Inadequate communication processes and over-reliance on an electronic health record system to convey critical information at Texas Health Presbyterian Hospital’s emergency department in Dallas led to the initial misdiagnosis last year of Thomas Duncan, America’s first Ebola patient.

That’s the finding of an independent panel which reviewed the 2014 events at Texas Health Presbyterian related to the care and treatment of Duncan, who was initially treated and released, only to return to the hospital’s ED where he was admitted for treatment of Ebola and later died from the disease. Texas Health Resources (THR), which operates the hospital, publicly released the panel’s report on Friday.

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