Dallas ER doc admits errors in country's first Ebola case

The Dallas hospital emergency room (ER) physician who initially misdiagnosed the country's first Ebola case acknowledged mistakes were made but told The Dallas Morning News that given the information he had at the time of the visit, his care and treatment were appropriate.

Joseph Howard Meier, M.D., was working the overnight shift at Texas Health Presbyterian Hospital when Thomas Eric Duncan first arrived at the emergency room on Sept. 25.  

Ebola wasn't considered, he told the publication in a written response to questions, because Meier didn't know Duncan was in Liberia and he denied having contact with sick patients. Furthermore, Meier said he didn't see a nurse's note in the chart that Duncan's temperature spiked to 103 degrees a few hours later. Had he known Duncan had been to Liberia, Meier says he would have contacted the Centers for Disease Control and Prevention.

Duncan was discharged with a diagnosis of sinusitis and an antibiotic. Two days later Duncan returned to the emergency room far sicker and told an ER nurse he had just moved to Dallas from Liberia. It was then that the ER doctor on duty, Otto Javier Marquez-Kerguelen, M.D., listed Ebola as a possible diagnosis.

Duncan died the morning of Oct. 8, the first casualty of Ebola in the U.S.

"As medical professionals we aspire to perfection in the diagnosis and treatment of all our patients and have regrets when an incorrect diagnosis occurs," Meier wrote to the publication. "It's very easy to make a diagnosis of any condition after the patient's medical evaluation confirms the final diagnosis. Unfortunately, such 20/20 hindsight is not available to medical professionals caring for patients in real time."

Since the first case, Meier said the hospital has better protocols in place, but it can be difficult to diagnose something so rare. Asked if he would have done anything differently, Meier wrote. "Hindsight is always 20/20 so it's virtually impossible to answer this question. Based on the information I had at the time, I believe that the care and treatment were appropriate," he said.

In other Ebola news, Ron Klain, who was named by the White House administration as the country's Ebola czar in October, will leave the position by March 1 to return to the private sector, Fortune Magazine reported.  The position was only temporary and Klain wants to go back to his former role now that the deadly virus is under control in the United States.

To learn more:
- read the full interview in The Dallas Morning News
- here's the Fortune Magazine article

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