The doctor transported out of Sierra Leone to get treatment in Nebraska for an Ebola infection has died less than 48 hours after his arrival. Dr. Martin Salia, a Maryland resident who returned to his native country to provide much-needed medical care in western Africa, was in worse shape on his arrival than first thought:

A surgeon who contracted Ebola while treating patients in Sierra Leone has passed away in a hospital in Nebraska, where he had been flown for treatment, officials announced Monday.

Dr. Martin Salia, 44, had been described repeatedly by health workers as being much sicker than the Ebola patients previously brought to the U.S. for treatment.

“Dr. Salia was suffering from advanced symptoms of Ebola when he arrived at the hospital Saturday, which included kidney and respiratory failure,” the Nebraska Medical Center said in a statement. “He was placed on dialysis, a ventilator and multiple medications to support his organ systems in an effort to help his body fight the disease. He also received a dose of convalescent plasma and ZMapp therapy was initiated on Saturday.”

The hospital had been treating Salia in its biocontainment unit that has successfully treated two other Ebola patients this fall.

Unfortunately, Salia’s treatment may have been delayed by a false negative test result. It also may mean that his colleagues have exposure to the virus as well:

When Martin Salia’s Ebola test came back negative, his friends and colleagues threw their arms around him. They shook his hand. They patted him on the back. They removed their protective gear and cried.

But when his symptoms remained nearly a week later, Salia took another test, on Nov. 10. This one came back positive, sending the Sierra Leonean doctor with ties to Maryland on a desperate, belated quest for treatment and forcing the colleagues who had embraced him into quarantine.

“We were celebrating. If the test says you are Ebola-free, we assume you are Ebola-free,” said Komba Songu M’Briwa, who cared for Salia at the Hastings Ebola Treatment Center in Freetown. “Then everything fell apart.”

How did the test miss the Ebola infection? The disease had not progressed far enough for the virus to be detected in the first test, one developed and administered by a Chinese medical team working in the region. However, that team and the medical staff in Freetown didn’t know that early tests could be inconclusive. Compounding this, the hospital at which Salia worked wasn’t explicitly part of the fight against Ebola. Salia didn’t wear the protective gear used by medical personnel in epidemic areas, and probably caught the infection from an unsuspecting patient. Ebola might not have been their first guess; at one point, Salia got treatment for malaria in the interim between the two tests.

Even more unfortunately, Salia’s family in Maryland was en route to Nebraska, according to one of the reports, and didn’t get to the hospital in time. Hopefully they will find support and prayer for them when they do arrive. It’s a sad ending for a man who wanted to make a difference.