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WSWS : News
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: Ireland
Irish blood bank "knowingly" risked using contaminated
products, Dublin tribunal told
By Julie Hyland
10 October 2000
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The Irish Blood Transfusion Service (BTS) knowingly risked
treating haemophiliacs with contaminated blood products during
the early 1980s, the official Lindsay Tribunal sitting in Dublin
has heard. More than 200 Irish haemophiliacs were infected with
HIV and Hepatitis C as a result, including young children. Seventy-five
of these people have since died.
Haemophilia is a hereditary condition in which the blood does
not clot normally, causing severe bleeding from even a slight
injury. In the early 1970s an injectable clotting agent was developed
made from donations by donors who had not been tested for HIV.
The blood product had also not been heat-treated to inactivate
viruses.
The Irish Haemophilia Society (IHS) said that, as a result,
220 of its 400 members became infected, 57 subsequently dying
from HIV-related diseases. On September 10, John Berry, 62, died
from liver cancer caused by contracting Hepatitis C from a clotting
agent. Mr. Berry was the third haemophiliac to die since the tribunal
was established last year, but the first since the public hearings
began in May. Mr. Berry had been given the contaminated clotting
agent after being admitted to hospital suffering from a nosebleed.
The tribunal was convened under Chairwoman Judge Alison Lindsay
to examine the sequence of events and to hear allegations against
leading officials at the BTS. The Irish Haemophilia Society agreed
to participate in the hearing after winning a dispute with the
state over the funding of its legal team and access to all tribunal
documents.
The inquiry began by hearing evidence from 22 witnesses, including
parents whose children had died. Using the pseudonym Felicity,
one mother told how three of her sons had become infected with
Hepatitis C from contaminated blood products. Her children wished
they had cancer, she said, because if they told their friends
they had Hepatitis C they would probably not be able to play with
them.
Martin testified that his son was tested for HIV
at age four, but no information of the result was relayed to him.
At a hospital meeting two years later a doctor had remarked that
the family seemed to be coping well with their counselling. When
Martin asked what counselling was being referred to
they were told that their son had been diagnosed as HIV positive
two years earlier. Their son's health had deteriorated from 1992,
when he became thin and frail before dying. I firmly believe
mistakes were knowingly made and I want to see heads on a plate
at the end of the tribunal, the boy's father said.
A widow also told the tribunal how she was diagnosed as HIV
positive three years after her husband died from an AIDS-related
illness in 1993, having contracted HIV and Hepatitis C from contaminated
blood products.
The tribunal has heard damning evidence of the disregard for
public health shown by the BTS and the state that resulted in
such fatalities. In testimony presented by former BTS executives
and medical experts it has emerged that the blood bank continued
to sell infected blood products to Irish hospitals even when concerns
had been voiced as to their safety.
Before 1974 haemophiliacs used the clotting agent cyroprecipitate
to stop bleeds. However, a concentrated agent produced by US-based
Travenol Laboratories was found to enter the bloodstream faster
and significantly reduce the time spent in hospital. A 1974 memo
presented to the tribunal revealed that Jack O'Riordan, then BTS
national director, had objected to the Travenol agent being given
a license on the grounds that the product was derived from skid-row
types paid for donating their blood.
However Travenol was granted a license and later that year
Dr. O'Riordan began negotiations with the company for the blood
bank to act as its wholesaler and distributor in Ireland.
A letter from April 1974 recorded an agreement that BTS would
get a 10 percent return on all products it sold and would be able
to mark up the units it sold to hospitals. The BTS continued to
buy clotting agents from Travenol through the early 1980s, even
when it became clear that the company was failing to implement
standard heat-treating procedures.
It has been alleged that in the early 1980s BTS discontinued
a drive to produce its own blood products because it could make
larger profits using commercial products. The tribunal heard that
BTS faced a major funding crisis at that time. Mr. McStay, a receiver
hired by BTS to analyse its accounts, told the hearing that Pelican
House (BTS headquarters) was effectively insolvent in 1981 and
would have been liquidated if it was a commercial company.
