Nina Pham, the first of two nurses at Texas Health Presbyterian Hospital Dallas who contracted the Ebola virus from Thomas Eric Duncan, has filed a lawsuit against the hospital’s parent company, Texas Health Resources (THR). Her lawsuit reveals for the first time troubling allegations about a long list of safety failures and undue risks committed by a hospital desperate to protect its image. “When Nina needed THR the most, THR failed her, despite the fact that THR wanted to sell her to the public as the face of the company,” says the complaint.
The complaint, embedded at the end of this article, is compelling reading, mincing no words as it describes Pham, the first person to contract Ebola on United States soil, as “a symbol of corporate neglect–a casualty of a hospital system’s failure to prepare for a known and impending medical crisis,” before laying out a detailed narrative about how Duncan arrived at the hospital, was treated by Pham, became sicker and ultimately died from the dangerous disease, but not before passing it on to two of his caretakers, Pham and another nurse named Amber Vinson.
Pham’s lawsuit accuses THR of engaging in growth “largely derived from an aggressive focus on increasing profitability,” and alleges that THR ignored the dangers of Ebola – including specific warnings – that left the hospital vulnerable. Duncan had first presented at the emergency room on September 25, but had been turned away without his symptoms being recognized as Ebola, only to be brought back on September 28. By that point, Duncan was already in the end stages of the disease and died shortly thereafter.
Acknowledging that it is impossible to know whether Duncan would have survived if he had received proper treatment on September 25, “[w]e do know that earlier treatment increases the likelihood of survival,” states the complaint. “Had THR heeded the CDC and other warnings and ensured its hospitals were ready for Ebola, Mr. Duncan would have had the best opportunity to possibly survive. Instead, what THR has admitted were ‘mistakes’ robbed Mr. Duncan of that chance and placed others at great risk when his condition progressed to the most dangerous and communicable stages of Ebola.”
These failures, says the complaint, unnecessarily put Pham at risk, and that risk was compounded due to the inadequate training and safety equipment provided to the nurses. Pham is described as being “shocked” in the complaint when she was assigned to treat Duncan, because she had no experience in this area:
She had never been trained to handle infectious diseases, never been told anything about Ebola, how to treat Ebola, or how to protect herself as a nurse treating an Ebola patient. The hospital had never given her any in-services, training or guidance about Ebola. All Nina knew about Ebola is what she had heard on the television about the deadly outbreak in West Africa.
Even worse, continues the complaint, the Intensive Care Unit (ICU) where Pham worked had “no written policies or manuals about treating level 4 infectious disease patients generally or Ebola specifically.” The only instructions that were apparently given to Pham were what her manager had found on a Google search and printed for her.
Regarding safety equipment, one of the key problems claimed by the complaint was that the gear provided to Pham and her colleagues by THR was less protective than the full body “moon suits” that are standard protocol in Ebola clinics in West Africa. “Despite the claims about our advanced health care system,” says the complaint, “Nina Pham would have been better offer treating Mr. Duncan in a Liberian Ebola center than in THR’s signature hospital.”
After Duncan died, Pham was apparently told by a supervisor at THR and a representative from the CDC that she was at “no risk” of having contracted Ebola, news that she describes as surprising. Pham was saddened by the loss of her patient, says the complaint, and sought solace in her friends and family, unwittingly putting them at risk, a risk she would never have taken if she had been given an accurate assessment of her true exposure to and risk of contracting Ebola.
When Pham’s temperature spiked a few days later, she returned to the hospital, where she received the chilling diagnosis, and began her fight for her life. The complaint makes brutal accusations that THR was more concerned with the PR image of the hospital than Pham’s health or right to privacy.
Even though Pham had specifically asked for her personal information to be protected and kept private, THR failed to do so, and her medical records were “grossly and inappropriately accessed by dozens of people throughout the THR system,” says the complaint.
The hospital also issued a press release claiming that Pham was in “good condition,” even though, as the complaint alleges, she had not given permission for such a release, and her health was far more precarious. Pham’s medical records at the time describe her condition as “critical” and “life-threatening.” Pham’s doctors admitted to her mother that the press release was not correct, leaving her family “shocked and confused.”
