Dr. P prescribed zidovudine (AZT). Six months later, a blood test showed the CD4 count was up to 918. Given such a substantial increase, the physician began to question the HIV diagnosis and ordered a new round of tests.

This time, the ELISA was negative, although the Western blot was still indeterminate. Dr. P concluded that the original ELISAs had been false positives. Giving Mr. J the good news, Dr. P discontinued treatment, advised retesting in six months, and referred the patient back to Ms. G.

But Mr. J did not return to the clinic or to Dr. P. Instead, he consulted an attorney and sued Ms. G for malpractice. [Note: at the time this case took place, there were far fewer treatments for HIV than there are today, and a diagnosis meant an almost certain and devastating death.]

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At trial, the plaintiff’s lawyer’s first witness was an expert specialist in infectious diseases. She explained that ELISA can produce false positives, which is why the Western blot analysis is also performed. However, the test requires interpretation based on the intensity of viral bands. If the ruling is “indeterminate,” the lab performs a third screening test—rDNA—to try to clarify the result.

The expert then asserted that Ms. G had failed to provide the proper standard of care. “Under the circumstances, with a positive ELISA, an indeterminate Western blot, and a negative rDNA, Ms. G should have either called the lab for clarification or immediately referred the patient to an infectious disease specialist with expertise in interpreting these test results,” the expert declared.

The next witness was a physician at a clinic similar to the one where Ms. G worked, who testified that the standard of care demanded that Ms. G contact the lab or a specialist.

Mr. J then took the stand and described the devastating effect Ms. G’s diagnosis had on him during the 18 months he thought he was HIV-positive.

The young man testified that he was raised in a neighborhood where gang violence, drugs, and prostitution were prevalent, but he stayed away from these criminal elements because he wanted something better for himself.

“I was the first person in my family to attend college,” he stated. “I got a basketball scholarship, and in college I was voted most valuable and most inspirational player. In my spare time, I worked with a support group for troubled kids from the ‘hood. I held down a job as a campus security guard to earn spending money, and I graduated with a B+ average and a degree in criminology and probation.”