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TorchTheWitch

(11,065 posts)
Mon Oct 13, 2014, 05:01 PM Oct 2014

CDC head criticized for blaming 'protocol breach' as nurse gets Ebola

http://news.yahoo.com/cdc-head-criticized-blaming-protocol-breach-nurse-gets-040454561.html

CHICAGO (Reuters) - Some healthcare experts are bristling at the assertion by a top U.S. health official that a "protocol breach" caused a Dallas nurse to be infected with Ebola while caring for a dying patient, saying the case instead shows how far the nation’s hospitals are from adequately training staff to deal with the deadly virus.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, made the declaration on Sunday at a news conference and called for an investigation into how the unidentified nurse became infected while caring for Liberian national Thomas Eric Duncan, the first Ebola patient diagnosed in the United States. Duncan died last week at Texas Health Presbyterian Hospital.

Healthcare and infection control experts said that hospital staff need to be coached through the stages of treating an Ebola patient, making sure they have the right safety equipment and know how to use it properly to prevent infection.

It was not immediately clear whether the Texas hospital prepared its staff with simulation drills before admitting Duncan, but a recent survey of nurses nationwide suggests few have been briefed on Ebola preparations. Officials at the hospital did not respond to requests for comment.


Much more at link.

There is also a photo from NYDailyNews that show hospital workers from Bellevue Hospital in NY modeling what the CDC had recommended for care of Ebola patients. No idea what the nurse in Dallas who became infected was wearing especially considering at the time the CDC only recommended protective covering of that shown of the hospital worker must uncovered.

Notice also that even the worker modeling the fullest covering of protective clothing has the foot covering on one foot slid over that exposes their shoe, and that these foot coverings do not cover the bottom of the shoes.

We also know that the CDC protocol did not recommend chlorine or any other disinfection of the clothing before these unskilled and unpracticed workers in such high level protection in Dallas removed their clothing. Friedman immediately blamed a breach in protocol when it is apparent that the protocol itself isn't good enough with unskilled and unpracticed care workers trying to deal with it on their own with no expert supervision and woefully ineffective clothing and disinfection guidelines from the CDC.

http://assets.nydailynews.com/polopoly_fs/1.1972514.1413218460!/img/httpImage/image.jpg_gen/derivatives/article_970/ebola-presser-bellevue.jpg





36 replies = new reply since forum marked as read
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CDC head criticized for blaming 'protocol breach' as nurse gets Ebola (Original Post) TorchTheWitch Oct 2014 OP
If Tom Frieden had to go in and clean up Mr. Duncan's shit and suction his ET tube, TwilightGardener Oct 2014 #1
Calling it a protocol breach isn't "blaming" anyone. Stuff happens. Accidental stuff kestrel91316 Oct 2014 #20
He was trying not to panic people, so he made a statement that served agency purposes TwilightGardener Oct 2014 #23
These workser are also doing risky procedures LisaL Oct 2014 #2
I do not see how the two POV are incompatible Mass Oct 2014 #3
When Dr. Frieden said that it was caused by a breach in the protocol, pnwmom Oct 2014 #4
He has said it was NOT a way to blame the nurse. elleng Oct 2014 #6
Who breached the protocol then, if not the nurse? pnwmom Oct 2014 #7
And it is easy to breach protocol, particularly if you are poorly trained. Mass Oct 2014 #11
I think poor training is a big problem. City Lights Oct 2014 #15
Yes. The protocols are probably too difficult to learn on the fly, which is what these people pnwmom Oct 2014 #17
You are acting like she was in a vacuum and couldn't have possibly been harmed by kestrel91316 Oct 2014 #21
what the hell does this have to do with the media? TorchTheWitch Oct 2014 #13
There's a lot of money to be made by a few in the healthcare business. icymist Oct 2014 #35
Of course he's criticized, elleng Oct 2014 #5
What was it meant as? LisaL Oct 2014 #8
He doesn't want to admit that the other option is that the CDC's protocols are inadequate. pnwmom Oct 2014 #9
That's my take on it too. LisaL Oct 2014 #10
He DID state that the protocols have to be examined, elleng Oct 2014 #12
But that is inconsistent with his earlier statement that the protocols had been breached. pnwmom Oct 2014 #16
Ok. Please kindly rewrite all Ebola protocols correctly and show us your work before you express kestrel91316 Oct 2014 #22
What is your problem, kestrel? I wasn't attacking him or you or anyone else. pnwmom Oct 2014 #30
I swear, practically every post here sounds like it was written by a card-carrying, Obama-hating kestrel91316 Oct 2014 #26
They take responsibility, elleng Oct 2014 #27
No, the CDC isn't your mother. That sounds like something a "nanny-state" ranter would say. pnwmom Oct 2014 #31
Well, unfortunately, Occam's Razor says it's the most likely cause, at this point. AverageJoe90 Oct 2014 #14
the CDC IS to blame TorchTheWitch Oct 2014 #18
Mr. Duncan's release is wholly the hospital's fault. AverageJoe90 Oct 2014 #19
I said not one word about his release when he went to the hospital TorchTheWitch Oct 2014 #33
Post removed Post removed Oct 2014 #24
a teabagger? TorchTheWitch Oct 2014 #36
Right, and here it comes! elleng Oct 2014 #28
What protocol, and who breached it? DirkGently Oct 2014 #25
CDC can't say. LisaL Oct 2014 #29
Well... greytdemocrat Oct 2014 #32
The President needs to demand his resignation WestSideStory Oct 2014 #34