Perhaps even more damning is the allegation that THR’s PR team continued to attempt to get Pham’s consent to release more of her information during this time. The complaint describes THR as “desperate” to be able to be able to put a positive spin on the story of of the brave, pretty nurse and her adorable dog, Bentley, as a higher priority than Pham’s medical care. “Even though THR’s own records indicate Nina’s condition left her unable to make important decisions on her own, THR had no problem asking for and relying on her consent to release information about her to the public for its own corporate benefit.”
Then, before Pham was transferred to the National Institutes for Health (NIH) in Maryland, one of her doctors entered her room wearing a small, portable “GoPro” camera. Footage from this video was posted publicly on YouTube by THR. The complaint says that Pham not only did not give her consent for the video to be released, but that THR also deceptively edited it for their own purposes.
“Never once did THR get Nina’s permission to be used as a PR pawn like this. Never oncedid THR discuss its purposes or motivations or tell Nina what it was going to do with theinformation it sought from her. Instead, THR went to this young lady who was not in the position to be making any such decisions, and used her when she was in the darkest moment of her life, all for THR’s own benefit.
Pham did survive Ebola, but now faces an uncertain future, and the complaint describes injuries to her, physical, mental, and emotional. The emotional trauma of her experience, plus the stigma associated with such a highly communicable and dangerous disease, makes it unlikely she will ever work as a critical care nurse again, a career she was just beginning. The long term effects Pham will suffer from the disease itself, plus from the heavy doses of experimental drugs used to save her life, are unknown. The complaint describes her worries if she will be able to have children one day, and the toll it has taken on her personal relationships.
The complaint does not specify the amount of damages sought — and the law does not require it to do so — instead listing twelve different types of injuries Pham has suffered, from medical expenses, “physical pain and mental anguish,” physical impairment, loss of earning capacity, and loss of reputation. Considering the nature of this case and the fact that Pham could potentially collect for both past damages suffered and future damages — her ongoing medical care, future lost earnings, etc. — if she prevails in this lawsuit, a jury award could be substantial, in the millions of dollars.
The Dallas Morning News posted a detailed interview with Pham over the weekend, where Pham describes the allegations in the complaint in more detail. An op-ed from Tod Robberson, one of the Morning News‘ editorial writers, describes Pham’s lawsuit as “underscor[ing] our deepest fears about Ebola missteps,” and hopes that the litigation will lead to answers about what went wrong, and how it can be prevented in the future:
If half of what [Pham] alleges is true — and I have no reason to believe it’s not 100 percent true — the hospital’s parent company, Texas Health Resources, has a lot to answer for.
The big question is whether any of those answers will see the light of day. Typically in big, embarrassing lawsuits like this, the parties sit down with a mediator, negotiate a settlement, agree to a large payment, then everyone agrees to keep the whole arrangement secret. All those salacious allegations fade away. And none of the important questions get answered.
Dallas deserves answers. Hundreds of people’s lives were thrown into upheaval by this crisis — public school students, hospital workers, first responders, neighbors of those quarantined, and of course, the scores who were quarantined or self-isolated.
Pham released a statement on Monday shortly after the lawsuit was filed:
“I was hoping that THR would be more open and honest about everything that happened at the hospital, and the things they didn’t do that led to me getting infected with Ebola. But that didn’t happen and I felt I was left with no choice but to turn to the courts for help. The fact is, I’m facing a number of issues with regard to my health and my career and the lawsuit provides a way to address them. But more importantly, it will help uncover the truth of what happened, and educate all health care providers and administrators about ways to be better prepared for the next public health emergency. I particularly want to express my continued sympathy to the family of Mr. Duncan, as it was my privilege to care for him. I also want to acknowledge my fellow nurses, and the many friends, family and strangers for their ongoing concern and support.”
THR also responded with a statement from their spokesman Wendell Watson: “Nina Pham bravely served Texas Health Dallas during a most difficult time. We continue to support and wish the best for her, and we remain optimistic that constructive dialogue can resolve this matter.”
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