A consultant haematologist at University College Hospital, Galway, yesterday said it was "inconceivable" that he did not tell the BTSB of a positive HIV test result on one of his patients within a week of his learning of it.
Prof Ernest Egan told the tribunal that he had no direct recollection of informing the Blood Bank of the case, but it was "just too bizarre that one wouldn't".
He was being questioned about his response to the discovery in January 1986 that a patient of his, given the pseudonym Fionn, had been infected with the AIDS virus through BTSB-made cryoprecipitate.
Prof Egan said a blood sample was taken for testing on October 16th 1985, in the same month the BTSB started screening donors for HIV. The result raised a "suspicion of positivity", which made a repeat test necessary.
Another blood sample was taken on November 29th 1985 and a positive test result was reported on January 6th 1986.
Prof Egan said that this naturally raised concern about the product used by Fionn, although the fact that Fionn was the first and only haemophiliac in the State to be infected through BTSB cryo was not apparent to him at the time.
He wrote to Dr Terry Walsh, of the BTSB, on January 14th 1986, requesting the replacement of all stocks of unscreened cryo with product sourced from HIV-screened donors. The letter referred to a telephone conversation the previous day, and Prof Egan said he could not imagine not discussing Fionn's case with Dr Walsh at this time.
He noted, however, that Fionn's case was one of a "constellation" of issues he was concerned about at the time, including the non-availability in Galway of factor 9 which had been heat-treated to guard against HIV. He said he found they were "out of line" with other treatment centres and he wished to be brought into line, particularly with the National Haemophilia Treatment Centre, of which Prof Ian Temperley was medical director.
Prof Egan said Prof Tem perley would also have received a copy of Fionn's test result and it was highly unlikely that they did not discuss the case. He said Fionn was informed of his HIV-positive status in Dublin and he [Prof Egan] subsequently lost clinical control over the patient.
On communication between hospitals, Prof Egan said no formal mechanism was ever put in place and the idea of a national network of centres headed by the NHTC "did not exist".
He sought advice from Prof Temperley on occasions and gave advice to other hospitals in the Western Health Board area. If anyone had a formal responsibility to inform him about product safety, however, it would have been the BTSB rather than Prof Temperley.
Prof Temperley was a person "we would all admire greatly", Prof Egan said. He held this view despite their disagreement over moves to centralise services in Dublin and his [Prof Egan's] non-co-operation with setting up a national register of haemophilia treatment.
Prof Egan said he did not believe this disagreement interfered with patient care or the development of services. His objection to the register was that he felt it meant he was "surrendering" his patients to the Dublin centre.