TwilightGardener

(46,416 posts)
1. If Tom Frieden had to go in and clean up Mr. Duncan's shit and suction his ET tube,
Mon Oct 13, 2014, 05:06 PM
Oct 2014

he'd make sure he was in a fucking moon suit. Way to blame the nurse for risking her life to care for her patient, asshole. She most likely did the best she could with what she had. How about not letting more Mr. Duncans into the country, rather than blaming our health care workers for doing their jobs?

 

kestrel91316

(51,666 posts)
20. Calling it a protocol breach isn't "blaming" anyone. Stuff happens. Accidental stuff
Mon Oct 13, 2014, 07:03 PM
Oct 2014

that doesn't BEGIN to approach negligence or stupidity. A contaminated gloved hand barely brushing against something else that is supposed to be clean. A moment's lapse in attention due to the need for multitasking.

The only thing that is going to be productive here is for people to STOP HATING and to work together to figure out what happened so others won't get caught by the same mistake/accident/lapse/breach again.

STOP HATING.

TwilightGardener

(46,416 posts)
23. He was trying not to panic people, so he made a statement that served agency purposes
Mon Oct 13, 2014, 07:09 PM
Oct 2014

(ebola is under control, as long as everyone follows protocol!) but this automatically shifts blame to the worker, who likely did the best she could under the circumstances, being that she doesn't want to die. He should have shut his yap about the incident, at least in terms of direct cause, until the matter was thoroughly investigated. The hospital sounds like a shitty facility, and it's not known what additional training the nurse was given, or if someone above her was closely supervising the following of CDC protocol.

LisaL

(44,973 posts)
2. These workser are also doing risky procedures
Mon Oct 13, 2014, 05:07 PM
Oct 2014

on the patients that can spread the virus. So they need more protection than in Africa, not less.
Yet I've seen images from Africa in better protection gear.

Mass

(27,315 posts)
3. I do not see how the two POV are incompatible
Mon Oct 13, 2014, 05:07 PM
Oct 2014

except may be in the mind of reporters trying to create a conflict.

This shows the very sad state of our media.

pnwmom

(108,980 posts)
4. When Dr. Frieden said that it was caused by a breach in the protocol,
Mon Oct 13, 2014, 05:15 PM
Oct 2014

that was a way to blame the nurse. His assumption was that the protocol was adequate, so if she got sick, it was her fault for not following the protocol.

But he was wrong. There are at least two DIFFERENT possibilities. Either the protocol is perfectly adequate, and she didn't follow it. Or she followed it, but the protocol isn't protective enough.

