Bil Browning

DC Man Can Sue for HIV Misdiagnosis

Filed By Bil Browning | July 12, 2011 10:00 AM | comments

Filed in: Living
Tags: Terry Hedgepeth

A man has been given the green light by the DC Court of Appeals to sue a health care provider who misdiagnosed him as HIV+ five years ago. His lawsuit alleging negligence had previously been thrown out of court for not meeting a "zone of physical danger" standard.

Thumbnail image for HIV medsThe original three judge panel found that Terry Hedgepeth couldn't sue because he wasn't physically harmed by the diagnosis. If he had taken HIV medications, the court said, he would have been able to sue, but based on previous malpractice cases the man wasn't physically in danger.

Hedgepeth argued that after learning he was HIV+ he engaged in risky behavior like drug use and having sex unprotected sex with HIV+ women. The stress of his diagnosis led to multiple mental breakdowns that resulted in hospital stays.

"Because care for the body and the emotions are so interlinked, and patients often are dependent on their physicians' exercise of due care, they therefore are susceptible to suffer emotionally as well as physically as a result of their physicians' negligence," the DC appeals court opinion stated.

Hedgepeth is suing the Whitman-Walker clinic for $20 million.


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I can see this, but I'm more baffled at how the patient was diagnosed as HIV+. A rapid test that comes back positive is always followed up with a second test, usually a blood test. Unless the physician never performed a test, a second test, somehow mixed up the results, or both tests gave false negatives, which, frankly, all seem unlikely, I can't imagine how he got a positive diagnosis...

Weird...

I would love to see the details of the case. Five years is a long time for medical professionals not to realize that this man isn't actually HIV-positive, unless he wasn't engaging in routine medical care around his HIV status.

Regardless of this particular case, though, I think it is an important step on the court's part to expand the definition of zone of physical danger to include mental health considerations. Whether this is a landmark case or not, I don't have the expertise to say, but the gesture on the court's part is a welcome one.

Well, I think ethics is pretty established and since they take care with debriefing after clinical trials where there is a risk of psychological trauma or disturbance, I would hope there's fodder to make an appropriate ruling in this case about zone of physical danger as it applies to mental health.

But you're right. If he hasn't consumed any ARVs as the article says, then his doctor should have known something was up after 5 years...

I wonder if he thought for a moment that his patient had been cured...?

Dan O'Neill Dan O'Neill | July 12, 2011 11:47 PM

This whole case sounds bogus in my opinion; and the"zone of physical danger" matter moot, as there are too many intervening, unanswered questions and details that don't seem to add up. These questions must be answered before any others concerning the mental toll a false positive test might have on the plaintiff should be considered.

Since I don't know what year he was tested, it's hard to draw conclusions on how the test was administered; however, in recent time it's standard, if not required, that everyone taking an HIV test know about the possibility of receiving a false positive from a screening test and the need for confirmation via Western Blot before a definitive diagnosis is made.

Terry Hedgeworth's actions are pathetic; and he needs to take some responsibility for himself. That he would put himself and others at risk after receiving a positive diagnosis and proceed to sue WWH, presuming he knew the possibility of a false positive, is ridiculous. It also shows his utter lack of poor judgement. What does he hope to achieve aside from damaging one institution that helps treat those actually infected with HIV and prevent countless others from becoming infected? If anything, his beef lies more with the testing company or his unlucky blood that just happen to cross-react with a particular ELISA test. Even so, I hold the test manufacturer harmless, since sensitivity/specificity for the tests were undoubtedly provided, indicating the remote possibility of false positives. Regardless, upon receiving a preliminary positive, the onus was on Mr. Hedgeworth to follow-up with a provider, which he didn't do; so responsibility for the anguish he suffered rested with him alone at that point and no one else.

In the end, I have no sympathy for him - regardless of the stress his false positive result might have caused. He is not HIV positive, while so many others are. His actions only aim to take away from the care that others would receive. He says that he's grown spiritual and had faith he would prevail. Nonsense, let's not pretend to not know what's motivating his actions - pure selfishness. Does he really think he's the first false-positive to have happened? He should be counting his blessings. Too many people are actually dying from this preventable disease to be quibbling about such a frivolous law suit. I find it appalling.

I thought that a positive test was ALWAYS followed up with a confirmatory test with higher specificity. But maybe that's just the responsible clinics/providers?

Britney Austin | July 13, 2011 3:16 AM

The science is actually not settled on HIV and AIDS. It is extremely tragic how much suffering and death has resulted from HIV/AIDS. Unfortunately, many if not most people do not do their own research on issues such as this but simply choose to accept the popular beliefs. One of these most popular beliefs is that the HIV test actually tests for the virus itself. It does not. Both the ELISA and Western Blot do not actually test for the virus. Even the viral load test does not. All of these tests use various criteria to determine one's positivity/viral load to the virus such as antibodies and proteins claimed to be specific to HIV. I can provide more information about this to those who request it but it may be off topic. The point is to not simply automatically believe everything the doctor tells you but do not be a blind skeptic of everything either. It is my opinion that anyone who is diagnosed with a terminal or potentially-terminal illness should get a second and even third opinion and do some of their own research before making any decisions. If the medical community is misrepresenting facts on HIV/AIDS (which I often think they are) then that may be grounds for litigation.

You are correct, to best of my knowledge, that ELISA and Western blot test both are sensitive to specific proteins related to the presence of the HIV, not the HIV particle itself.

However, PCR (polymerase chain reaction) tests do test for actual DNA or RNA sequences ... and if you test for a gene sequence that is unique to HIV, then you are testing for the virus itself, or at least an identifying subset of it.

Check out the following Wikipedia entries (these are not working links):
Molecular biology (includes a short section on PCR)
Western blot (also includes info in passing about ELISA)