Dallas Ebola patient waited nearly a week for experimental drug; family claims bias達拉斯埃博拉患者等待了近一個星期的實驗性藥物; 家庭索賠偏見

By Elizabeth Cohen, Senior Medical Correspondent
October 7, 2014 -- Updated 2347 GMT (0747 HKT)
Watch this video

Duncan given alternative Ebola treatment

 
STORY HIGHLIGHTS
  • Thomas Eric Duncan was admitted to a Dallas hospital for Ebola on September 28
  • He got an experimental drug October 4; others with Ebola got such drugs much faster
  • Nephew: "He didn't get the medicine and treatment for the disease because he's African"
  • Hospital: Duncan was "treated the way any other patient would have been treated"
 

(CNN) -- Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, received an experimental medicine nearly a week after being admitted into the hospital -- a far longer wait than experienced by four other Ebola patients treated in the United States.

Those patients -- two each at Atlanta's Emory University Hospital and the University of Nebraska Medical Center -- received their experimental medicines immediately. Those four are U.S. citizens; Duncan is a Liberian national.

"We feel he didn't get the medicine and treatment for the disease because he's African and they don't consider him as important as the other three," Josephus Weeks, Duncan's nephew, said at a press conference Tuesday afternoon.

The Rev. Jesse Jackson, who attended the press conference with Weeks and Duncan's mother as a newly appointed spokesman for the family, added, "We don't feel good about that. It's been a concern he had to wait so long."

 
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Jackson said he thinks money also played a role in Duncan's treatment.

"I would tend to think that those who do not have insurance, those who do not have Medicaid do not have the same priorities as those who do," the civil rights leader said.

In a statement, a spokeswoman for Dallas' Texas Health Presbyterian Hospital said Duncan is being "treated the way any other patient would have been treated, regardless of nationality or ability to pay for care. We have a long history of treating a multicultural community in this area."

The hospitals that took care of the four other patients had substantial advance notice that patients were on their way.

Duncan went the emergency room at Texas Health Presbyterian Hospital on September 25, but staff there didn't realize he had Ebola and sent him home hours later. He was admitted on September 28 when the hospital realized he had the disease. He started receiving the experimental drug, brincidofovir, on October 4.

He was in critical condition Tuesday. Weeks, though, said his uncle is "doing better" -- he's still on dialysis, but his heart rate has improved, his blood pressure is "normal," "his fever is pretty much gone" and his diarrhea has "slowed." It's not clear if the experimental drug has anything to do with these changes.

Since the drugs being used to treat Ebola are still experimental, it is up to each individual hospital to file the paperwork with the Food and Drug Administration for permission to get the drug from the manufacturer and use it.

The hospital has declined to tell CNN when they filed for permission to the FDA to use brincidofovir.

"The care team has been consulting with the CDC and Emory, on a daily basis since Mr. Duncan was admitted to the hospital, discussing the possible course of treatment, including the use of investigational drugs," hospital spokesman Wendell Watson said in a statement.

The FDA and Chimerix, the company that makes the drug, said if there was any delay it wasn't on their part. Stephanie Yao, a spokeswoman for the FDA said she couldn't comment on any particular case, but when doctors make requests for experimental Ebola treatments, "we turn them around in a matter of a few hours -- often less than one hour."

Joseph Schepers, a spokesman for Chimerix, said requests to use brincidofovir "are expedited immediately in the most expedited way you could possibly do it."

"It's a general rule in medicine that the earlier you start therapy in a sick person who needs the therapy, the better the response," said Dr. Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases, when asked about the impact of the wait for the drug.

Weeks said he and his family had to "pressure" the hospital to apply for permission to give the drug, brincidofovir, to Duncan.

"They were treating him with oxygen, water and a bed to lay on," he said.

Weeks and Jackson said they believe the hospital applied for permission to use brincidofovir only after Jackson gave out the hospital's phone number on his radio show last week and urged listeners to call in and complain.

Ashoka Mukpo, a freelance NBC cameraman, was admitted to the University of Nebraska Medical Center Tuesday and began receiving brincidofovir the same day. Dr. Rick Sacra received another experimental drug called TKM-Ebola, which is easier to access but still requires permission from the FDA. Dr. Kent Brantley and Nancy Writebol -- both treated at Emory -- took Zmapp, which is no longer available because the company ran out of supplies of the drug.

CNN's John Bonifield and Matthew Stucker contributed to this report.

