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Legal View with Ashleigh Banfield

Will Ebola Patient Face Prosecution?; Some Hospitals are Ready for Ebola, but Many Aren't; Four People to be Quarantined for 21 Days

Aired October 03, 2014 - 12:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

(COMMERCIAL BREAK)

DEBORAH FEYERICK, CNN ANCHOR: Hi, everyone. I'm Deborah Feyerick, in for Ashleigh Banfield. Welcome to LEGAL VIEW.

We begin with news just in from Howard University Hospital in Washington. A patient who had traveled to Nigeria is now being tested for Ebola. We are told that the person's symptoms seem consistent with Ebola, but it has not yet been confirmed. We will keep you posted on the very latest.

In the meantime, the top health official in Dallas says the Ebola case that's put the city under a microscope is contained. He says, and I quote, we have the situation under control. And yet five days after Thomas Eric Duncan was taken from a Dallas apartment by ambulance, three days after his Ebola diagnosis was confirmed, Duncan's bed sheets, his towels, his clothing, they remain in that apartment, along with a woman, his partner, her young child and two adult nephews. They're not allowed out and the company that's hired to sanitize the dwelling isn't allowed in because it doesn't yet have the proper permits. No word on how long that will take.

Back in Liberia, where Duncan was infected just days before flying to America, officials say he lied on a custom's form that asks about contact with anyone who has Ebola. He answered "no" to everything, as you can see on this form. He may well face prosecution if and when he does go home.

Also in Liberia, an American photographer, working for NBC, is now confirmed to have Ebola. So far he is showing only mild symptoms. He will be flown to the U.S. for treatment. His fellow crew members are flying out as well. They plan to self-quarantine for 21 days, though they have already taken every precaution.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): We share a workplace. We shared vehicles. We shared equipment. But everyone here is hyper alert. We have not been in close proximity. No one shakes hands. There's no hugging. So I do believe that our team, while we are being hyper vigilant, we are at very, very, very low risk.

(END VIDEO CLIP) FEYERICK: Now, I want you to hear from the woman who Thomas Eric Duncan flew all the way to Dallas to visit. A woman who now is confined to the apartment where Duncan lay sick and suffering for many hours. She's the one who actually took him to the hospital the first time when he was turned away. Her name is Louise. She does not want us to use her last name. But yesterday she spoke by phone exclusively with our Anderson Cooper.

(BEGIN VIDEO CLIP)

ANDERSON COOPER, ANCHOR, CNN'S "AC 360": So the sheets that Thomas used and the towels that he used, what have you done with those?

LOUISE (via telephone): They are in a plastic bag.

COOPER: In your apartment?

LOUISE: Uh-huh.

COOPER: So you put the -- you took them off the bed. You -- and put them into a plastic bag?

LOUISE: No, only the towel is in a plastic bag. The rest of his stuff stayed the same all the day (ph), the bed sheets, everything is on the bed.

COOPER: So the sheets that he used, that he slept on, that's still on the bed?

LOUISE: Yes.

(END VIDEO CLIP)

FEYERICK: Well, we have so much more to talk about when it comes to Ebola. We go to Dallas, where CNN's Martin Savidge is there, Dr. Sanjay Gupta also with us.

Martin, again, we're going to go to your first. Martin, you have some news on the quarantine front. What is going on with these people who are told you cannot leave, you've got to stay in this apartment?

MARTIN SAVIDGE, CNN CORRESPONDENT: Yes, there are four people that are officially quarantined. They're the ones that are said to be inside the apartment. One of whom you heard was speaking to Anderson Cooper. That's the partner of Thomas Duncan. And then her son. And then on top of that, said to be two adult-aged nephews. Those are the four people and they have actually had court documents that were delivered, they had to sign, saying they will not leave that apartment for the 21-day period.

And there's another issue. When those documents were delivered on Wednesday night, the doctors, the health officials from the county that took the documents in were escorted by sheriff deputies. Three of them actually entered the premises, went into the apartment. Now those deputies have been put on leave. Apparently, the county is saying, it is doing that for their own peace of mind. There, obviously, is some concern on the part of the sheriff's department or the deputies themselves that they want to stay home and apparently monitor their conditions. They're not quarantined, but they are now apparently staying home and monitoring their health as well.

Deborah.

FEYERICK: You know, Martin, what's so fascinating, I think, to so many people is, really just how almost nonchalant everybody has been who has come in contact from the initial days when he went to the hospital and they said, oh, we're going to send you home with antibiotics, then to the clean-up crew, the sanitation workers and the deputies.

