US - Texas: Mr. Duncan - Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

[Michael Coston]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Secondary Transmission confirmed in Dallas Case. This from the State of Texas

https://www.dshs.state.tx.us/news/releases/20141012.aspx

Texas Patient Tests Positive for Ebola

News Release
Oct. 12, 2014

Texas Patient Tests Positive for Ebola

A health care worker at Texas Health Presbyterian Hospital who provided care for the Ebola patient hospitalized there has tested positive for Ebola in a preliminary test at the state public health laboratory in Austin. Confirmatory testing will be conducted by the Centers for Disease Control and Prevention in Atlanta.

The health care worker reported a low grade fever Friday night and was isolated and referred for testing. The preliminary ​test result was received late Saturday.

"We knew a second case could be a reality, and we've been preparing for this possibility," said Dr. David Lakey, commissioner of the Texas Department of State Health Services. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."

Health officials have interviewed the patient and are identifying any contacts or potential exposures. People who had contact with the health care worker after symptoms emerged will be monitored based on the nature of their interactions and the potential they were exposed to the virus.

Ebola is spread through direct contact with bodily fluids of a sick person or exposure to contaminated objects such as needles. People are not contagious before symptoms such as fever develop.

 

[Pathfinder]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Louisiana attorney general to try and stop Ebola waste from ending up in state landfill

Advocate staff report
Oct. 12, 2014

The Louisiana attorney general said Sunday he will take legal action to stop the incinerated personal belongings of a Dallas Ebola victim from being disposed of in a landfill in Calcasieu Parish.

Buddy Caldwell said he plans to ask for a temporary restraining order on Monday morning preventing any of the wastes from entering Louisiana, the Attorney General?s Office said in a release.

?The health and safety of our Louisiana citizens is our top priority,? Caldwell said in a news release. ?There are too many unknowns at this point, and it is absurd to transport potentially hazardous Ebola waste across state lines.?

The waste will not consist of the belongings themselves, but rather the incinerated remains of six truckloads of items that could have been contaminated by Thomas Duncan when he fell sick, according to the release.
...
http://www.theneworleansadvocate.com/news/10511289-123/louisiana-attorney-general-to-try

 

[Pathfinder]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

CBS/AP /October 13, 2014, 2:34 PM

Ebola fears: La. waste facility won't take Dallas man's incinerated belongings

NEW ORLEANS - A Louisiana waste disposal facility said Monday it would not accept the ash from the incineration of a Texas Ebola victim's belongings, at least not until state officials agree that doing so would pose no threat to the public.

"We are in contact and working with all the appropriate Louisiana state officials and certainly want these officials to agree that any acceptance of this ash at our Lake Charles facility is safe prior to its acceptance," Chemical Waste Management Inc.-Lake Charles said in news release about the Calcasieu Parish facility.

The company said it is permitted by the state and federal government to accept such material and that the decontaminated and incinerated material poses no threat to the environment or human health.

But, the company said, "we do not want to make an already complicated situation, more complicated."
...
http://www.cbsnews.com/news/ebola-f...wont-take-dallas-mans-incinerated-belongings/

 

[Emily]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

http://deq.louisiana.gov/portal/Portals/0/assistance/ELP/P2/Chem-Waste-Mgmt.pdf.

Environmental Leader Facility
CHEMICAL WASTE MANAGEMENT
Lake Charles Facility
Sulphur, LA
The Chemical Waste Management (CWM) Lake Charles Facility is a wholly-owned subsidiary of Waste Management, Inc., the largest waste treatment and disposal company in the United States. The CWM
Facility, located in Carlyss, Louisiana, treats and disposes hazardous and non-hazardous waste from industrial clients in secure double-lined landfills.
With 80 employees, the CWM Facility has maintained strict environmental controls since its inception more than 20 years ago. These controls include rigorous personnel training, daily inspections of the disposal
areas, leachate management, groundwater monitoring, surface water sampling and analysis, and ambient air sampling. Through these programs the CWM Lake Charles Facility has maintained the quality of air,
surface water, ground water, and soil in and around the site...

 

[Pathfinder]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

News Releases
Ebola Update, Oct. 16, 4:00 a.m. CDT
10/16/2014

Correcting the Record: Facts about Protocols and Equipment at Texas Health Presbyterian Hospital Dallas

National Nurses United recently made allegations regarding the protocols and equipment in place during Thomas Eric Duncan?s treatment at Texas Health Presbyterian Hospital Dallas.

The assertions do not reflect actual facts learned from the medical record and interactions with clinical caregivers. Our hospital followed the Centers for Disease Control (CDC) guidelines and sought additional guidance and clarity.

The following are facts about procedures and protocols in place during Mr. Duncan?s treatment:

When Mr. Duncan returned to the Emergency Department (ED), he arrived via EMS. He was moved directly to a private room and placed in isolation. THD staff wore the appropriate personal protective equipment (PPE) as recommended by the CDC at the time.

