THE Department of Health had equated the terms "infective hepatitis" and "jaundice" since the outbreak of the hepatitis C scandal, an official told the tribunal of inquiry yesterday.
Mr Donal Devitt, a department assistant secretary who has dealt directly with the scandal since February 1994, said use of the two terms had been synonymous: he denied that discovery of a file last year which referred to patient X as having "infectious hepatitis" was the first time he learned of the woman's condition.
He said a letter in February 1994 from Mr Ted Keyes, former chief executive officer of the Blood Transfusion Service Board (BTSB), referring to a jaundice diagnosis "was equal to a diagnosis of infective hepatitis".
"But since spring 1996, infective hepatitis has taken on a life of its own," he said.
But it was not until February 1996 that he learned that the BTSB knew in 1976 that patient X had been clinically diagnosed with infective hepatitis.
Use of blood donations from such a patient was a breach of BTSB procedures, in place since 1968. He had informed the Expert Group of this, he said.
He said senior BTSB staff failed to co-operate with the Miriam Hederman O'Brien Expert Group in its initial investigations.
Before the scandal broke, on February 17th, 1994, there had been "rumblings in the undergrowth" a day or two beforehand, he said.
He agreed with Mr Paul Gallagher SC, counsel for the BTSB, that a note two days previously, on February 15th, from Dr Rosemary Boothman, a BTSB board member, had "information about a problem with the 1977 anti-D". He did not pay any attention to it until the night of February 17th because a colleague had died suddenly and he had left the note in his office. He agreed he had read it at the time.
That month he also learned of anti-D batches relating to a 1989 donor (patient Y) testing positive for hepatitis C, but it had been "downplayed" by the BTSB at the time.
He understood that criticisms contained in the Expert Group report of queries which required "considerable supplementary probing" related to BTSB senior staff on the medical and technical side.
"There were, apparently, difficulties, I would have to say ... in terms of extracting the clinical information from the events of 1977," he said.
He named the former BTSB national director, Dr Terry Walsh, as one of the senior staff with whom there was a difficulty with "information co-operation". Extracting the information and the "uncertainty of relying on the information" were the problems.
"Were the senior staff employed in 1977?" asked Mr Rory Brady SC, for the tribunal. "Yes, I was going back to people who were there in 1994 and were there in 1976, 1977," Mr Devitt said.
But in the autumn of 1994, with the appointment of a new chairman, Mr Joseph Holloway, that had changed. "There was a new chairman and a significant improvement took place following that in terms of flow of information and co-operation."
He said that following the implementation of recommendations contained in the Expert Group report, available to the Minister in January 1995, and the Bain & Co consultancy report of May 1995, there had been a "sea change" at the BTSB.
Asked about the foolhardiness of leaving the response to the scandal to the BTSB, "given the enormity of the incident", he said: "In an ideal world, things would have been different.