In my mind there's a third. The protocol might be adequate, but few humans could follow it well enough, at least not with constant and complete supervision -- which I don't think that nurse had.

elleng

(130,948 posts)
6. He has said it was NOT a way to blame the nurse.
Mon Oct 13, 2014, 05:20 PM
Oct 2014

I just heard him explain the meaning of 'protocol' on the radio, and he's sorry the world doesn't understand the medical jargon.

pnwmom

(108,980 posts)
7. Who breached the protocol then, if not the nurse?
Mon Oct 13, 2014, 05:23 PM
Oct 2014

Of course he was blaming her.

From the article in the OP:

Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also disagreed with the talk of a breach of protocol, saying it just puts the onus on the nurse.

"I think that is just wrong," said Macgregor-Skinner, who helped the Nigerian government train healthcare workers when a traveler from Liberia touched off an outbreak of Ebola this past summer.

“We haven't provided them with a national training program. We haven't provided them with the necessary experts that have actually worked in hospitals with Ebola," he added in reference to U.S. hospital staff.

Legal experts said the Dallas nurse may be entitled to compensation if the hospital carries workers' compensation insurance. If it doesn’t, she would have the right to sue the hospital for damages under Texas law, said Jay Harvey, a lawyer in Austin, Texas.

Mass

(27,315 posts)
11. And it is easy to breach protocol, particularly if you are poorly trained.
Mon Oct 13, 2014, 05:32 PM
Oct 2014

which is obviously the case here and everywhere in the country. You may not even realize it.

I find the media effort to create conflict dangerous and destructive, but this is all they know.

City Lights

(25,171 posts)
15. I think poor training is a big problem.
Mon Oct 13, 2014, 05:52 PM
Oct 2014
Nearly 80 percent of registered nurses said their hospital has not explained their policies for admitting a potential Ebola patient in a new survey that the union released Monday.

http://thehill.com/policy/healthcare/220565-cdc-more-nurses-might-have-ebola

pnwmom

(108,980 posts)
17. Yes. The protocols are probably too difficult to learn on the fly, which is what these people
Mon Oct 13, 2014, 06:19 PM
Oct 2014

were forced to do.

And they might not be adequate. I read someone today saying that they might need to be changed to require a higher degree of protection -- including respirators or space suits -- during the end-stage of the disease, when the patient is spewing large amounts of fluids.

 

kestrel91316

(51,666 posts)
21. You are acting like she was in a vacuum and couldn't have possibly been harmed by
Mon Oct 13, 2014, 07:05 PM
Oct 2014

SOMEONE ELSE'S breach of protocol.

Get a grip. For all we know, somebody ELSE didn't do THEIR part quite right and this poor woman is paying the price.

And STOP HATING. You're acting like a gubmint-hating, librul-elite hating RWer.

TorchTheWitch

(11,065 posts)
13. what the hell does this have to do with the media?
Mon Oct 13, 2014, 05:45 PM
Oct 2014

These are care workers and experts weighing in. The CDC's protocol itself is ineffective for those caring for an Ebola patient. They haven't been given proper protective clothing since the CDC's protective clothing recommendations don't call for head to toe covering nor disinfection before that clothing is removed. There is no one there to supervise these workers that until this case had no previous training or practice with the clothing and may not have gotten any at all before having to take care of Mr. Duncan.

You can see in the photo I linked that the CDC's recommendation for protective covering is inadequate as shown by the worker modeling protective covering that is not head to toe and leaves much of their head, face and neck as well as their feet exposed. The CDC is not using experienced care workers familiar and practiced with high level infectious patients which Ebola patients are nor are they having them supervised in their work in caring for the patient or removal of their protective clothing.

Friedman immediately blamed the infected nurse as becoming infected by breaching protocol when it is obvious to anyone paying attention that the CDC's protocol itself isn't adequate. This isn't the media "creating" a conflict, there IS a conflict. The CDC is of the belief that their woefully inadequate protocol is perfect when it very obviously is not even close and experts and care workers angry that he immediately blamed the nurse for a breach in that inadequate protocol as to why she became infected when the problem is because of the inadequate protocol.

icymist

(15,888 posts)
35. There's a lot of money to be made by a few in the healthcare business.
Tue Oct 14, 2014, 12:06 AM
Oct 2014

What to expect when lobbyists are aloud to write policy? Only this time, it's going to come back and bite us all in the a$$!

elleng

(130,948 posts)
5. Of course he's criticized,
Mon Oct 13, 2014, 05:15 PM
Oct 2014

'we' do virtually nothing else.

