THE scientist in charge of the unit handling patient X's plasma never knew it was transferred to the BTSB and being used to manufacture anti-D.
Dr Denis Reen thought the nine litres of plasma taken from her each week was simply a waste product. It had been allowed to accumulate in the hospital laboratory, he said. The first the senior biochemist at Crumlin Hospital heard of its use by the board was last April when a solicitor involved in Mrs Brigid McCole's legal case showed him records.
Asked by Mr John Rogers SC, for the McCole family and Positive Action, if he "knew nothing" about it Dr Reen replied, "Absolutely".
However, an internal BTSB memo, dated January 25th, 1977, states that a plasma exchange programme was being performed on a pregnant patient (patient X) in the cell separator unit in Crumlin.
"The BTSB is supplying fresh plasma for this procedure," the memo stated. "In return the patient's plasma containing anti-D is being given to the BTSB. Accordingly please arrange for credit to be given for the units of fresh liquid plasma supplied to the cell separator unit in Crumlin. The procedure has been in progress for the last three months of 1976 and will continue for about a further 6-8 weeks."
Patient X was the first patient to be treated with a new cell separator machine in the State.
It was used for exchanging her plasma because she was a rhesus negative mother with a rhesus positive foetus.
Dr Reen, a non-medical doctor, who was not aware of this internal memo, said he had "no direct role" in patient X's treatment.
However, he admitted that regular samples of patient X's blood had been sent to the BTSB for testing in his name. "I was the only full-time member of staff in the cell separation unit. I would have been associated with reporting to anyone outside the hospital. But I had no actual role in this procedure," said Dr Reen.
"Are you saying that these samples were sent in your name but it was no concern of yours?" asked Mr James Nugent, counsel for the tribunal.
Dr Reen said he was interested, but the person "most interested" in the well-being of the patient was her clinical consultant. It would have become "routine" to send the samples to the BTSB.
"This was the first patient ever in this country. Are you saying she became routine to you in the space of a few months?" asked Mr Nugent. Dr Reen, an immunologist who is now head of the research laboratory at Our Lady's Hospital for Sick Children, said the results would become routine very quickly.
He said he did not know about patient X's bad reaction to a transfusion on November 4th, 1976. He agreed he was aware that she had developed infective hepatitis.
He did not know who had taken the decision to mark her samples to the BTSB "infective hepatitis".
Mr Nugent said the evidence would show that the only quantitative reports being sent to the BTSB for 1976-1977 to include this detail of "infective hepatitis" were those relating to patient X.
Dr Reen did not know why no decision had been taken to discard patient X's plasma from where it was stored. He said that they may not have discarded it because she was the first such patient.
He agreed that in 1976 he would have realised that it was unsafe to use plasma from a patient who had hepatitis.