But, Sanjay, let me ask you, why do you think -- when you hear the word Ebola, when you hear Ebola-like symptoms, why is it that everybody thinks they're OK?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Oh, you know, I don't think that people typically think of Ebola and think they're OK. I mean I think people are quite fearful of this. I think what has happened here is that a, you know, very important detail - you know, they say the devil's in the details and some very important details have not been addressed here. You know, there's been so much focus on public health preparedness overall in this country, anticipation of patients coming here, vaccine trials.

The idea of, what are we going to do with the waste from people's apartments, I think that was pretty low down on the list. It shouldn't have been, Deborah, to your point, because that's, obviously, very important to the people who are there now. But I think these are the details that I think just did not get as much attention as they should have. And even the issue with him being sent home from the hospital, I think that was an issue where somebody asked about where he had been traveling from, Liberia, but did not communicate that. Human error. So all of sudden you start adding these things up and it doesn't look too good.

FEYERICK: Yes, no question about that.

Martin, has there been an update on whether, in fact, they are going to remove this waste from the apartment?

SAVIDGE: Well, the CDC maintains that this is an issue not so much of the cleaning and who will do it. That's apparently been decided. And, in fact, the company that's been hired, their representatives went to the apartment last evening. They were turned away because of the fact that there was -- apparently they did not have the proper paperwork or the authority to transport the waste from the apartment. In other words, after they had cleaned the apartment and took everything out, they didn't have the proper licenses or documents to transport it on a Texas highway. And that's what's trying to be worked out. You're talking about an issue between CDC federal health and then Department of Transportation federal transportation. The CDC believes that they will get that ironed out today, but it's crucial because you can't remove the waste until all that is figured out.

FEYERICK: Yes. And, Sanjay, we're hearing now about a case in Washington, somebody presenting with symptoms. You know, we had what we thought was a case in New York City actually with somebody going to present. Do you have any information as to what symptoms that man has or any insight into how the hospital is really going to react?

GUPTA: No. We're hearing very little at this point. And that's not unusual. Typically this type of patient information is kept pretty -- held pretty closely. But what typically has been triggering this, and as you point out, Deb, this has happened a hundred times now across the country where there's been a -- flags raised. Someone comes to the hospital, they have symptoms which are typically fever, muscle aches, they may have nausea and vomiting and they have a concerning travel history, having come from Liberia, Sierra Leone, Guinea, one of these countries, and that raises the flag.

And I will tell you, and this maybe a little source of comfort, is that the vast majority of the time, that's not going to be Ebola. There's a lot of things that can cause fever when you've just returned from western Africa and Ebola is going to be a little low down on the list. But given what is happening in the world today, it is going to be a considering. I think that's why we're hearing about it.

FEYERICK: And it's interesting, the patient who presented in New York initially thought he had malaria. So a lot of the symptoms similar, as you suggest, to other illnesses from that region. And the concern is, if you're on other medications for other illnesses, it could potentially mask some of the symptoms, right, Sanjay?

GUPTA: Yes. A very good point. It can mask some of the symptoms. And, by the way, taking medications to reduce fever, even simple things like Tylenol, I mean fever is such an important descriptor when it comes to Ebola. It's the things that they use to screen at airports and all that. Taking medications that reduce fever can also make it more challenging to screen and to diagnose, Deborah.

DB: All right, clearly keeping an eye on this, everyone involved. Sanjay Gupta, thank you. Martin Savidge, you in Dallas as well, we appreciate it.

Well, the Ebola outbreak is raising some interesting legal questions. Liberia may decide to prosecute Thomas Duncan for lying on a questionnaire about his exposure to the disease before he left the country. Now assuming he survives this illness, what kind of legal trouble could he potentially face?

(COMMERCIAL BREAK)

FEYERICK: Surviving Ebola is not the only battle ahead for Thomas Duncan. The president of Liberia is now considering prosecuting him if he lied on his health screening questionnaire before leaving the country, claiming that he did not have contact with people infected with Ebola. President Ellen Johnson Sirleaf says that move would be unpardonable.

(BEGIN VIDEO CLIP)

PRESIDENT ELLEN JOHNSON SIRLEAF, LIBERIA: With the U.S. doing so much to help us fight Ebola, and, again, one of our compatriots didn't take to care and so he's gone there and sort of in a way put some Americans in a state of fear and put them at some risks, I feel very saddened by that and very angry with him, to tell you the truth.