He has explained his use of the term 'protocol' in no way was meant as criticism, so everyone STFU! (Not directed at DU, but the lame street media. )

LisaL

(44,973 posts)
8. What was it meant as?
Mon Oct 13, 2014, 05:24 PM
Oct 2014

They don't know how the nurse was infected. So they don't know if the protocol was breached, or the protocol is inadequate.
Because breach of protocol is not the only option here, yet he immediately assumed that protocol was breached.
The protocol, which you all can read on cdc website, calls for very basic PPE (gown, gloves, goggles, face shield and face mask).
Not even head cover.
That would leave a lot of exposed skin.
The protocol does not ask for any disinfection being sprayed after the person exits the infected room.
So is it any wonder that the nurse got infected?

pnwmom

(108,980 posts)
9. He doesn't want to admit that the other option is that the CDC's protocols are inadequate.
Mon Oct 13, 2014, 05:26 PM
Oct 2014

So instead it must be a breach of his perfect protocols. And who breached them? The nurse.

LisaL

(44,973 posts)
10. That's my take on it too.
Mon Oct 13, 2014, 05:28 PM
Oct 2014

The cdc went with minimal protective gear.
Apparently he thinks that more gear could actually be more dangerous.
But that minimal gear doesn't appear to be adequate.

pnwmom

(108,980 posts)
16. But that is inconsistent with his earlier statement that the protocols had been breached.
Mon Oct 13, 2014, 06:17 PM
Oct 2014

He can't know that since he doesn't know how they were breached. He only assumed they were -- and that's because he was sure they were enough.

 

kestrel91316

(51,666 posts)
22. Ok. Please kindly rewrite all Ebola protocols correctly and show us your work before you express
Mon Oct 13, 2014, 07:08 PM
Oct 2014

mail them to CDC with a nasty note to Frieden telling him how better qualified you are to do the job than anybody else.

pnwmom

(108,980 posts)
30. What is your problem, kestrel? I wasn't attacking him or you or anyone else.
Mon Oct 13, 2014, 07:40 PM
Oct 2014

And you and I have been on close to the same page for most of this, since we both realized this was being mishandled by the Dallas hospital before a lot of people recognized it.

So I don't understand the snark behind this post. We do NOT know which is true: that the nurse breached the protocols, or that the protocols themselves are insufficient. And even the CDC is acknowledging this now, if only indirectly.

But I heard one infectious disease expert with a serious suggestion for a change to the CDC protocols. He suggested that they might need one level of protective gear for patients in the early stage, and a higher level of protection -- involving respirators and/or space suits -- for patients in the end stage, when they're producing profuse amounts of fluids.

What do you think about that suggestion for a change in the current protocol?

 

kestrel91316

(51,666 posts)
26. I swear, practically every post here sounds like it was written by a card-carrying, Obama-hating
Mon Oct 13, 2014, 07:18 PM
Oct 2014

teabagging freak.

CDC isn't your mother or anybody else's. At some point, physicians and nurses need to take responsibility for learning how to their jobs properly without having to be spoon fed every single concept.

CDC can lead them to water but it can't make them drink. My guess is most physicians AND nurses have texted and whispered and web-surfed their way through every single infectious diseases "inservice" (or whatever they are called) they've ever had to be forced to attend. God knows I've never met one that had a clue about infectious diseases other than an Infectious Diseases resident down at County-USC years ago.

I'm sure not falling down and worshipping the human medical or nursing professions. The hubris and egos and denialism there are appalling.

elleng

(130,948 posts)
27. They take responsibility,
Mon Oct 13, 2014, 07:22 PM
Oct 2014

and recognize the need for hands-on training in dealing with the ebola 'protocol.' Just watched a segment on PBS NewsHour on the subject.

pnwmom

(108,980 posts)
31. No, the CDC isn't your mother. That sounds like something a "nanny-state" ranter would say.
Mon Oct 13, 2014, 07:42 PM
Oct 2014

But it IS the job of the CDC, together with the Surgeon General, to lead the nation's medical establishment in situations with this. And even they are acknowledging they need to do a better job.

