TWO Dublin doctors said yesterday that both had become convinced as far back as 1977 that hepatitis-like symptoms in their patients were linked to anti-D treatment.
Dr Dermot Carroll and Dr Garrett May were giving evidence on the second day of the Tribunal of Inquiry into the hepatitis C scandal, which continued in Dublin yesterday.
Dr Carroll, who had been a GP in Clontarf, Dublin, during 1977, said patient M McG had attended his surgery on July 18th, 1977, with symptoms of mild jaundice. Tests he conducted indicated it was not hepatitis A, and there were no reports of any incidence of hepatitis A in the area. (Hepatitis A is a milder form of jaundice which is highly infectious and usually occurs in "clusters"). By August 23rd, the patient had become "very seriously jaundiced."
He knew she had received an anti-D injection at the Rotunda Hospital, Dublin, on May 29th that year, and felt the matter was "worth further investigation".
He notified the hospital about his concerns, and also informed the Blood Transfusion Service Board. He "may have spoken to Dr Walsh", then a senior staff member at the BTSB. He also sent Mrs M McG to see Mr John Lennon, a gastro-entrologist at the Mater Hospital.
A letter, dated October 4th, 1977, from Mr Lennon to Dr Carroll said that Dr Walsh of the BTSB had also been contacted by his staff at the Mater Hospital on the issue, "following up your suggestion concerning the anti-D injection". Dr Carroll said he also contacted the Eastern Health Board, as he is obliged to where all notifiable diseases are concerned.
At the time Dr Carroll was also a locum at St Joseph's Hospital in Raheny, Dublin, where he met two other GPs, Dr Garret May and Dr Sean O'Toole, who had being treating cases similar to Mrs M McG, also on the north side of the city. Some of their patients had also received anti-D injections some time beforehand, and there were no indications of an outbreak of hepatitis A.
Dr Carroll told Mr Rory Brady SC for the tribunal, that he was not aware then the affected mothers had been treated from the same anti-D batch at the Rotunda. "I only learned recently it was batch 238," he said. He continued to treat the patient who suffered "profound fatigue". When contacted about the national screening programme for such patients in 1994, he was not told by the BTSB about any link between it and his 1977 diagnosis.
Dr Garrett May, a doctor in Portmarnock, Co Dublin, who was also a house doctor at St Joseph's in 1977, said his patient, SB, received anti-D from batch 238, at the Coombe Hospital on June 24th 1977. He told Ms Dora Foynes, barrister for the tribunal, that SB attended him on July 31st with symptoms of jaundice.
He had heard of similar cases from Dr O'Toole "and felt there could possibly be an anti-D connection". He arranged for blood samples to be sent to the BTSB and the laboratory at Jervis Street Hospital. SB had gone in to the BTSB to give blood for the test.
He also sent her to Dr Weir, a gastro-entrologist and liver specialist at Sir Patrick Dun's Hospital, Dublin, on September 28th, 1977.
In a letter dated the same day, Dr Weir assured him there was no longer any real problem. It was concluded SB had had hepatitis A and recovered.
In 1994, when the hepatitis C scandal came to light, Dr May discovered from solicitors' documents that SB's blood had been stored at the Middlesex Hospital in London since 1991. When analysed (in 1994) it was discovered to be hepatitis C positive. It was concluded SB had "serio-converted" (overcome the disease naturally).
Dr May also spoke of CR another patient of his who had received anti-D at Holles Street Hospital on October 26th, 1977. He saw her before Christmas, when she was jaundiced. By then he "was convinced there just had to be a connection with anti-D". He contacted Dr J.P. O'Riordan, chief medical consultant at the BTSB, and said there might be a problem with the anti-D. Dr O'Riordan, he recalled, "didn't think so, but said he would look into it".
Tests in all the cases had indicated they were hepatitis B negative.
Dr May agreed with Mr Donal O'Donnell SC, for the BTSB, that no further cases had been reported between then and 1994.