TB patient says doctors knew of travel plans - @ JEMS.com


TB patient says doctors knew of travel plans


 
 

Mimi Hall Anita ManningUSA Today | | Monday, June 25, 2007


WASHINGTON The tuberculosis patient who triggered a global health scare by traveling to Europe and back with a rare form of the infection told the Senate on Wednesday that doctors knew he was planning to go abroad and never told him that he was a threat to others.

"I didn't go running off or hide from people. It's a complete fallacy; it's a lie," Andrew Speaker, a 31-year-old Atlanta lawyer, testified by phone from the Denver hospital where he is being held in isolation. He has a drug-resistant form of tuberculosis that health officials say could become contagious.

At the same time, House members sharply criticized the Homeland Security Department for failing to stop Speaker when he and his wife drove back into the USA across the Canadian border on May 24. At the time, there was a "lookout" alert instructing any agent who encountered him to detain him and call health officials.

Homeland Security's chief medical officer, Jeffrey Runge, said "the system worked as intended" because the alert was posted and border agents received it. There was "a single point of human failure in this case," he said.

Members of Congress cited communications and procedural breakdowns at almost every level: among local and federal health officials, between various divisions of Homeland Security and at the border checkpoint.

Rep. Dan Lungren, R-Calif., called it a "catastrophic failure" of the government systems put in place after 9/11 to protect the public.

Speaker told senators that "numerous people" at the Centers for Disease Control and Prevention (CDC) in Atlanta knew of his plans to travel to Greece to get married.

Federal and local health officials testified that Speaker flew to Europe after he'd been told he had a drug-resistant form of TB and should not travel.

"Was he ordered not to travel? The answer to that was no," said Steven Katkowsky, the Fulton County (Ga.) health director. "The local health department does not have the authority to prohibit or order somebody not to travel."

CDC Director Julie Gerberding said federal health officials contacted Speaker on his honeymoon in Rome at midnight on May 22 after tests confirmed he had the potent infection. He was told "he must not fly," she said.

Speaker said he was told there was no funding available to bring him home on an air ambulance, and he would have to pay for his safe return, at a cost of "up to $140,000."

He said he didn't want to be "stuck there indefinitely in an Italian hospital." So he booked a flight to Canada on May 24 and drove across the border, despite the Homeland Security alert to all border officers.

Runge and Homeland Security's Customs and Border Protection chief Ralph Basham testified that it took Justice and Homeland Security lawyers four hours to decide whether they could place Speaker on a government no-fly list even though he wasn't considered a potential terrorist.

Homeland Security officials have said Speaker was already in the air by the time they tried to put him on a list.

"The failure by us to stop this individual is inexcusable," Basham said.

Gerberding testified that CDC's mistake was that "we gave the patient the benefit of the doubt" that he wouldn't get on a commercial plane and possibly expose hundreds of travelers to his infection. "In retrospect, we made a mistake."

Rep. Jane Harman, D-Calif., called it a government "meltdown" that could have had devastating consequences. If Speaker had been infected with smallpox, she said, "we could have a major national emergency right now."




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