Make no mistake, the Dallas Emergency Department physician who examined the patient sick with Ebola and did not elicit a travel history must bear responsibility for the grievous mistake of discharging the patient home while he was infectious and likely transmitted the virus to contacts.
Tonight, officials at Texas Hospital Presbyterian tried to diffuse the growing criticism about the handling of the case by releasing details on Duncan’s stay.
Apparently, the patient admitted that he had recently been in Africa and it was noted in the nursing section of the electronic health record.
However, this information did not at the time display in the physician section and was not available for perusal. Thus the physician could not know about the recent history.
Except, he or she could have asked the patient themselves.
This is not a hard call. When a man with a heavy African accent shows up with a fever and abdominal pain, query as to recent travel just absolutely should be a part of the history. Physicians are still ultimately responsible for the care of patients.
One of the first rules taught to many medical students is to trust no one. The teaching is to always confirm the important parts of every case personally. And, in this case, the physician did not do that.
Yes, the nurse who took the history should have verbally given a report to the physician.
Yes, the electronic health record that is no doubt loathed by most of the providers in the ER that night should have shown the information on the “doctors screens.”
But, that is no excuse for what happened. It is the duty and responsibility of the physician to take care of patients and this was not done.
It will be interesting when the identity of physician comes out to learn how about the level of training and experience of the provider.
Was it a resident or a more senior provider? Was it a physician at all or perhaps a nurse practitioner or physicians assistant?
Was it someone who was recently trained under a system where there has been an over-reliance on the electronic health chart?
Whoever it was, it is a career-ending mistake and will have likely devastating consequences for patients who were likely infected with Ebola needlessly.
They need to fired if they don’t resign. And they can take the hated electronic medical record with them.
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