presbyterian Hospital to protect her from the Ebola virus.

“They kind of dropped the ball,” in caring for the late Thomas Eric Duncan, who was felled by Ebola, said Richardson, 52. She said she’d opt for another hospital in an emergency.

Presbyterian released Duncan, a Liberian who was the first Ebola patient diagnosed in the U.S., when he first came to the emergency room, although he told nurses he had just flown from West Africa. Nurses Nina Pham and Amber Vinson then contracted Ebola despite the hospital’s best efforts to protect them.

Another nurse has blanketed national media with her accusations that the hospital prepared poorly, didn’t isolate Duncan adequately and outfitted staff with sub-standard protective suits. Overwhelmed and under congressional scrutiny, the hospital earlier this week sent Pham and Vinson to special centers for treating infectious diseases.

The 898-bed hospital was too fast to express confidence and damaged what had been a strong reputation in the Dallas market, said Fraser Seitel, a partner with Rivkin & Associates, a marketing and communications consultant in Glen Rock, New Jersey.

“They emphasized speed over accuracy and now the patients are out of there,” Seitel said. “Their reputation has been tarnished by their handling of the Ebola patients.”

Mistakes Made

At the hospital’s Sept. 30 press conference announcing that it was treating Duncan, Mark Lester, an executive vice president of Texas Health Resources, Presbyterian’s parent company, said “we’re prepared” and “the hospital is operating normally.”

Since then it has issued corrections to various statements it has put out, including one trying to explain why it initially let Duncan go. Presbyterian made mistakes when it failed to correctly diagnose his symptoms on his first visit, said Daniel Varga, chief clinical officer, in testimony prepared for a House hearing yesterday.

A hospital executive, who wasn’t identified, apologized to Louise Troh, Duncan’s fiance, and expressed “regret that the hospital was not able to save his life,” according to a statement she released through Mark Wingfield, associate pastor of Troh’s church, Wilshire Baptist.

Exporting Patients

Beyond the costs of treating Duncan, who died Oct. 8, and the nurses, the hospital is losing income as it diverts emergency patients carried by ambulance to other hospitals. Many of the medical professionals who would normally staff its intensive care unit have been “sidelined for continuous monitoring” of patients at risk of possible Ebola infection, Candace White, hospital spokeswoman, said in a statement.

Pham, the first infected nurse, has been moved to the National Institutes of Health Clinical Center in Bethesda, Maryland. Vinson was moved to Emory University Hospital in Atlanta.

With so many staff members out of service, the hospital said Pham’s transfer was “in the best interest of Nina, hospital employees, nurses, physicians and the community to give the hospital an opportunity to prepare for whatever comes next.”

Dallas County’s top elected official, Judge Clay Jenkins, said he has been staying at the hospital some days around the clock, eating three meals of “delicious cold hospital food” every day.

“They are going through a wealth of emotions and concerns dealing with the national spotlight with having had the first American Ebola patient,” Jenkins said in a telephone interview.

Readiness Questioned

Yesterday Briana Aguirre, one of the hospital’s nurses, appeared on NBC’s Today show and said she couldn’t defend the hospital’s handling of Duncan. She said he was put in an area with as many as seven other patients and it took more than three hours to contact the U.S. Centers for Disease Control and Prevention when the hospital suspected Ebola. Workers didn’t even know how they were supposed to handle his lab specimens, she said.

“I watched them violate basic principals of medical care,” Aguirre said in the interview. “They should have known it was getting out of hand.”

Nurses caring for Duncan used “a variety of forms” of personal protective equipment, sometimes creating more dangers by wearing three or four layers, which made it riskier to remove, said Thomas Frieden, director of the CDC, at an Oct. 15 press conference.

Internal Interviews

“It takes weeks of training to learn how to do this right,” said Robert Glatter, an emergency room physician at Lenox Hill Hospital in New York. “After these missteps they need to restore community confidence and assure the community that they’re safe for workers, not just for patients.”

White, the hospital spokeswoman, said none of its employees used an internal process to anonymously raise concerns about the care of Duncan or the two nurses. The hospital interviewed 100 people involved with Duncan’s case and they all “endeavored to be compliant” with CDC guidelines, White said.

“Third parties who don’t know our hospital, our employees and who were not present when the events occurred are seeking to exploit a national crisis by inserting themselves into an already challenging situation,” the hospital said in its statement. “We do not believe it is necessary or helpful for outside parties to intervene in this relationship.”

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Dallas security guard Joanna Richardson said she wouldn't trust Texas Health Presbyterian Hospital to protect her from the Ebola virus."They kind of dropped the ball," in caring for the late Thomas Eric Duncan, who was felled by Ebola, said Richardson, 52. She said she'd...
Ebola, confidence, Dallas, hospital
Friday, 17 October 2014 08:50 PM
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