Hospital forced to apologise
Royal Melbourne Hospital (RMH) has apologised for its handling of two separate Post Exposure Prophylaxis (PEP) cases.
A second man has come forward to share his PEP experience at the hospital after reading Southern Star’s exclusive story last week about the hospital’s bungling of a St Albans man’s request for PEP treatment.
Dave*, 28, said he was refused PEP at RMH because the doctor decided he had a one in a million chance of contracting HIV.
“I had the same experience,” Dave said. “After an exposure incident with [a man] who was HIV-positive I needed to access PEP. The junior doctor had no idea what PEP was.”
Dave said after referring to a hospital print-out the doctor told him he wouldn’t prescribe the drug course because he had a one in a million chance of contracting HIV.
“I said I can guarantee that’s not correct,” Dave said. “He said that’s what the guidelines say and, because of the effects of the medication, we’re not going to give it to you.”
RMH spokesman Rodney Jackson-Smith admitted the hospital had made an error and offered apologies to the two men.
“The two recent breaches of our PEP protocols are regrettable and the hospital apologises for them,” he said.
When Dave left RMH he phoned the Alfred Hospital’s 24-hour PEP line and was told to seek PEP treatment immediately.
“I was lucky enough to know there was a PEP info line, just to double check … he made me doubt myself because he was a doctor,” Dave said.
After seeking and getting treatment at the Prahran Market Clinic, a nurse from the RMH infectious diseases unit contacted Dave.
He said the nurse apologised and promised such an incident would not happen again.
Two weeks later he read Southern Star’s story about the similar experience of a St Albans man.
“[The nurse] said the doctor had obviously read the guidelines incorrectly,” Dave said.
“I said, ‘If you can guarantee me this will never happen again, or that the guidelines are updated or made clearer … I wouldn’t pursue it.’ ”
Jackson-Smith said staff would be given PEP training following the two PEP incidents.
“When this was first brought to the hospital’s attention we took immediate steps to prevent a recurrence by fully briefing our emergency department staff and reminding them of our PEP protocols and the correct procedures to be followed,” he said.
“The hospital will also be conducting follow-up education sessions with relevant staff.”
RMH and the Alfred are the only two Melbourne hospitals providing 24-hour PEP services.
info: The Alfred’s 24-hour PEP line
is 1800 889 997.
* Name has been changed.
I’m on PEP at the moment. It was prescribed at the Melbourne Sexual Health Centre at 580 Swanston Street, Carlton and their response and care has been outstanding, supportive and prompt. If you can, I would encourage patients to go there if they need PEP. Just remember that you must start PEP within 72 hours of potential exposure to HIV. Starting PEP treatment within 24 hours is ideal.
The RMH should be saying they will have an investigation, and report to the public the findings and what changes they will make.
Presently the same thing will happen again as they have not done this.
Perhaps the Souther Star can ask what investigation they did, what the findings were, and what changes they have made.
This should be directed at the Director of Medical Services. This is a reportable adverse event and by law must be followed up. It is a failure to treat a patient with a potentially serious illness.
I would also encourage people to make a formal complaint to the Medical Board of Victoria. It is important to do this as it sends the message to the medical community at the RMH that they must follow best practice regardelss of the sexuality of a patient. You are allowed to Freedom of Information all files on you held by the Hospital.
It is not a failure of guidelines, it is a failure to use best practice to treat a possible exposure.