The Ebola virus' history in the United States has been quite limited: One overseas and two domestic infections in total, far fewer than the number of people in the country who will die today from automobile accidents or influenza. It also appears the contacts the three patients have had have did not lead to any further infections, confirming that the hysteria surrounding Ebola in the United States is exactly that.
However, that two of the three cases occurred due to potential infection containment lapses have shined a light on Texas Health Presbyterian Hospital, the large Dallas facility that treated the initial patient and where the two exposed healthcare workers were employed. Within days of the nurses being infected, the hospital's patient census apparently dropped like a stone. The potential loss of revenue in the short term was so great that Moody's Investors Service placed its parent company, Texas Health Resources, on watch to potentially downgrade its debt.
Were there errors regarding the way the original Ebola patient, Thomas Eric Duncan, was quarantined? Possibly, although given the Centers for Disease Control and Prevention changed its containment guidelines for healthcare workers not long after the two infections, they may not have been stringent enough.
Were there serious medical errors that occurred at Texas Health Presbyterian involving patients other than Duncan during his treatment? Almost certainly. And if they didn't occur at Texas Health Presbyterian, they occurred at other U.S. hospitals at exactly the same time the Ebola story has been unfolding. Surgical patients were discharged with a sponge or an instrument in their body that may not be detected for months, if at all. Patients died because they received the wrong dosage of medication, or because they acquired an infection when a staffer forgot to wash their hands.
The difference has been in the response: Little light is shed on these errors, even though they routinely kill 100 patients or more a day nationwide and cost the healthcare system billions of dollars annually. Meanwhile, the two Texas Health Presbyterian nurses are receiving such attentive care that despite Ebola's high mortality rate they have as good a chance as anyone of making a full recovery.
This would have been an opportune time to focus the spotlight on serious medical errors in U.S. hospitals. The media has blown it.
The only reference I have seen so far was made by CNN anchor Brooke Baldwin. However, it was part of her suggestion that Texas Health Presbyterian was a dangerous place due to the fact that Medicare had fined it for excessive readmissions--a plight being faced by a majority of hospitals in across the country. She also said Duncan was the victim of a readmission because he had been prescribed antibiotics and sent home when he first presented at its ER. CNN reporter Christina Alesci gently corrected her on the fine issue, but ... really?
Meanwhile, hospitals are attempting to bury the medical error issue and mostly succeeding. The California Department of Public Health had been regularly disclosing hospital medical error reports. But in recent months, while the agency was disclosing that hospitals were getting fined for mishaps, the reports of what actually transpired were disappearing. Whenever I inquired, I was told it was the result of "privacy" issues. No elaboration would be provided because it was a private matter.
Reports that had also been posted on the CDPH website for months or even years also began to disappear, apparently because the hospitals were appealing and winning cases in administrative law courts. I have been told the hospitals have mostly relied on the legal concept of laches--they couldn't be fined because too much time had lapsed for regulators to take action. HealthyCal, a regional news website, reported on the disappearing error reports in some depth last week.
In New Jersey just last month, the state Supreme Court ruled that hospitals can keep medical errors secret in order to ensure privacy--of the employees who screwed up.
Now that Texas Health Presbyterian has issued the apparently de rigeur apology and hired a crisis PR firm, its management will no doubt going to lie low and wait until the public forgets what happened, its census returns to normal, and its bottom line becomes healthy again. No doubt, other hospitals are going to use this as a teaching moment, shaken to their core by the notion their business could collapse so quickly.
And who knows--this may be the very last cases of Ebola we hear of in the United States ever again. I'd like to think that's because our healthcare delivery system will have gotten its act together. But if it's because hospitals have improved their veil of secrecy, don't say you weren't warned. – Ron (@FierceHealth)