CALIFORNIA Error led man to think he had HIV for 8 years

The 57-year-old patient is relieved but angry.
SAN FRANCISCO CHRONICLE
SAN FRANCISCO -- For eight years, Jim Malone attended biweekly counseling sessions for men living with HIV. His rent was paid in part by a county health program. Project Open Hand delivered free meals. A nurse visited him at home every two weeks.
He lost weight, grew depressed and thought the end was near each time he caught a cold. He had been told in 1996 that he was HIV-positive.
Last month, Malone, 59, was summoned to his doctor's office. He listened as Dr. Richard Karp, his physician, delivered the stunning news and acknowledged the error: Malone is HIV-negative.
"He told me, 'We made a very big mistake. We did not do our job,'" said the Hayward, Calif., resident, who is gay and has lost friends to AIDS. "I said, 'You mean to tell me that all you have to say is you are sorry? Sorry that I lived for all this time believing I was going to die?'"
Things gone wrong
Malone says he is relieved but angry. Family relationships that had been strained were severed after his diagnosis. Romance became a thing of the past. Planning seemed pointless. The array of services he received for free could have gone to someone else.
His misdiagnosis is rare but undisputed and shows the far-reaching damage wrought by medical mistakes and the potential for flaws in burdened health care systems.
Officials at the Oakland Department of Veterans Affairs' outpatient clinic, where he was treated, admit the mistake and have launched an investigation into what went wrong and how the error was perpetuated year after year.
Karen Pridmore, a spokeswoman for VA's Northern California Health Care System, which has eight clinics and a medical center and serves more than 65, 000 patients, said Malone had arrived at the clinic in 1996 with lab results from an outside testing firm in Southern California. Those results showed he was HIV positive. The VA did its own HIV test on Malone and found he was negative.
Even though the VA's internal software program raised a red flag on Malone's case because of this inconsistency, he was never informed because the human handlers did not pass the information on.
"An HIV-positive person can have good T-cell counts and undetectable viral loads over a long period of time," Pridmore said. "And in this case, the patient exhibited symptoms that could be consistent with an HIV diagnosis."
Myriad problems
Malone, who has been on disability since 1984, when he ruptured two disks in his back while at work, has myriad health problems including heart disease and scoliosis.
In a September 2003 letter from Karp, Malone was classified as "permanently disabled and unable to work or participate in any stressful situation whatsoever." His medical prognosis was deemed "very poor." The letter said Malone was being treated for 20 medical conditions, the first condition being HIV. The sixth item on the list, nausea and vomiting, was said to be "related to condition 1."
Malone, who is thin and voluble and walks with a cane, said that he attributed his frequent nausea, vomiting, diarrhea and weight loss to being HIV-positive. When he learned he is HIV-negative, he feared that he would be charged with fraud, but it turns out that no agency serving him has done that.
A Hayward resident for most of his life, Malone enlisted in the Army right after high school and served for three years as a clerk typist in Germany. After service was completed, he was an ambulance driver for 17 years before he took a job at a mortuary, where he injured his back.
To please his family, he said, he lived a kind of double life. He was married for nearly seven years and has a daughter who is now 34 and a granddaughter who will be 13 in October.
"His recent painful life lesson has a practical side, he noted. "I would tell people to get not just one HIV test, but multiple tests," he said. "I would say test, test and retest."
Mistakes are rare
Dr. John Stansell, professor of medicine at UCSF and medical director of HIV programs at San Francisco General Hospital, called false positive tests "extraordinarily rare." Since 1984, standard screening for HIV has included both the so-called Elisa and Western Blot tests. If done together, as is customary, the results are nearly infallible.
Dr. Jon Green, chief of infectious diseases at VA Northern California, also noted the reliability of the tests. He added, however, that mistakes can happen through handing and reporting.
Cases similar to Malone's are being played out in courts across the country.
Malone has retained an attorney and expects to file a malpractice claim against the VA Health Care System.