AAR Health Services Faces Accusations of HIV Misdiagnosis

On March 29, 2007, Denis Okaka underwent an HIV test at a laboratory owned by AAR Health Services (Uganda) Limited.

Uncertain Results

The test results indicated that he was HIV positive, and he was given a copy of the results. Three months later, Okaka visited the same laboratory, as advised, for a repeat test, which again confirmed his HIV-positive status. However, this time he was not provided with a copy of the results, and the reasons for this omission were not explained.

Exploring Immunity Status

On November 17 of the same year, the laboratory conducted a CD4 count to assess Okaka’s immune system, which is crucial in the context of an HIV infection.

Tests Show Negatives

In May 2008, Okaka experienced breathing difficulties and sought medical attention at Kampala Family Clinic, where he was diagnosed with high blood pressure and prescribed medication. Surprisingly, the clinic’s tests revealed an undetectable HIV viral load in his blood and a nearly normal CD4 cell count. The clinic performed three subsequent HIV tests, all of which came back negative, leading to the conclusion that Okaka was HIV negative.

A Disappearing Act

Three years later, on July 14, 2010, Okaka returned to AAR laboratory to retrieve his results. However, the laboratory failed to provide him with the results, citing a software overhaul that had resulted in the deletion of previous test records for all patients.

A Legal Battle

In response to these events, Okaka filed a civil suit against AAR on December 17, 2014, alleging medical negligence. He claimed that due to the negligence of AAR’s laboratory staff, he was twice misdiagnosed as HIV positive, causing him severe emotional distress, loss of self-esteem, pain, embarrassment, and loss of enjoyment of life. He sought compensation of Shs1 billion for the damages he had endured.

Allegations of Negligence

Okaka’s lawyer argued in court that AAR’s laboratory technicians did not adhere to the medically stipulated procedures when conducting the HIV test. These procedures, outlined by the Ministry of Health in the Uganda National Policy on HIV Counseling and Testing, are designed to ensure accurate results.

Question of Responsibility

The lawyer contended that AAR was ultimately responsible for the wrongful actions and omissions of its employees during their duties. These lapses in adhering to guidelines resulted in a false positive HIV diagnosis.

Denial of Liability

AAR denied Okaka’s claims, asserting that it was not negligent in testing his blood for HIV. The company argued that it was not liable for the alleged acts of its officers and placed some blame on Okaka, claiming he failed to follow the advice of undergoing routine HIV tests and returning for follow-ups.

The Defense’s Perspective

AAR’s lawyer maintained that the laboratory’s actions were in line with the best practices of medicine, asserting that guidelines were not rigid, and AAR had the liberty to adapt procedures to specific circumstances, as long as they adhered to medical standards.

Policy Perspective

The lawyer also emphasized that the policy guidelines primarily targeted policy makers and planners of HIV/AIDS programs, not service providers. According to him, the relevant document for service providers was the Uganda National Policy Implementation Guidelines for HIV Counseling and Testing Services.

Testing Methods

AAR’s lawyer pointed out that there were various test kits available to determine HIV status, and the laboratory’s choice to use the Determine Abbot test was consistent with policy directives. The guidelines recommended two testing methods, both considered acceptable, so the service provider’s choice was well within the norm.

Key Events in the Okaka HIV Diagnosis Case

Table: Legal Arguments in the Okaka HIV Diagnosis Case