MR JAMES Nugent SC, for the tribunal of inquiry, drew attention to correspondence between the BTSB and Middlesex Hospital, London, concerning queries about the patient X case in 1977. He described a letter from Dr D. S. Dane at Middlesex Hospital as "very significant" and at best "a guarded certificate" for continued use of the product.
Middlesex Hospital had been sent blood samples from patient X to test for hepatitis B and "for the positive presence of an organism other than the hepatitis B virus".
On September 2nd, 1977, Dr Dane replied there was no evidence of hepatitis B being present in the sample, but they had "frozen the specimens away for future reference; if and when any test is developed which is likely to solve the mystery we will take them out again".
On April 12th, 1978 Mr J. Craske, a consultant virologist at Withington Hospital, Manchester, wrote to Dr J. P. O'Riordan at the BTSB asking about the "interesting outbreak of non B hepatitis associated with a batch of anti D immunoglobulin" it had there. He asked fir details in connection with research he was doing into transfusion hepatitis.
In his reply to Dr Craske on May 3rd, 1978, Dr O'Riordan said six women who had received anti D were reported to have developed "clinical icteric hepatitis" following receipt of the product. Mr Nugent pointed out that the number of women infected at the time was "seven, and maybe more".
Dr O'Riordan continued in his letter that "all had reverted to normal after 28 days". "Not correct Mr Nugent told the tribunal and it was "not true" for Dr O'Riordan to say that patients infected were linked by geographic location, as he indicated, or that one patient "had developed abnormal liver function tests during the course of her treatment".
Mr Nugent also drew attention to a letter sent by Dr O'Riordan to Dr John Watt of the Scottish Blood Transfusion Service on January 13th, 1984. "If one is satisfied that replies to those letters were misleading, the tribunal has to ask why," Mr Nugent said.
Earlier, he mentioned an event at the BTSB in 1975, which a former BTSB biochemist, Dr Stephen O'Sullivan, believes was the infection of the anti D product with hepatitis C. Mr Nugent suggested that in the light of subsequent knowledge Dr O'Sullivan's belief might not be well founded. "But at the same time I think it is relevant to the whole story," he said.
Dr O'Sullivan would tell the tribunal, Mr Nugent said, that on some date in 1975 Ms Cecily Cunningham, head of the fractionation (blood product manufacturing) laboratory, took a stock of blood plasma from a freezer and brought it to the hepatitis testing laboratory, in violation of strict procedures "and thereby exposing it to the risk of infection".
Dr O'Sullivan had created "quite a stir" about this and said there was nothing for it but the destruction of all the plasma. He understood this was done, but later found out that only the outer wrappings on the bottles in which the plasma was stored, were destroyed, and that the plasma had been used.