 With symptoms advancing, Acer's work began to get sloppy, prompting other patients to take notice that he was reusing gloves and other disposable components, not sterilizing instruments, and taking shortcuts that put patient safety in jeopardy.Acer also began showing lesions on his skin, prompting him to wear long sleeves and buttoned collars, regardless of the weather.By early 1989, Acer's symptoms worsened, with frequent coughing, blurred vision and more lesions appearing on his skin.