DALLAS — Just minutes after Thomas Eric Duncan arrived for a second time at the emergency room, the word is on his chart: “Ebola.” But despite all the warnings that the deadly virus could arrive unannounced at an American hospital, for days after the admission, his caregivers are vulnerable.

The Centers for Disease Control and Prevention has pointed to lapses by the hospital in those initial days. And Duncan’s medical records show heightened protective measures as his illness advanced. But either because of a lag in implementing those steps or because they were still insufficient, scores of hospital staffers were put at risk, according to the records.

The hospital’s protective protocol was “insufficient,” said Dr. Joseph McCormick of the University of Texas School of Public Health, who was part of the CDC team that investigated the first recorded Ebola outbreak in 1976. “The gear was inadequate. The procedures in the room were inadequate.”