Texas Hospital Misses Ebola Diagnosis

By now it is common knowledge that there is an outbreak of the infectious disease Ebola in West Africa. Having killed thousands there, the disease has also spread to the United States, where one patient just died (at the time of this writing). Thomas Duncan, of Liberia, had reportedly been working with Ebola patients in his home country before visiting family in the United States at the end of September. But what may have been lost in the urgency of the story is that Duncan went to the emergency room of the Texas Health Presbyterian Hospital Dallas with a “low-grade fever and abdominal pain,” before being sent home by the staff there.

While misdiagnoses happen very often (medical errors are the third leading cause of death among Americans behind heart disease and cancer), what makes this instance particularly troublesome is the fact that the hospital staff was aware of Duncan’s travel history. In other words, they knew that he had very recently been in Liberia, a hotbed for the Ebola outbreak where more than 1,800 people have died. The director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci explains, “A travel history had been taken, but it wasn’t communicated to the people who were making the decision [about whether or not to admit the patient]. It was a mistake. They dropped the ball. You don’t want to pile on them, but hopefully this will never happen again… The CDC has been vigorously emphasizing the need for a travel history.” Similarly, CNN medical correspondent Dr. Sanjay Gupta claims that this information “was not acted upon in an appropriate way… There’s no excuse for this.”

While all of this is bad enough on its own, this incident provides us with an opportunity to discuss the state of hospital safety and tort law in Texas more broadly. As we have written here in the past, Texas passed a draconian tort reform package in 2003 that all but closed the courthouse doors to victims of medical negligence. This has led to a system in which many doctors operate without any kind of oversight. In October 2013, this blog published an article on a Texas surgeon who had his license revoked after leaving in his wake two dead and four paralyzed patients. The Texas Observer writes that though this man’s mistakes were “obvious and well-documented,” it took the Texas Medical Board more than a year to discover them. The same article calls this oversight system one in which “there’s no way to know for sure if your doctor is dangerous.”

The most inconvenient part of the tort reform effort in Texas for those who supported the legislative package over ten years ago is the fact that is has not lowered healthcare costs in that state, nor has it significantly increased the number of doctors practicing there. These were meant to be its goals. According to a 2012 study from the University of Texas, Northwestern University, and the University of Illinois, researchers “found absolutely no evidence that tort reform saved money.” In fact, Medicare costs in Texas have actually risen one to two percent faster than the national average. While the healthcare climate is bad enough on a day-to-day basis in Texas, it is incidents like this Ebola outbreak that have exposed its cracks to a national and a global audience.