Until Jan. 15, Hester Harbison thought she was a healthy mother of three young boys.
But at an appointment with her doctor that day, Ms. Harbison, 23, was told -- mistakenly -- that she was infected with the AIDS virus.
The news terrified her. For nearly a year she had been a nursing assistant, often working with AIDS patients at Johns Hopkins Hospital.
What followed was a five-month nightmare that Ms. Harbison believed would end in a painful, lingering death similar to those she had witnessed at Hopkins.
"I cried every night," she said yesterday. "I thought I was no better than a junkie."
Before a doctor at Hopkins' East Baltimore Medical Center told her last month that she wasn't infected after all, she had sent her three children away to live with their father. She also sought help from an AIDS support group, lost two months of work and began taking medication to ward off AIDS symptoms.
"Now I'm more scared than any thing else," she said. "I'm scared if I go [for medical appointments] they'll tell me again they made another mistake." Even so, Ms. Harbison is to have another blood test today, seeking further assurances.
She also has filed suit against Johns Hopkins Hospital, Johns Hopkins Medical Services Inc., the East Baltimore Medical Center Inc., and two physicians. The suit alleges that she was emotionally scarred, humiliated and prevented from working for a time by the diagnosis.
By law, no dollar amount is listed in claims before the Health Claims Arbitration Board, which hears all medical malpractice cases in an effort to resolve them out of court.
But Ms. Harbison's attorney, Marvin Ellin, said, "This is a case that will most assuredly end up before a Baltimore jury, and . . . we will seek certainly not less than a million dollars."
Hopkins officials declined all comment on the suit.
Ms. Harbison, of the 2600 block of Polk St., continues to work as a nursing assistant for a nursing agency owned by Hopkins. A small woman who speaks barely above a whisper, Ms. Harbison says she was in good health last fall, free of any of the usual risk factors for AIDS, such as intravenous drug abuse or sexual contact with high-risk individuals.
"I never did drugs, I don't smoke or drink. I'm a pretty much boring person," she said.
But she needed a routine physical and was somewhat worried about getting AIDS because of her work with AIDS patients. So in November Ms. Harbison asked for a complete physical and AIDS blood test at the East Baltimore Medical Center.
According to a Nov. 30 laboratory report filed with the claim, Ms. Harbison's initial "Elisa" blood test was positive for the Human Immunodeficiency Virus (HIV) that causes AIDS. But a second, confirmatory test -- called the Western Blot test -- was negative. Both results are listed on the same form.
Dr. Karen L. Kotloff, an infectious disease specialist at the University of Maryland Medical System, who has no connection to the Harbison case, said the Elisa test is a broad screening test designed to detect "virtually everybody who is infected" with HIV.
But that broad sweep also produces many "false positives" for people who are not really infected. In fact, she said, 75 percent of all positive results from the Elisa test for HIV will be false.
"Clinically, if you have a positive Elisa, it means nothing," she said. "It's not a result you would even need to report to a patient."
For that reason, the Centers for Disease Control recommends a second, far more precise "confirmatory test" for all people with positive Elisa tests.
"The second test weeds out the people who aren't truly infected," Dr. Kotloff said. For the Western Blot test, "the false positive rate is lower than 1 in 100,000."
"I think all doctors are expected to understand this," she said.
Despite the negative Western Blot test, Ms. Harbison's suit says, Dr. Kenneth Covinsky, a Hopkins resident working at the East Baltimore Medical Center, told Ms. Harbison on Jan. 15 that she was HIV-positive. He is named as a defendant in the suit.
"I fell back in my chair as if somebody had hit me, and cried," Ms. Harbison said. "I asked him if it could be a mistake, and he said no, the test was pretty accurate."
Laboratory documents filed with the suit show that a second set of blood tests dated Jan. 17 were identical to the first, with a positive Elisa result and a negative Western Blot result. The suit alleges that Ms. Harbison was told those tests confirmed the diagnosis of HIV-positive.
Ms. Harbison says the medical center gave her booklets and advice on how to deal with AIDS, and she was advised to seek support from a support and education group for AIDS patients, which she did.
She informed her employer of her test results and took two months off. She also consulted a social worker for advice on preparing a will.
When she returned to Dr. Covinsky in February with the flu, she was convinced it was the beginning of her physical deterioration and, the suit says, she also "contemplated suicide."
"I thought a lot of the time of just running. I didn't want them [her children] seeing me die like that," she said. She never told her family of the diagnosis, and couldn't tell her children why she cried so much. Only the children's father suspected something was wrong. But she did not tell him what it was, even after she took their three sons last month to live with him in Norfolk, Va.
"I had to keep going for the kids' sake," Ms. Harbison said. Somehow, she even managed to complete her high school diploma during this period.
On June 3, she saw Dr. Maura McGuire, another resident at the East Baltimore Health Center and also a defendant in the suit, Dr. McGuire provided further advice on how to cope with the HIV-positive diagnosis. Ms. Harbison also received prophylactic injections to ward off some of the common complications of AIDS.
But on June 17, her suit alleges, she received a telephone call from Dr. Covinsky informing her that a mistake had been made.
"I thought he was going to tell me I was going to die soon," she said. Instead, Dr. Covinsky told her she was not HIV-positive, after all. "He said it could have been a number of things, why the HIV antibodies showed up. He said it happens to 1 percent of the people tested."
"I still was scared. I didn't know what to believe," she said. "I cried and I prayed. Then I got real angry."
She said she has not gotten an apology from Dr. Covinsky or from Hopkins.
"He hasn't even acted as if this was a mistake," she said.
Ms. Harbison said the experience has strengthened her compassion toward AIDS patients.
"It's a lonely feeling, and I try to say I understand," she said. "I also have a personal friend who has AIDS and young children. I cry with her, and tell her I know what it feels like to have AIDS."