TEXAS EBOLA PATIENT’S FAMILY SAID HOSPITAL LED THEM TO BELIEVE HE WAS ALIVE

DALLAS — Relatives of the first person to die of Ebola in the United States, joined by the Rev. Jesse L. Jackson Sr., continued on Saturday to denounce the treatment he and his family had received from a hospital here and from Texas officials, claiming that he had been cremated without their knowledge or permission and given substandard care because he was African.
Josephus Weeks, a nephew of the Ebola victim — Thomas Eric Duncan, 42, a Liberian who died Wednesday at the Dallas hospital where he had been found to have Ebola on Sept. 30 — said his uncle had been “handled poorly, unfairly, and an injustice was done.”
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Mr. Weeks spoke to reporters on Saturday in Chicago with Mr. Jackson and Mr. Duncan’s mother, Nowai Gartay. They asked why Mr. Duncan had not been taken to Nebraska Medical Center, where two Americans who contracted the disease in West Africa have been treated. And they said the Dallas hospital, Texas Health Presbyterian, had not immediately informed them that Mr. Duncan had died and had led them to believe that he was still alive.
“I feel bad about my son,” Ms. Gartay said inside a chapel at the Chicago headquarters of Mr. Jackson’s Rainbow/PUSH Coalition. “We call the hospital — they know that my son died, and they didn’t tell me. They only told me, ‘You can’t talk to your son.’ ”
Mr. Jackson said the other Ebola victims in the United States “came back to Atlanta and Nebraska, got quick treatment and early treatment, and their lives have been spared.”
“That did not happen with Eric Duncan,” he said. “And the critical hours, critical days, were missed.”
Unlike Mr. Duncan, the other Ebola patients treated in the United States were diagnosed in Africa and then flown to American hospitals.
On Friday, Mr. Weeks released Mr. Duncan’s medical records to The Associated Press. Those documents raised new questions about why the hospital that treated him had sent him home after his first visit to its emergency room on Sept. 25. The medical records showed that during that first visit, his temperature had peaked at 103 degrees and he had reported severe pain, rating it an eight on a scale of 1 to 10.
The details contradicted the hospital’s initial description of Mr. Duncan’s condition. It had said that he had a temperature of 100.1 and that his symptoms “were not severe at the time he first visited the hospital emergency department.”
Mr. Jackson said Mr. Duncan had been very ill and feverish at the time of his initial discharge. “He left there on a stretcher and was put in the car,” he said. “He should never have left the hospital after he got there.”
Dr. Amesh A. Adalja, an infectious-diseases specialist and emergency-medicine expert at the University of Pittsburgh Medical Center who reviewed some of Mr. Duncan’s medical records at the request of The A.P., said that Mr. Duncan had not had a fever when he first arrived at the emergency room, but that he had complained of abdominal pain and a headache. About three and a half hours into his stay, his temperature reached 103 degrees, the highest reading during his four-hour visit.
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Mr. Duncan’s symptoms, and the fact that he had recently arrived from West Africa, should have alerted the nurses and doctors treating him that he was a possible Ebola patient, Dr. Adalja said. The hospital has acknowledged that when asked if he had traveled outside the United States in the last four weeks, Mr. Duncan told nurses that he had been in Africa, where an Ebola outbreak in the west has killed at least 4,000 people.
“You have a person who arrived from Liberia in the last 21 days, who has abdominal pain and a headache and eventually exhibits a fever in the emergency department,” Dr. Adalja said. “That’s clearly a constellation of findings that meets the criteria for Ebola. From the very start, Ebola should have been in the minds of all the health care providers.”
Based on his review of the medical records, Dr. Adalja said the diagnosis given to Mr. Duncan before his discharge included sinusitis, a sinus infection. But Dr. Adalja said that sinusitis rarely caused a fever as high as Mr. Duncan’s and did not cause abdominal pain, and that a CT scan of Mr. Duncan’s head showed no evidence of sinusitis.
A spokeswoman for the Texas Department of State Health Services said the agency was considering investigating the delay in treating Mr. Duncan for Ebola, including the hospital’s compliance with state health and safety laws and regulations, but added that its immediate focus was on monitoring those who had come into direct or indirect contact with Mr. Duncan.
Hospital officials have said that Mr. Duncan’s symptoms during his first visit could have been “associated with many communicable diseases, as well as many other types of illness,” but they have retracted their previous statement that a flaw in the hospital’s electronic records system was to blame. And they have said that after Mr. Duncan returned on Sept. 28 and was admitted, a team of more than 50 people “cared for him in a professional and compassionate manner.”
On Friday, Wendell Watson, a spokesman for Texas Health Resources, the parent organization that oversees Texas Health Presbyterian Hospital, said in a statement that the hospital continued to “closely review and evaluate the chain of events,” and that it had “made changes to our intake process as well as other procedures to better screen for all critical indicators of Ebola virus.”
In Chicago, Mr. Weeks said that Mr. Duncan had been cremated without his family’s permission, but that he could not explain the sequence of events.
“I need to find out,” he said. “They’re saying a whole bunch of stuff. They change the rules on us every single day.”
Guidelines issued by the federal Centers for Disease Control and Prevention on the safe handling of the remains of Ebola patients in American hospitals and mortuaries states that the Ebola virus can be transmitted in post-mortem settings. The C.D.C. advises that the remains should be cremated or buried promptly in a coffin that has been documented as being hermetically sealed.
Officials have said that Dr. David L. Lakey, the commissioner of the state health services department, recommended cremation to the family and that the family agreed. On Saturday, a spokeswoman for the agency reiterated that the family had agreed to cremation, saying that officials had an oral and written agreement with Mr. Duncan’s next of kin. She declined to identify that person for privacy reasons