Regarding the ED tube delivery system utilized during Mr. Duncan?s initial visit, all specimens were placed into closed specimens bags and placed inside a plastic carrier that travel through a pneumatic system. At no time did Mr. Duncan?s specimens leak or spill ? either from their bag or their carrier ? into the tube system.

During Mr. Duncan?s second visit, the tube system was not used at all. His specimens were triple-bagged, placed in a container, and placed into a closed transport container and hand-carried to the lab utilizing the buddy system.

Additionally, while Mr. Duncan was in the MICU, all lab specimens were hand-carried and sealed per protocol. Routine labs were done in his room via wireless equipment.

Nurses who interacted with Mr. Duncan wore PPE consistent with the CDC guidelines. Staff had shoe covers, face shields were required, and an N-95 mask was optional ? again, consistent with the CDC guidelines at the time.
When the CDC issued updates, as they did with leg covers, we followed their guidelines.

When the CDC recommended that nurses wear isolation suits, the nurses
raised questions and concerns about the fact that the skin on their neck was exposed. The CDC recommended that they pinch and tape the necks of the gown. Because our nurses continued to be concerned, particularly about removing the tape, we ordered hoods.

Protective gear followed governing CDC guidelines at the time.

The CDC classified risk/exposure levels. Nurses who were classified as ?no known exposure? or ?no risk? were allowed to treat other patients per the CDC guidance.

Per the CDC guidelines, patients who may have been exposed were always housed or isolated per the CDC guidance.

Regarding hazardous waste, the hospital went above and beyond the CDC recommendations. Waste was well-contained in accordance with standards, and it was located in safe and containable locations.

Admittedly, when we received Tyvek suits, some were too large. We have since received smaller sizes, but it is possible that nurses used tape to cinch the suits for a better fit.

According to an employee satisfaction survey by Press Ganey, Texas Health Dallas is in the top one percent in the country when it comes to employee engagement and partnership. We support the tireless and selfless dedication of our nurses and physicians, and we hope these facts clarify inaccuracies recently reported in the media.


http://texashealth.org/news-alert.cfm?id=1629&action=detail&ref=1898

 

[MHSC]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

My experience has been that nurses don't speak up very often and when they do we better listen or expect to suffer the consequences.

 

[Pathfinder]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

News Releases
Ebola Update, Oct. 16, 8:33 p.m. CDT
10/16/2014

Statement from Texas Health Presbyterian Hospital Dallas

Texas Health Presbyterian Hospital Dallas is committed to working together with its employees to provide a safe, healthy and satisfying workplace.

In the pursuit of open feedback, Texas Health Dallas has a strict nonretaliation policy. Employees are encouraged to raise issues and concerns via the chain of command. This process is a core tenet of our culture and values. It is documented in our Code of Business Ethics.

In addition, Texas Health Dallas employees have two mechanisms available to anonymously raise issues about safety concerns or related matters. It is important to note that no Texas Health Dallas employee did so concerning their care of Mr. Duncan or our two co-workers.

Third parties who don?t know our hospital, our employees and who were not present when the events occurred are seeking to exploit a national crisis by inserting themselves into an already challenging situation. Based on our strong track record of having excellent relationships with our employees, we do not believe it is necessary or helpful for outside parties to intervene in this relationship. Everyone should be focused on supporting each other in our pursuit of learning and continuous improvement that can be applied to hospitals throughout the nation. We are dedicated to providing a wide range of opportunities for employees to give input and influence decision making. From Magnet? designation to multiple Employer of Choice awards, this has long been a recognized strength of our organization.

Many of the comments we have seen or heard in the media are only loosely based on fact, but are often out-of-context and sensationalized. Others are completely inaccurate. We would like to address some of those that have surfaced over the last 24 hours:

We have conducted interviews with well over 100 caregivers involved in Mr. Duncan?s care, some multiple times. The consistent and universal theme we have heard is that all caregivers reported being consistently compliant with utilizing the appropriate PPE in accordance with guidelines from the CDC. The CDC guidelines changed frequently, and those changes were frustrating to them and to management. Nonetheless, they endeavored to remain compliant with what was communicated as the most recent and appropriate guideline.

When Mr. Duncan returned to the Emergency Department (ED), he arrived via EMS. He was moved directly to a private room with a negative air pressure and placed in isolation. There were no other patients in that room. Again, THD staff wore the appropriate PPE as recommended by CDC at the time.

The Infection Prevention coordinator was properly notified in a timely manner of the initial diagnosis and followed Dallas County Health and Human Services process of notification, which includes notification of the CDC.

