Texas Narrows Ebola Focus to 10 Considered to Be at Greatest Risk

Health officials’ handling of the first Ebola patient diagnosed in the United States continued to raise questions Friday, after the hospital that is treating the patient and that mistakenly sent him home when he first came to its emergency room acknowledged that both the nurses and the doctors in that initial visit had access to the fact that he had arrived from Liberia.

For reasons that remain unclear, nurses and doctors failed to act on that information, and released the patient under the erroneous belief that he had a low-grade fever from a viral infection, allowing him to put others at risk of contracting Ebola. Those exposed included several schoolchildren, and the exposure has the potential to spread a disease in Dallas that has already killed more than 3,000 people in Africa.

On Thursday, the hospital, Texas Health Presbyterian Hospital in Dallas, released a statement essentially blaming a flaw in its electronic health records system for its decision to send the patient — Thomas E. Duncan, a Liberian national visiting his girlfriend and relatives in the United States — home the first time he visited its emergency room, Sept. 25. It said there were separate “workflows” for doctors and nurses in the records so the doctors did not receive the information that he had come from Africa.

But on Friday evening, the hospital effectively retracted that portion of its statement, saying that “there was no flaw” in its electronic health records system. The hospital said “the patient’s travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician’s workflow.”

The hospital had said previously that the patient’s condition during his first visit did not warrant admission and that he was not exhibiting symptoms specific to Ebola.

The admission came on a day when health officials narrowed down to 10 the number of people considered most at risk of contracting Ebola after coming into contact with Mr. Duncan. They also moved the four people who had shared an apartment with him from their potentially contaminated quarters, as local and federal officials tried to assure the public that the disease was contained despite initial missteps here.

The four people, a girlfriend of Mr. Duncan and three of her relatives, had been under orders not to leave their home, and Texas officials apologized to them for not moving faster to have the apartment cleaned of potentially infectious materials.

The cleanup began Friday afternoon — more than a week after Mr. Duncan first went to the hospital — as television-news helicopters swirled in the skies above and workers in yellow protective suits scoured the apartment, whose entryway and balcony were covered with a tarp.

“I want to see them treated as I would want my own family treated,” said County Judge Clay Jenkins, the top elected official of Dallas County, who visited the family inside the apartment on Thursday night and again on Friday, when he drove them to an undisclosed location, where they will remain under quarantine.

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Dan Mullin is an active writer and editor for the Pluto Daily who covered the 2014 Ebola Outbreak. Mullin attended the Wake Forest School of Medicine before leaving to pursue his lifelong science goal of allowing humans to live forever via a computer/brain transfer.