Thomas Duncan's temperature spiked to 103 degrees during the hours of his initial visit to an emergency room—a fever that was flagged with an exclamation point in the hospital's record-keeping system, his medical records show. Despite telling a nurse that he had recently been in Africa and displaying other symptoms that could indicate Ebola—fever, sharp headache, and abdominal pain—the Liberian man who would become the only person to die from the disease in the US underwent a battery of tests and was eventually sent home. Duncan's family provided his medical records to the AP, more than 1,400 pages in all. They chronicle his time in the ER, his urgent return to the hospital two days later, and his steep decline as his organs began to fail.
In a statement, Texas Health Presbyterian Hospital said it had made procedural changes and continues to "review and evaluate" the decisions surrounding Duncan's care. Duncan carried the virus with him from his home in Liberia, though he showed no symptoms when he left for the United States. He arrived in Dallas on Sept. 20 and fell ill several days later. When he first showed up at the hospital, Duncan reported severe pain—rating it an eight on a scale of 10. Doctors gave him CT scans to rule out appendicitis, stroke, and other ailments. Ultimately, he was prescribed antibiotics and told to take Tylenol, then returned to the apartment where he was staying with a Dallas woman and three other people. "I have given patient instructions regarding their diagnosis, expectations for the next couple of days, and specific return precautions," an ER physician wrote. "The condition of the patient at this time is stable." (Meanwhile, making Ebola jokes while on a plane isn't a good idea.)