達拉斯埃博拉患者等待了近一個星期的實驗性藥物; 家庭索賠偏見
由伊麗莎白·科恩,資深醫藥記者
2014年10月7日 - 更新2347 GMT(0747 HKT)
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鄧肯給予替代治療埃博拉病毒
新聞提要
托馬斯·埃里克·鄧肯被送往達拉斯醫院埃博拉9月28日
他得到了一種實驗性藥物10月4日; 其他埃博拉了這類藥物要快得多
侄子:“他沒拿到藥和治療的疾病,因為他的非洲”
醫院:鄧肯被“處理任何其他病人將會被對待的方式”
(CNN) -埃里克·托馬斯·鄧肯,在美國確診為埃博拉病毒的第一人,獲得了實驗醫學被送進了醫院,經過近一個星期-遠較長等待時間超過了所經歷的在美國治療的其他四個埃博拉患者國。
這些患者 - 每兩個在亞特蘭大的埃默里大學醫院和美國內布拉斯加大學醫學中心 - 立即得到他們的實驗藥品。這四個是美國公民; 鄧肯是利比里亞國家。
“我們覺得他沒有得到的藥物和治療這種疾病,因為他是非洲的,他們不把他當作是其他三個重要的是,”約瑟夫週,鄧肯的侄子,在新聞發布會上週二下午說。
牧師傑西·傑克遜,誰出席了新聞發布會與週和鄧肯的母親作為新任命的發言人家人補充說:“我們不覺得行,這是一個關心他不得不等待這麼久。”
很難招聘工人打伊波拉 達拉斯埃博拉患者略有提高“ 埃博拉病毒的疫苗,道德問題
傑克遜說,他認為錢也起到了鄧肯的治療作用。
“我傾向於認為那些誰沒有保險,這些誰沒有醫療補助沒有那些誰做同樣的優先級”的民權領袖說。
在聲明中,發言人達拉斯的得克薩斯州衛生長老會醫院表示,鄧肯被“處理任何其他病人將會被對待的方式,不論其國籍或支付能力的照顧。我們對待一個多元文化的社會中有著悠久的歷史這個區域。“
即把其他四個病人護理的醫院有大量的提前通知,患者在他們的途中。
鄧肯就在9月25日的急診室在得克薩斯州衛生長老會醫院,但那裡的工作人員沒有意識到他有埃博拉病毒,並送他回家小時後。他被錄取了9月28日,當醫院發現他得了這個病。他開始接受實驗性藥物,brincidofovir,10月4日。
他在生命垂危週二。週,雖然說他的叔叔是“做更好的” - 他仍然在透析,但他的心臟率有所提升,他的血壓為“正常”,“他的高燒是相當多了”,而他拉肚子已經“放緩”。目前尚不清楚,如果實驗藥物有什麼這些變化。
由於所使用的藥物來治療埃博拉病毒仍然是實驗,它是由每個醫院的情況下對食品和藥物管理局的文書工作許可獲得來自製造商的藥物,並使用它。
院方已拒絕告訴美國有線電視新聞網,當他們申請許可,美國FDA使用brincidofovir。
“護理隊伍已經諮詢了疾控中心和埃默里,每天因為鄧肯先生住進了醫院,討論治療的可能,當然也包括使用研究藥物,”醫院發言人溫德爾·沃森在一份聲明中說, 。
FDA和Chimerix,該公司製造的藥物,說如果有任何延誤這不是對他們的一部分。斯蒂芬妮姚明的發言人FDA表示,她不能就任何個別情況發表評論,但當時醫生讓實驗埃博拉病毒治療的要求,“我們把他們在幾個小時內各地的 - 通常不到一小時”
約瑟夫Schepers的發言人Chimerix說,請求使用brincidofovir“立即以最快速的方式你可能做的加快。”
“這在醫學上是越早在有病的人誰需要治療開始治療的一般原則,響應越好,”安東尼說福奇博士,國立過敏和傳染病主任在被問及影響的等待藥物。
週說,他和他的家人不得不“壓”醫院申請許可給予藥物,brincidofovir,鄧肯。
“他們用的氧氣,水和躺在床上的對待他,”他說。
週和傑克遜表示,他們認為申請許可使用brincidofovir後才傑克遜給出了該醫院的電話號碼在他的廣播節目上週呼籲聽眾打電話抱怨醫院。
阿育王Mukpo,一個自由的美國全國廣播公司的攝影師,考上了內布拉斯加大學醫學中心週二開始接受brincidofovir同一天。里克·薩克拉博士獲得另一實驗性藥物稱為TKM-埃博拉病毒,哪一個更容易訪問,但仍需獲得美國FDA許可。肯特布蘭特利博士和南希Writebol - 無論是處理埃默里 - 花Zmapp,它不再可用,因為該公司跑出來的藥物供應。
CNN的約翰Bonifield和馬修Stucker促成了這一報告。

 

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