 

AverageJoe90

(10,745 posts)
14. Well, unfortunately, Occam's Razor says it's the most likely cause, at this point.
Mon Oct 13, 2014, 05:49 PM
Oct 2014

Sad, but it's really true.....unfortunately, though, you all can bet Faux News and all the other hard-right agitprop organs will take every step possible to find some way to blame the CDC, or Obama, etc.(because, after all, big gubmint bad, right?)


TorchTheWitch

(11,065 posts)
18. the CDC IS to blame
Mon Oct 13, 2014, 06:27 PM
Oct 2014

Their protocol for caring for Ebola patients is woefully inadequate. Mr. Duncan shouldn't even have been in a hospital so obviously unprepared to deal with an Ebola patient and using care workers unfamiliar with the protective gear and untrained, unsupervised and unpracticed in it's use. The CDC guidelines do not call for head to toe covering nor for disinfection of that clothing after the worker has been caring for an Ebola patient before taking off their inadequate protective clothing. Nor does the CDC's guidelines call for supervision of workers in either putting on or taking off the inadequate protective clothing.

This isn't about a scare mongering media nor trying to blame Obama or "big gubmint" it's about the very real problems with the CDC's inadequate protocol, a hospital and workers untrained, unsupervised and unpracticed in treating an Ebola patient, and that because of the inadequate protocol by the CDC much more likely that the nurse became infected because of that inadequate protocol.

Mr. Duncan should have been sent to one of the four US hospitals that are equipped to handle Ebola patients with staff that have had years of training and practice using the correct clothing and disinfection and removal of it just as the people found to be infected in Africa were sent to.

The CDC was immediately on the ground in Dallas when Mr. Duncan was admitted yet Ebola testing wasn't even done until two days after he was already in the hospital, his family was quarantined in an infected house for days before they were removed to sanitary conditions and the house cleaned. His vomit remained on the pavement in front of the apartment complex entrance for days before two totally unprotected workers were sent to power wash it off, etc. Where was the CDC during that time giving instruction in how to handle the family, the apartment, the vomit, etc. when the whole time they were right there in Dallas tracking people who might have been exposed to Mr. Duncan? That whole cluster-fuck happened under the guidance of the CDC.

 

AverageJoe90

(10,745 posts)
19. Mr. Duncan's release is wholly the hospital's fault.
Mon Oct 13, 2014, 06:47 PM
Oct 2014

The CDC had nothing to do with that screw up, at all.


This isn't about a scare mongering media nor trying to blame Obama or "big gubmint"


I don't think that was the intention with this OP, no. But guess what? That *is* happening elsewhere. The MSM doesn't seem to be too willing to really actively combat any these misconceptions, either.



TorchTheWitch

(11,065 posts)
33. I said not one word about his release when he went to the hospital
Mon Oct 13, 2014, 09:51 PM
Oct 2014

the first time. Not ONE word. Everything I referred to was after he was hospitalized and when the CDC was there on the ground and supposed to have been giving direction.

One more time, this has NOTHING to do with the media. I can certainly see now why people are being very quick to claim the CDC has been absolutely perfect when they have not and with examples of WHY not. All because people here are just scared that criticizing the CDC means criticizing Obama or giving the media opportunity to do so.

This is NOT about politics or the media. It's only about peoples' lives and the mistakes being made by the CDC. Go to their website and look at their guidelines for clothing protocol for those caring for Ebola patients. And anyone that doesn't know already why they're at issue doesn't have a leg to stand on in blaming a scare mongering media.

The OP I posted had NOTHING whatsoever to do with a scare mongering media or anything to do with politics whatsoever. It was knowledgeable people angry with the CDC for automatically blaming the nurse for breaching the protocol when the protocol itself is woefully inadequate. And I listed the reasons why that is so and what the protocol is even showing a photo of workers one of which was dressed in what the CDC's protective wear protocol was which was the worker that was NOT covered head to toe.

