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Harbor-UCLA ER refuse to give me PEP! PLEASE ANSWER ASAP.
Mar 5, 2011

Doctor, I was at Harbor-UCLA this morning to seek PEP but they didn't want to give the treatment. The nurse said that the ER is not equip to give PEP there and that its only for life threatening emergency. It was for me because I didn't want to get expose. Now I google PEP available in Los Angeles and Harbor-UCLA was on there. I spoke to their nurse and doctors and they refuse to give me treatment. I went to Cedar-Sinai ER and they took me right away and gave me a 3 pack treatment and to seek AHF for follow up for more drugs as well since its a 28 day treatment. This was a stressful weekend because monday is presidents day and most clinics are close and I was expose Saturday morning.If I made it to tuesday it wouldve pass the 72 hour mark. Thank God for Cedar Sinai! Now my other question is Can I sue a hospital emergency room for refusing my treatment? and why is that that mose ER hospital dont have any idea what PEP is? Will there be change in the future?

Ferdi.

Response from Dr. Frascino

Hello Ferdi,

The medical decision whether to recommend or offer a course of PEP to someone who may have had an HIV exposure depends on the likelihood of transmission. Many folks arrive in ERs requesting PEP for inconsequential events or even non-exposures. All hospitals and urgent care facilities should be PEP-knowledgeable and equipped to prescribe PEP, as a significant HIV exposure is indeed a medical emergency and the efficacy of PEP is dependent on how soon the first dose can be administered. Harbor-UCLA is certainly equipped to prescribe PEP. Without additional information I really can't comment as to why they refused to treat you. Perhaps in their evaluation your potential exposure was not significant enough to warrant a course of PEP. When in doubt, most ERs will provide a three-day starter pack and, as in your case, advise the patient to see an HIV specialist for further evaluation. The specialist, after taking a more detailed history, may advise discontinuing PEP or completing the full 28-day course and provide a prescription for the additional 25 days.

Regarding suing Harbor-UCLA, it's unlikely you would be successful in a malpractice case. You can discuss this further with your HIV specialist, as he will have much more information than I about what transpired.

Regarding hospital ERs, most are knowledgable about PEP, particularly in larger cities or locations where HIV is prevalent.

Good luck with your PEP regimen Ferdi.

Dr. Bob



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