Dallas doctor explains why he sent Ebola patient home

The Dallas emergency-room doctor who missed signs of Ebola in a Liberian man who later became the fist to die of the disease in the U.S. is telling his story for the first time.

Dr. Joseph Howard Meier told The Dallas Morning News that when he treated Thomas Eric Duncan in the early morning hours of Sept. 26, he was unaware that Duncan had recently arrived from a country ravaged by the Ebola outbreak in West Africa. He also said he did not realize Duncan had such a high fever.

"I was unaware of a 103-degree fever," Meier said in written answers to questions from the paper, released by his attorney. "It appears in the chart, but I did not see it."

Meier said he believed his care was appropriate given what he knew at the time, though he acknowledged missing the diagnosis -- something he said a doctor always regrets. Encountering the nation's first Ebola patient, he told the paper, was "a little bit like getting struck by lightning, but mild in comparison to what Mr. Duncan's family has gone through in losing a loved one to Ebola."

Duncan was sent home from Texas Health Presbyterian Hospital, but returned two days later in an ambulance and was quickly diagnosed with Ebola. He died Oct. 8.

Duncan's sister and fiancee have said he told medical staff in the emergency room during that first visit that he was from Liberia, though the hospital's medical records only indicate Duncan said he was from Africa.

The hospital has already acknowledged mistakes in its care of Duncan and said its records system previously didn't make a patient's travel history clear.

Duncan's case set off a scramble by authorities to monitor dozens of people who potentially had contact with him, including in the days after his release from the hospital. None of those people ended up testing positive for Ebola. Two nurses at the hospital were infected while treating him, but have since recovered.

Meier said that had he known Duncan was from Liberia, "this would have prompted me to contact the CDC (Centers for Disease Control and Prevention) and begin an evaluation for Ebola."

But he was less sure about the 103-degree temperature reading.

"Given what little information I had, a 103 temperature would most likely not have helped with the diagnosis of Ebola," Meier said. "Although, if it did not quickly improve, he could have possibly been admitted to the hospital."

Asked about whether he would do anything differently, Meier said it was "virtually impossible" to say.

"Based on the information I had at the time, I believe that the care and treatment were appropriate," he said.

According to The Dallas Morning News, Meier has worked as a doctor in Texas since 2001, after graduating from the Mayo Medical School in Rochester, Minn., and doing his residency at the University of California-Davis School of Medicine in Sacramento.

One doctor who has worked with Meier for several years described him to the paper as a "very thorough and very reliable emergency-room physician."