- Hospital exec says nurses didn't ask Thomas Eric Duncan what African country he visited
- Duncan left the emergency room but died October 8 of Ebola virus
- The hospital didn't conduct any simulations on how to handle Ebola cases, executive says
- "We are certainly forthcoming and transparent about the fact that we missed a diagnosis"
Texas Presbyterian Hospital "fell short" several times in treating Ebola patient Thomas Eric Duncan, starting by not asking the right questions in the emergency room, the hospital's chief clinical officer, Dr. Daniel Varga, said in an interview with CNN.
On September 25, Duncan came into the ER with a fever and was interviewed by a nurse who wrote down that he "came from Africa 9-20-14," Varga said. The nurse didn't specify which nation, he said.
Around the same time a physician recorded Duncan as "a local resident, no contact with sick people. No symptoms of nausea, vomiting, diarrhea," Varga said.
Duncan, a 42-year-old Liberian native, was let go four hours later. He returned to the hospital a few days later and on October 8 became the first person to die of Ebola in the United States.
New questions in the emergency room
Varga said the hospital has updated its admitting policy and that ER workers ask whether patients have traveled to five specific countries in Africa.
"We were completely prepared to take care of someone who came in with a diagnosis of Ebola," Varga said. "The place where we fell short was being able to diagnose a patient walking in off the street with symptoms that could be consistent with Ebola or anything else and really being able to manage that."
After Duncan died and two nurses who cared for him contracted Ebola, the CDC issued new guidelines Monday on how health care workers should handle Ebola cases. The CDC director stressed that hospitals train workers more thoroughly and make sure no skin is exposed when dealing with Ebola patients.
Varga told CNN the hospital didn't conduct enough training in how to handle Ebola patients -- something that contributed to the initial misdiagnosis.
"Where we fell short was in really going through simulation and training and drilling around what might happen if someone with appropriate (symptoms), appropriate history showed up to the ED and raised a suspicion of Ebola," he said.
Two nurses weren't told not to travel
Varga was asked if any nurses raised concerns about having to treat an Ebola patient. He replied, "Not to my knowledge."
Yet several days ago nurses at the hospital complained about lack of safety protocols at the hospital, such as having protective gear that left their necks uncovered.
Varga said the hospital didn't issue no-travel mandates to two nurses who treated Duncan and later developed Ebola. One of them flew on commercial flights.
"Our job was to identify the folks who were the contacts of Mr. Duncan and travel policy and all that other sort of stuff was largely dictated by county, state and the CDC," Varga said.
He said the policy has been changed so that hospital workers who might contract Ebola are told not to take public transportation.
Duncan's family has criticized the hospital, saying they don't think he had to die. Varga said he doesn't know if that's true.
"I don't think you can prognosticate about whether there would have been a change in outcome," he said. "We are certainly forthcoming and transparent about the fact that we missed a diagnosis on the 25th and 26th, and we've said over again that that's something that we deeply regret and wish we could have hit the diagnosis right then."