Dallas AIDS Group Sues County Hospital On AIDS Care

A major lawsuit over substandard care of persons with AIDS in Dallas may establish national precedents on whether indigent patients have a right to health care.

Parkland Memorial Hospital, the large county hospital comparable to San Francisco General here, treats over 1,000
patients with AIDS, ARC, or who are HIV positive. Only one full time and one half time physician have to handle this patient load, with 700 patient visits per month. Typical AIDS patients are persons who lost their jobs as the disease progressed, and exhausted their savings, thus becoming indigent.

The lawsuit, brought by the Dallas Gay Alliance and the American Civil Liberties Union AIDS Project, seeks to end these practices:

* A waiting list for AZT. The cost of the drug is not the issue, because the AZT is provided by a State program with Federal funds. But the hospital does not assign enough physicians to monitor patients using the drug.

The lawsuit also names the University of Texas Southwestern Medical Center, which provides medical personnel-- students, residents, fellows, and professors--to the hospital. This medical school rotates its personnel through all 132 of
the clinics at Parkland Memorial, except for one--the AIDS clinic. This discrimination exacerbates the shortage of physicians in the AIDS clinic.

The hospital admitted that in the one-month period from April 7 to May 6, 1988, seven people on the AZT waiting list
died. These were patients for whom AZT was medically prescribed but not available due to the hospital policy.

* Arbitrary denial of aerosol pentamidine prophylaxis and treatment. The hospital's full-time AIDS physician, after his recent resignation, pointed out that pentamidine costs the hospital about $100. per month per patient, while each hospitalization for pneumocystis costs the hospital $10,000 for the average stay of seven days.

* Rationing of AIDS beds. Persons with AIDS have been forced to wait for a rationed AIDS bed until another patient is
discharged or dies, even though other beds are empty. Patients ill enough to need hospitalization have had to wait 12 hours or more for a bed.

Legal Results So Far

The lawsuit was first filed in a state court. Judges in Dallas are assigned at random, and a conservative judge was assigned to the case. But even he ruled against the hospital, forcing it to end the AZT waiting list, deliver aerosol
pentamidine, and end the AIDS bed control. He gave the hospital 30 days to comply.

Then the hospital moved the case to the Federal court system. This time a moderate-liberal judge, with a reputation for being very thorough and fair, has been assigned.

Recently the Dallas Gay Alliance has asked the court for permission to change their pleading to a class-action lawsuit, which would include 28,000 people and have a wider impact. The ruling on this motion is pending.

This article cannot do justice to the excellent organizing and action around the Parkland hospital case by the Dallas Gay Alliance and other organizations. This work is a model for organizations elsewhere and may set important legal precedents concerning health care for AIDS and other conditions as well.

For more information, call William Waybourn, president of the Dallas Gay Alliance, (214) 748-2222.

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