Fagan, who had a history of asthma, delivered babies in the ob-gyn unit of HCA Houston Healthcare West. However, she started working shifts in the emergency room treating COVID-19 patients in July amid the surge of coronavirus infections and deaths in Texas.
She experienced flu-like symptoms during a 12-hour shift, with a subsequent test finding her positive for the coronavirus. Her condition eventually deteriorated and she was hospitalized; doctors treated her with several drugs and therapies to help her overcome the virus. She was intubated and placed on a ventilator in August as her lungs weakened, but she was “not responding well” to the machine.
This led doctors to take the last option available: Fagan was hooked to an extracorporeal membrane oxygenation (ECMO) machine to oxygenate her blood.
In the ECMO procedure, blood is removed from the body through tubes implanted in the blood vessels and artificially oxygenated using a machine. The oxygen-rich blood is then returned to the body. However, this invasive procedure came with side effects – including the brain hemorrhage that caused Fagan to expire on Sept. 18.
Fagan’s family claims that the lack of personal protective equipment (PPE) at the hospital where she worked played a role in her death. Her sister Maureen told The Guardian: “Adeline had an N95 mask [with] her name written on it. [She] wore the same N95 mask for weeks and weeks, if not months and months.”
It is unclear how the doctor, in her second year of residency at the hospital, contracted the coronavirus. But Maureen claimed that her emergency room shifts in July had a role in her infection.
Guidelines released by the Centers for Disease Control and Prevention (CDC) indicate that N95 masks should only be reused up to five times at most, unless the mask manufacturer says otherwise. (Related: Face masks and other equipment meant to protect against coronavirus are polluting our oceans.)
HCA Houston Healthcare West Chief Medical Officer Dr. Emily Sedgewick said the hospital did not have a policy on constantly reusing masks. “Our protocol … includes colleagues turning in their N95 masks after each shift and receiving another mask at the beginning of their next shift,” she added. Sedgewick did not comment on Maureen’s allegations.
HCA Houston Healthcare West is part of HCA Healthcare, America’s largest hospital chain.
National Nurses United (NNU), the largest union of registered nurses in the country, urged the federal Occupational Health and Safety Administration in August to look into medical facilities owned by HCA Healthcare and impose citations for “willful violation” of workplace safety protocols. It pointed out 17 hospitals in Florida, Kansas, Missouri, North Carolina and Texas with dangerous working conditions.
In one instance cited by the NNU, several nurses at Mission Hospital in North Carolina performed aerosol-generating procedures without wearing N95 masks on a patient with respiratory failure – who later tested positive for the coronavirus.
HCA Healthcare’s work policy mandates asymptomatic employees to continue working despite their confirmed COVID-19 exposure. In addition, the company refuses to test asymptomatic employees, which exacerbates the problem of coronavirus transmission in the workplace.
Malinda Markowitz, president of the National Nurses Organizing Committee representing registered nurses in HCA Healthcare facilities, said: “HCA’s callous disregard for the safety of the nurses and their co-workers who have put their lives, their co-workers, and their families on the line every day, is deplorable. They must be held accountable.”
Data from Johns Hopkins University shows that the U.S. has 7.6 million coronavirus cases with 212,733 deaths and 3 million recoveries. Adeline Fagan joins the more than 200,000 coronavirus fatalities – which would have been prevented if the hospital she was working at had sufficient N95 masks available.
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