I don't CARE what the MSM has been saying about Obama or anything else political about their reporting. My OP didn't address ANY of that and neither did the article. So why the hell are so many people even bringing it up instead of commenting on what the article addressed and what I addressed? No wonder people here have been claiming hair on fire about anything discussed about the disease and its handling and whining about a scare mongering media while pretending everything the CDC has been doing is perfect when they don't even know themselves what the hell the CDC's protocol IS or why it's inadequate. For far too many here it's ALL about covering the CDC's ass so Obama doesn't some how look bad and at the expense of care givers not being adequately protected, supervised, trained or practiced risking infection themselves which is exactly what happened to this nurse. And the CDC refusing to agree that their protocols are inadequate for those caring for Ebola patients and toeing the line that all of our hospitals are prepared is bullshit and with evidence of why that is.

No bloody wonder a serious discussion about the issue can't be had here without someone barging in and screaming hair on fire, making stupid jokes, and worse trying to blame everything on a scare mongering media because who cares about peoples' lives and appropriate handling and care of those infected when somebody somewhere might be trying to blame Obama. Rather than find out what the protocols the CDC has called for and understanding why they're not effective or even wanting to the focus for some people here has been nothing but remain ignorant and wag a finger at the media in case it has something to do with Obama looking bad when it doesn't anyway - Obama doesn't oversee the CDC any more than any other president, and it's the same CDC under any president.

Response to TorchTheWitch (Reply #18)

TorchTheWitch

(11,065 posts)
36. a teabagger?
Tue Oct 14, 2014, 12:56 AM
Oct 2014

What the FUCK? You said yourself that they should be disinfecting before taking off their protective clothing and horrified that they weren't covered from head to toe. What the FUCK does the CDC offering inadequate protocol to people untrained and unpracticed and unsupervised have to do with being a teabagger??? Jebus, you're a prime example of pretending the CDC's inadequate protocol is perfect for no other earthly reason than something having to do with Obama when whatever the CDC does or doesn't do has nothing to do with whoever is the sitting president ANYWAY.

No wonder you've been so grossly rude to anyone that offers any information you don't personally like even when you've agreed with it in other threads and comes from experts and even the CDC's own website though you've angrily demanded everyone else to utilize their website. You just want to ass cover for the CDC because "Obama". Anyone pointing out how woefully inadequate the CDC's protocol is for protection clothing alone you've been horrified by while at the same time pointing fingers at people pointing it out as being ignorant and/or a teabagger because "Obama" as if he has anything to do with anything.

For crying out loud, people have shown numerous times what the CDC's protective clothing protocol is and you yourself were horrified by the lack of head to toe covering and disinfection before removing it when that's what the CDC's protocol IS but not willing to blame the CDC directly but everyone else using the inadequate protocol that you yourself have agreed isn't adequate.

That nurse got sick because the CDC assured everyone that hospitals could handle Ebola patients using their inadequate protocol with no training, supervision or practice. Rather than having Mr. Duncan transferred to one of the four hospitals that DOES deal in the high level of deadly contagion that Ebola is as all the other Americans infected in Africa were sent to and that DO have people well trained with the correct protocol and years of experience the CDC believed there would be no problem caring for Mr. Duncan at the Dallas hospital that has PROVED to be woefully unprepared with staff to care for him that had no training, supervision or the correct PPE protocol, and the CDC's inadequate PPE protocol is right there on their website. You have one hell of a nerve calling anyone a teabagger for pointing out the wrongness of the CDC's PPE protocol as well as their decision to allow Mr. Duncan to be cared for by staff with no experience, training, practice and supervision all because they had assured everyone that any hospital in the US can adequately care for an Ebola patient when it's painfully obvious they can't and can't with the inadequate PPE protocol from the CDC.

Done with you.

>>>CLICK<<<


DirkGently

(12,151 posts)
25. What protocol, and who breached it?
Mon Oct 13, 2014, 07:14 PM
Oct 2014

is the question. Off the bat, it sounds like victim is being blamed. What precisely was done or not done, by whom, according to whom, will be interesting to find out.

LisaL

(44,973 posts)
29. CDC can't say.
Mon Oct 13, 2014, 07:40 PM
Oct 2014

Nurse can not identify what she supposedly breached, so they don't know.
Add to that, 70 people cared for Mr. Duncan, all presumably wearing the same PPEs and following the same protocols.
Presumably other people could have been infected and are among those 70.

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