Here's How A Dallas Hospital Allegedly Botched The Care Of The First Ebola Patient

The country's largest nurses' union is alleging that the Dallas hospital in charge of caring for the first Ebola patient diagnosed in the US made severe missteps, potentially contributing to secondary Ebola cases in two healthcare workers there.

Nurses who spoke to National Nurses United said staff went days caring for Thomas Eric Duncan without proper protective gear and while dealing with constant changes in protocol.

Duncan contracted Ebola in Liberia and was treated at Texas Health Presbyterian Hospital after he developed symptoms while visiting family and friends in Dallas. He died last week.

The union said the nurses' allegations were vetted but declined to specify exactly how many nurses provided these accounts. Dozens of healthcare workers at the hospital, where the nurses are not unionized, were contacted by the Associated Press in an attempt to corroborate the union's allegations, but they were "unwilling to speak." Some say they were told not to speak to the media.

Texas Health Presbyterian released a statement Thursday saying workers followed guidelines established by the Centers for Disease Control and Prevention once Duncan received his diagnosis.

The nurses' allegations could not be independently verified, though the Centers for Disease Control and Prevention is talking to dozens of Texas Presbyterian workers to try to piece together what happened. In the meantime, here's an outline of what nurses say went wrong, according to National Nurses United:

Duncan wasn't immediately isolated.

The first alleged misstep in Duncan's care occurred when the hospital reportedly sent him home when he first came into the emergency room showing symptoms.

Duncan allegedly told a nurse he had recently traveled to the US from West Africa, where three countries are currently seeing an unprecedented Ebola outbreak. However, he was diagnosed with a minor infection and sent home, according to the Associated Press. He returned to the hospital when his symptoms worsened and was later diagnosed with Ebola.

Duncan was also allegedly left in the open emergency room area for hours the day he returned to the hospital with worsened symptoms, which could have exposed other patients to Ebola.

A nursing supervisor allegedly faced resistance when asserting that Duncan should be isolated.

Nurses allegedly didn't have proper protective gear.

Nurses allege that they didn't have the right equipment to care for someone with Ebola.

Top US hospitals like Emory University Hospital, which cared for an American Ebola patient who was evacuated from Africa, and the Centers for Disease Control and Prevention have hazmat suits that healthcare workers wear when facing possible exposure to Ebola.

Nurses and other hospital workers caring for Duncan eventually got hazmat suits once tests confirmed that Duncan had Ebola, but they spent two days treating him without wearing the protective suits, according to The Dallas Morning News.

When Duncan visited the hospital the second time with worsened symptoms, he was suspected of having Ebola and isolated. That day, he was projectile vomiting and had diarrhea. During this time and before the Ebola test came back positive, hospital workers were reportedly treating him wearing only gowns and scrubs, according to the nurses' union.

This delay could have "potentially exposed perhaps dozens of hospital workers to the virus," the newspaper reports.

Even now, one nurse claims that the hazmat suits the hospital have aren't sufficient. They reportedly leave the front of the neck exposed.

Waste was allegedly left on the floor.

The nurses' union also alleges that hazardous waste from Duncan was left to pile up in the hospital.

They allegedly did not have access to the proper supplies to dispose of the waste.

Texas Presbyterian nurse Briana Aguirre told the "Today" show Thursday: "The CDC, our infectious disease control nurses, they had been up and down that hallway where there was garbage piled to the ceiling without so much as even gloves on … and then [they were] just walking into other general areas that are supposed to be clean. There was no one to pick up our garbage."

Staff did not have adequate training, according to the union.

Some on the nursing staff at Texas Health Presbyterian reportedly did not have adequate training to prepare for caring for an Ebola patient.

Nurses allege that the training for Ebola care consisted of just an optional seminar, the AP reports.

"We never talked about Ebola, and we probably should have," Aguirre said. "We never had a discussion. They gave us an optional seminar to go to, just informational, not hands-on, and it wasn't even suggested that we go."

Nurses were allegedly caring for other patients in addition to Duncan.

The nurses who had a hand in Duncan's care were reportedly also caring for other patients in the hospital at the same time.

Although Ebola is not contagious before a person starts showing symptoms, it's concerning that nurses who were exposed to Duncan's bodily fluids might have then worked in other areas of the hospital and cared for other patients.

And while nurses were caring for Duncan and coming into contact with contagious fluids before it was confirmed that he had Ebola, hospital records obtained by the Associated Press suggest that wearing protective shoe covers was viewed as optional. This means nurses could have potentially tracked contagious fluids to other parts of the hospital.

Lab specimens were allegedly not handled properly.

Nurses allege that lab specimens from Duncan were "sent through the hospital tube system without being specially sealed and hand delivered," according to the nurses' union. That means that the tube system for the hospital could have been contaminated, the union claims.

Aguirre said hospital staff didn't have the proper training to deal with these specimens.

"We were unprepared in the sense that we did not know what to do with his lab specimens," she said. "They were honestly mishandled."

A statement the hospital released Thursday disputes this concern: "All specimens were placed into closed specimens bags and placed inside a plastic carrier that travel through a pneumatic system. At no time did Mr. Duncan's specimens leak or spill - either from their bag or their carrier - into the tube system."

Protocols were allegedly inconsistent.

The protocols for treating Duncan were constantly changing, nurses allege. They say they were told to follow whatever guidelines they chose.

"There was no advance preparedness on what to do with the patient, there was no protocol, there was no system," Deborah Burger of National Nurses United said.