Banks were refusing to honour Pelican House cheques and nearly
£1 million was needed to avert a total financial breakdown.
In the late 1980s, to cut costs, BTS had reduced the number of
full-time medical consultants it employed by two-thirdsleaving
just one consultant for the entire country. Over the same period,
revenue from haemophiliac blood products grew steadily to account
for 26 percent of Pelican House total income by 1990.
By 1984 there were strong indications that HIV was being transmitted
to haemophiliacs through blood products. There had been a three-fold
increase in the number of haemophiliacs contracting Hepatitis
B, deemed to indicate the presence of HIV, for which no test then
existed.
In January 1986 the Department of Health had issued a circular
stressing that it was imperative that all blood products
made from donations not tested for HIV be withdrawn. This followed
an EEC directive that all blood banks were subject to product
liability claims in the case of contamination from infected blood.
BTS agreed to change the heating procedure for its Factor 9 clotting
agent, but did not recall its old products from hospitals.
The tribunal also heard that in 1988 Armour Pharmaceuticals,
another supplier of blood products, announced it would be changing
its manufacturing procedures for safety reasons, with a consequent
doubling of prices. However, Pelican House asked Armour to continue
with the old method until the end of year and Mr O'Riordan's successor,
Ted Keyes, signed a document indemnifying Armour. Although there
is no evidence that any person was infected with hepatitis from
the blood product following the indemnity, a Pelican House clotting
agent made from a by-product of the Armour process infected two
children from the same family with Hepatitis C.
Throughout the late 1980s BTS did not contact haemophiliacs
who tested positive for HIV, even though it had powerful
evidence that a blood product made by Pelican House was
responsible, the tribunal was told. They had also dismissed IHS
charges that BTS blood products had caused HIV infection even
though they knew it to be true.
The tribunal also heard that Sean Hanratty, former Chief Technical
Officer at the BTSB, was a director and beneficial shareholder
with Accu-Science, a company that sold products to Pelican House
throughout the 1980s. Hanratty had invested in Accu-science, whose
subsidiary company Intrascience received the contract for the
supply of blood packs to the board in 1990. Hanratty is said to
have subsequently resigned his directorship and transferred his
shares, but the hearing was told that Hanratty was held responsible
for the destruction of 20 years of BTS records in 1993 that were
crucial to efforts by infected haemophiliacs to sue the pharmaceutical
firms.
However, the tribunal so far has shown no interest in pursuing
the mainly US-based pharmaceutical firms. In her opening remarks
Judge Lindsay made no inference as to what inquiries would be
made into the companies' involvement, despite there being a considerable
amount of material relating to this in the US following civil
law suits.
The judge also ruled that three documentary World In Action
programmes would not be viewed in public at the tribunal. The
World in Action programmes, two of which were transmitted
as part of a series in 1975, investigated how US blood companies
screened blood donors who were being paid for donations and the
risk of blood products being infected with hepatitis.
The programmes make serious charges against US blood companies,
and were clearly relevant, John Trainor, senior counsel
for the Haemophilia Society, had argued. The decision by BTS to
continue dealing with Travenol even after the broadcasts was an
act of irresponsible madness, he said. Judge Lindsay
dismissed the application, ruling that the documentary comprised
allegations rather than fact and that their viewing could blur
issues. However, she did order that transcripts of the programme
be made available and that the allegations could then be put to
any witness.
Both Hanratty and O'Riardon are now deceased. An earlier public
hearing, the Finlay Tribunal, had held O'Riardon primarily responsible
for the fact that a number of women had become infected with Hepatitis
C from anti-D, a contaminated blood product produced by the BTS.
An estimated 1,600 people were infected in the 1980s, the majority
of them women who required the anti-D immunoglobulin during pregnancy.
Others infected included haemophiliacs, those who received blood
transfusions, and people with kidney problems.
The tribunal is continuing.
See Also:
Australian schoolgirl
contracts HIV via blood transfusion
[13 August 1999]
French HIV-tainted
blood trial
Court acquits former prime minister
[12 March 1999]
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