Mr. Duncan?s initial ED specimens were handled in accordance with normal protocol, bagged and sent in a sealed container through the tube delivery system. There was no spillage of Mr. Duncan?s specimens.

Mr. Duncan?s later specimens in the ED were triple-bagged, placed in a transport container and hand-carried to the lab utilizing the buddy system.

Mr. Duncan?s specimens in the Medical ICU were hand-carried and sealed per protocol. Routine labs were done in his room via wireless equipment.
Nurses who interacted with Mr. Duncan wore PPE consistent with CDC guidelines. Staff had shoe covers, face shields were required, and N-95 mask was optional ? again, consistent with CDC guidelines at the time. When CDC issued updates, as they did with leg covers, we followed their guidelines.

When CDC recommended that nurses wear isolation suits, the nurses raised questions and concerns about the fact that the skin on their neck was exposed. Two onsite CDC members approved and recommended that they pinch and tape the necks of the gown. Because our nurses continued to be concerned, particularly about removing the tape, we ordered medical shrouds.

The CDC classified risk/exposure levels. Nurses who were classified as ?no known exposure? or ?no risk? were allowed to treat other patients per CDC guidance.

Patients who may have been exposed were always housed or isolated per CDC guidance.

Waste was contained in accordance with CDC standards, and waste was located in safe and containable locations. It is a gross exaggeration to say that trash was stacked up to the ceiling.

When we received Tyvek suits, some were too large. We have since received smaller sizes, but it is possible that nurses used tape to cinch the suits for a better fit.

It is incorrect and disturbing to many of our staff to hear media exaggerations about their commitment to the organization they love. They are understandably worried and concerned in the eye of this storm, but they are steadfastly supporting their patients, each other, and the hospital they love.

Texas Health Dallas was the first hospital in the United States to receive a patient with undiagnosed Ebola. We have acknowledged that we made mistakes and that we are deeply sorry. Our amazing caregiving team did not hesitate to rise to the challenge despite being in an unprecedented situation.

Texas Health Dallas remains a safe place for employees and patients. We support the tireless and selfless dedication of our nurses and physicians, and we hope these facts clarify inaccuracies recently reported in the media.

http://texashealth.org/news-alert.cfm?id=1629&action=detail&ref=1901

 

[Pathfinder]

Re: US - Texas: Mr. Duncan - Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Ebola waste from Dallas hospital arrives at UTMB-Galveston
...
Author: Phil Archer, Reporter
The Associated Press
Published On: Oct 18 2014 09:26:11 AM CDT Updated 1 h

GALVESTON, Texas -

Health officials say the University of Texas Medical Branch at Galveston in the coming days will destroy medical waste from a Dallas hospital where a Liberian man died of Ebola and two nurses became infected. The waste arrived at UTMB in a truck early Saturday morning.

Dr. David L. Callender told a town hall meeting of students and employees Friday that most of the waste is articles of protective clothing worn by health workers who were treating Thomas Duncan who died from Ebola at Texas Health Presbyterian Hospital Oct. 8.
...
Callender said the campus has the only licensed medical incinerator in Texas capable of receiving and incinerating the biohazardous material coming from the Dallas hospital.

He said waste suspected of being contaminated by Ebola is sealed in 55-gallon drums. It will be trucked from Dallas in a refrigerated vehicle, and placed in the 1,500-degree Fahrenheit incinerator. Any residue not turned to ash can then be placed in an 1,800-degree incinerator.
...
http://www.click2houston.com/news/utmbgalveston-to-destroy-ebola-waste-from-dallas-hospital/29211168

 

[Gert van der Hoek]

Re: US - Texas: Mr. Duncan - Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

ALL CLEAR NEARS FOR CONTACTS OF FIRST DALLAS EBOLA PATIENT

All of the 48 people who had contact with the first person to be diagnosed with Ebola in the United States will no longer have to be monitored for the virus at the end of the day today, the Dallas official spearheading the county response said.

Thomas Eric Duncan's fiancee Louise Troh and her family will have their active control order lifted at the end of the day, according to the Texas State Health Department.

"They will no longer need to stay home starting Monday," the statement said. "Someone will formally bring the release to them on Monday."

More: 7online

 

[Chicagogal]

Re: US - Texas: Mr. Duncan - Patient tests positive for Ebola in Dallas - traveled from Liberia -deceased

Ebola Fear Stalks Home Hunt for Quarantined Now Released

A new-apartment deal busted up after Troh had already made a deposit, and Dallas?s top county official and Troh?s pastor say people are reluctant to rent to someone who was so close to Ebola.

...

Josephus Weeks, who describes himself as Duncan?s nephew, said the family begged the hospital to do more, and asked the medical staff to give him a blood transfusion from a recovered Ebola patient. Weeks told Bloomberg the hospital said it was too late. After his death, the hospital said no donor with a compatible blood type could be located.