By 9:40 p.m., Duncan was experiencing explosive diarrhea and projectile vomiting.[33] At 8:28 a.m. the next morning, the doctor noted that Duncan "appeared to be deteriorating." By 11:32 a.m., Duncan was suffering from fatigue severe enough to prevent him from using the bedside toilet.[33] Later that day, Duncan was transferred to an intensive care unit (ICU) after all other patients had been evacuated. The next day, September 30, Duncan was diagnosed with Ebola virus disease after a positive test result.[33]