(END VIDEO CLIP)

FEYERICK: And joining me to talk about Duncan's potential legal problems are CNN legal analyst Danny Cevallos and Jeffrey Toobin.

All right, let's look at the facts about - surrounding Duncan. First of all, he was in a neighborhood that knowingly had cases of Ebola. He lifted a woman, trying to get her to the hospital for treatment and was told, no, she's too far gone, took her back. And then he gets to the airport and he puts no on a form? That is problematic, to say the least. Is this criminal intent?

JEFFREY TOOBIN, CNN SENIOR LEGAL ANALYST: You know, I don't claim great expertise with the Liberian criminal justice system, but that country has so many problems, the idea that prosecuting their way to public health is some sort of good idea strikes me as extremely unlikely. Look, he didn't have Ebola symptoms, as far as we know, on a plane. What he said on a form in Liberia is not going to make that much difference here today. I just think is not very productive to figure out how he's going to be -- whether he's going to be prosecuted in Liberia or not.

FEYERICK: And what about - Danny, what do you think about America? Do you think that people here, obviously a very litigious society, do you think people here could potentially say, this man knowingly got on a plane after being exposed to people who had the disease?

DANNY CEVALLOS, CNN LEGAL ANALYST: Well, there are a couple of problems there. First of all - and I've read that the hospital is interested in seeing criminal prosecution against him for lying apparently to them. But, you know, the ultimate question is, what was his intent? I mean how can you articulate that he knowingly -- he was aware that he was at a high risk of infection? You know, just like Jeff says, forms don't mean the same thing in other countries that they mean here in the United States. And I'm not saying that glibly. It's because, since our inception, we've always placed a greater emphasis on paperwork, laws, the idea that the laws are superior to the right of just an individual despite. And that's - I think that critical rule is why we take forms seriously, we take filing our taxes seriously, we take, you know, what we write down and we can be prosecuted for it. I would be interested to find out what the history of prosecution is for - for false statements on these forms in Liberia (INAUDIBLE).

FEYERICK: Right. It's probably low, but at the same time, lying on your tax form is not exactly spreading an outbreak in another country.

TOOBIN: Right. The stakes -- the stakes are high when it comes to public health. But I think what President Ellen Johnson is concerned about, understandably, is that the United States will say, look, Liberia is not taking this issue seriously enough. We're going to cut off air travel with Liberia. FEYERICK: Right.

TOOBIN: That's what she's really concerned about, for good reason.

And, you know, that is a question that we're going to have to come to terms with soon about whether the risks outweigh the benefits of continued air travel.

However, it's important to remember, this is not all of Africa. It is not all of west Africa. It's isolated in certain countries, so we shouldn't think that all of Africa is suddenly dangerous to the United States.

FEYERICK: Of course. Of course. And one thing, also, is that, look, until this disease is eradicated in the countries where it exists, it is going to spread. That, I think, nobody has a question about.

I want to ask you about the quarantine, though. This is family is now in quarantine. Why not quarantine them in a facility where they can be monitored?

What you're doing is you're having these individuals looking, take their temperature and see if they began sweating. And then what happens? Then they are removed?

I don't understand that. Is that legal? Is that justifiable?

CEVALLOS: First of all, it's legal under Texas public law. They have the authority -- local public health officials in Texas have substantial discretion.

The real question is whether or not it's medically indicated, if it's something that is the best course of action, and that would have to be a question you'd have to ask the local Texas public official in charge.

TOOBIN: It strikes me as a perfectly appropriate response on the part of the state of Texas.

We don't need to start incarcerating people on the suspicion that they have Ebola. They are in their home. That seems fine. It seems unlikely that they will show symptoms or get Ebola.

But, I mean, look, can I just say, this has been bothering me. Ninety- two people a day in the United States die in automobile accidents, 30,000 people a year. The number of people who have died in the United States of Ebola in the history of the United States is zero. So let's just keep the risks in perspective.

FEYERICK: You're 100 percent right on that. But the issue for me is, if you have four people in a small apartment and one person's infected, guess what, if they are all in that same apartment, by the end of that quarantine, my suspicion would be most likely all of them become infected.

TOOBIN: But three of them are children. You just going to put them -- you going to just lock up each one of the children.

FEYERICK: I'm not talking about locking them up. I'm talking about putting them in some sort of a hospital where they can be monitored. That just seems to be the reasonable or the conscientious thing to do, you know?

CEVALLOS: Think of the precedent that sets. If this spreads any further, now if you have a precedent, well, we have to put these people in these special facilities -- look, if a medical official deems that the apartment is good enough, Texas officials express a preference for keeping people out of jail. They don't want to incarcerate people with infectious diseases.

