Lawsuit: Bad prescription hurt HIV+ man

SUMMARY: An HIV -positive man in Boston is suing CVS pharamacy because of an alleged prescription error that has made him resistant to several drugs.

Boston resident Adam Barrett calls himself a "dinosaur" of the AIDS epidemic, but "survivor" may be a better description. He was diagnosed with HIV in 1985 and went on to beat the odds, successfully fighting off illness with the help of new medications. Then came January of this year, when an alleged error by a pharmacy gave the virus the boost it needed to turn the tables on Barrett.

Now, Barrett has filed suit against one of the nation's largest pharmacy chains, accusing it of threatening his health by botching a prescription.

The CVS company "hasn't even had the courtesy to accept responsibility for their error," said Barrett, who has become resistant to several AIDS drugs, apparently because he unknowingly took an incorrect dose of one medicine for three weeks.

The alleged mistake is a "huge error" and may not be an isolated incident, warned Maria DeRisi, a pharmacist at Scripps Mercy Hospital in San Diego and expert on AIDS issues. "This is very scary and could be much more common than we hear about because the patients, doctors and pharmacists aren't aware of it."

A spokesman for the CVS company didn't return a phone call seeking comment. Barrett, 40, was infected by a sex partner in the early 1980s. AZT helped keep his HIV at bay in the early 1990s, and he went on combination therapy, known as the AIDS "cocktail," a few years later.

The level of virus in his blood shrunk to zero (although it remained in his body), and his immune system remained strong. "I was incredibly compliant as far as never missing dosages," he said. "It worked phenomenally well for me."

Then, in January 2001, his body began to lose its battle against HIV. "I did start to notice I was having some more fatigue, and I saw that my lymph nodes were inflamed again," a sign that his immune system was fighting off something.

Barrett didn't know what was happening until he dumped out his Crixivan pills and noticed they were 200 milligrams each instead of the prescribed 400. "For a little more than three weeks, I was taking half the dose," he said.

Then came the bad news. Barrett's doctor confirmed that the virus was coursing through is blood, and he had become resistant to Crixivan and two other AIDS drugs. He is partially resistant to two more.

Drug resistance is an increasingly common problem for AIDS patients. A study released this month found that more than half of patients surveyed who had AIDS in 1996 developed resistance to at least one drug by 1998 and 1999.

HIV can mutate into forms that are immune to medications, and the risk of mutation is especially high if the virus stays alive because a patient takes a break from his or her drug regimen.

Barrett said he is now taking five medications, which cause a variety of side effects and have kept him home from his job as an intensive care nurse at a Boston hospital.

In his lawsuit, Barrett asks for damages of at least $257,000 to pay for lost wages. According to The Boston Globe, CVS is expected to defend itself by saying Barrett would have become drug-resistant anyway, regardless of the prescription mix-up.

It is easy for pharmacists and their technicians to not question an odd-sounding AIDS prescription, said DeRisi, the San Diego pharmacist. "I could see how complacency could develop when it's so complicated," she said. "They just assume what the doctor wrote is correct."

Patients must pay attention to the drugs they take, she said. "They need to make sure they're well educated, and they need to access all the resources out there."