Nurse Cut by Scalpel Names HIV-Positive Patient, Who Countersues : AIDS: The doctor’s aide said the woman secretly exposed her to the virus. The infected person is angry that her identity and condition have been made public.

In an unusual case that promises to further complicate the issue of AIDS in the doctor’s office, a nurse and a cosmetic surgery patient are suing each other over claims that the patient secretly exposed the nurse to the virus.

Nurse Diane Boulais last month sued patient Jan Lustig in Los Angeles Superior Court. She asserts that Lustig knew she was HIV-positive but kept quiet about it until after the nurse cut her finger on a scalpel during a medical procedure.

Lustig, angry that her identity and condition were made public in the suit, this week filed a countersuit against Boulais, saying that the nurse at the Breast Center in Van Nuys was “malicious.”

“The only reason to name me was to get back at me because she felt angry at having been exposed,” Lustig said at a press conference Tuesday.

Lustig also argued that Boulais and the plastic surgeon, Dr. Neal Handel, put themselves at risk by not wearing surgical gloves while working on her, in violation of accepted medical guidelines.

Boulais vs. Lustig represents a novel flip side of recent efforts to force disclosure by HIV-positive medical professionals, and is likely to become part of the debate over whether confidentiality rights must sometimes yield to other rights in AIDS-related situations.

“It is difficult to imagine a legal case that could contain more issues which affect our clients than this one,” said Mark Senak, director of client services for AIDS Project Los Angeles, a nonprofit service and education organization that supports Lustig’s countersuit.

Lustig is also backed by Lambda Legal Defense and Education Fund, a national public-interest law firm specializing in sexual orientation cases, and the activist group ACT-UP (AIDS Coalition to Unleash Power).

Lustig’s attorney, John Duran, said Boulais could have filed her lawsuit without naming the patient, simply by listing her as Jane Doe. Boulais’ attorney Rex Beabersaid Lustig’s countersuit has no merit since state law restricts the use of “Doe” to child abuse cases and a few other limited circumstances.

“No case . . . anywhere in America has ever required that the victim of wrongdoing protect the wrongdoer,” he added. In her suit, Boulais accuses Lustig of fraud, deceit and intentional and negligent infliction of emotional distress.

Lustig, a psychologist and AIDS counselor who recently moved from Los Angeles to Vancouver, Wash., does not deny that she concealed her medical condition from Handel until after the accident with the scalpel. She has known she is HIV-positive since 1987.

She and Boulais disagree, however, over whether the nurse was in fact endangered. Lustig maintains that none of her blood was on Handel’s scalpel when he accidentally nicked Boulais’ finger. But attorney Roy L. Schultz, also representing Boulais, contended that it is far from certain that the instrument was blood-free.

Although his client has tested negative for the AIDS virus, it is possible that the virus “may not manifest itself for a period of months or longer,” he said

Federal officials say the risk of contracting AIDS from a single exposure to contaminated blood in a medical setting is extremely low, ranging from 1 in 41,667 to 1 in 416,667, according to figures released in January by the Centers for Disease Control.

At Tuesday’s news conference at the office of AIDS Project Los Angeles, Lustig, 44, said she kept her condition secret from Handel when he performed breast reduction surgery on her last December for fear that “either I would be refused or I would be treated in such a way that would make me uncomfortable.”

When she returned to have her stitches removed, Lustig said, she heard Boulais say “ouch” and then realized that neither the nurse nor the doctor was wearing surgical gloves.

Lustig said she questioned Handel about why he failed to abide by precautions formally recommended four years ago by the Centers for Disease Control. According to her, he responded: “I know I’m being really lax, but you don’t have AIDS, do you?”

After the doctor suggested she take an AIDS test, she revealed she was HIV-positive.

Beaber said gloves would have been a useless precaution since the scalpel would have ripped right through the thin rubber.

He said health-care workers need to be apprised if a patient is HIV-positive so they can take other precautions.