FEYERICK: I'm talking about a hospital where you can be treated if, God forbid, you come down with a symptom. But also you know it's interesting. You say the hospital may press charges against this man.

I'm sure this man and others will press charges against the hospital because they simply did not -- they either did not ask the right questions and it's about asking the right questions. Where were you?

TOOBIN: Deb, it's America. Everyone will probably wind up suing everyone.

CEVALLOS: Of course. Everyone's a plaintiff.

TOOBIN: But the question is, what is the best way of dealing with the problem.

FEYERICK: The problem with democracy.

TOOBIN: And I don't think keeping these people in custody is necessarily right.

FEYERICK: All right, Jeff Toobin, Danny Cevallos. thank you both so very much. We appreciate all your insights on this subject.

Well, we keep hearing that U.S. hospitals are prepared for Ebola, but is that really the case? Next, we're going to find out some of the things that still need to be done.

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FEYERICK: Texas Health Presbyterian Hospital now says a flaw in its electronic records system, not human error, is to blame for doctors missing their Ebola patient's travel history the first time he came to the emergency room.

The problem has been fixed apparently, officials say, but the fact remains -- some hospitals are more prepared than others for Ebola and other infectious diseases.

More on that from our senior investigative correspondent, Drew Griffin.

(BEGIN VIDEOTAPE) DREW GRIFFIN, CNN INVESTIGATIVE CORRESPONDENT: It's supposed to work like this. A sick patient enters the E.R., faces an intake clerk who immediately assesses the big question, if your symptoms match Ebola, where have you been?

Somewhere in that process at Texas Presbyterian, there was a breakdown. The Liberian man was sent home instead of placed here, inside a secure, separate isolation room where hospital staff could know for sure if the patient has Ebola.

Obviously, there was a misstep. What do you do at your hospital to make sure that the communication is flowing between the staff, the patient and everybody knows what is going on and do you rehearse this, do you drill this?

DR. JAMES D'ENTIENNE, BAYLOR HOSPITAL EMERGENCY MEDICINE: We do. And part of that drill is general disaster preparedness and part of the drill is always gearing up when we know an infectious disease is heightened in our area, whether it is a flu, whether it's a respiratory virus, the screening process again starts in triage.

GRIFFIN: Dr. James D'Entienne at Baylor's emergency room says since the first of this year, this hospital, just miles from Texas Presbyterian, has trained its staff how to isolate a patient and protect itself through masks, gloves, protective clothing, and only entered through what's called the warm room, until test results can determine exactly what is wrong.

And that's what this is -- this is not being used by anybody else, this is not an overflow room. This is an isolation room specifically for any kind of in infectious disease, Ebola included?

D'ENTIENNE: Correct. And we have more than one of these rooms and we can use them in day-to-day operations.

GRIFFIN: D'Entienne says his hospital is ready, but infectious disease experts say this level of readiness across the U.S. is only now being addressed.

GAVIN MACGREGOR-SKINNER, ELIZABETH R. GRIFFIN RESEARCH FOUNDATION: We've seen that hospitals now are downloading paper-based guidance plans from the Internet and working out how to do the management, how to do the implementation and how is the how, how to make she's things happen to make sure if they do get an Ebola patient, everyone in the hospital is going to be safe.

GRIFFIN: And it's not just hospitals that need to improve their response. This December 2013 study by the Robert Wood Johnson Foundation and Trust for America found a majority of states scored poorly in their ability to control infectious diseases.

The study's executive director quoted as saying, "The bad news is that we found major gaps in the country's ability to prevent and control and treat outbreaks, leaving Americans at an unacceptable level of unnecessary risk." The report calls for more uniform vaccinations, better health monitoring and much better communication between hospitals who possibly have infectious patients and the health officials who can stop those infections from spreading.

Drew Griffin, CNN, Dallas.

(END VIDEOTAPE)

FEYERICK: And that begs the question, what more should U.S. hospitals and local governments do to prepare for an Ebola outbreak, a possible outbreak?

Our Dr. Sanjay Gupta and Bonnie Castillo with the National Nurses United Union will join me next to talk about what they think needs to change on the frontlines of this fight against Ebola.

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FEYERCIK: And we are looking right now at live pictures of the apartment complex where that family is currently in quarantine, the family that was in contact with Thomas Duncan, who has Ebola.

You can see that red truck there that moved in, that red and white truck. It's a hazmat truck.