DR Joan Power, regional director of the Blood Transfusion Service Board for Munster, yesterday agreed that Donor L had tested positive five times by December 1992 and was not told anything about these tests or their results for another year.
Replying to Mr James Nugent SC, at the tribunal of inquiry into the hepatitis C scandal, she said repeated tests of the kind used did not prove he was positive and more sophisticated tests were needed.
She agreed that outside the Munster area it was BTSB policy to immediately inform donors who tested positive.
"When you decided to go on a different path to Dr (Terry) Walsh, the chief medical consultant (at the BTSB), your superior, it must have been a major decision?" suggested Mr Nugent, counsel for the tribunal.
"It was a significant decision," Dr Power replied. She said only about half of those notified that they were positive in the rest of Ireland came forward for further, tests. There was "not a great level of feedback".
Mr Nugent: (That was) their decision?
Dr Power: Yes.
The case of Donor L was unique", she said, as "on average most donors in the Munster region were told after they had tested hepatitis C positive for the second time. And though she did not remember her discussions with Donor L in December 1993, she felt sure she would have spoken to him about all the previous tests, as that would have been her practice.
She explained what she termed the "dilemma" she was placed in when donors tested positive under the tests available then. Her research had indicated that just one in "six or seven" of those who, tested positive went on to be confirmed positive. The rest were "false positives".
She had deferred telling people in the hope that more sophisticated and reliable tests would soon be available. Apart from causing people possibly unnecessary alarm, it would be difficult to provide effective counselling with so little information.
The reason people were tested twice before being told was that it was possible they could be normal on a subsequent test. Cards posted to Donor L inviting him to give blood again and again, even after he had tested positive, would have been "sent out automatically," she, said. Blood left over after tests had shown he was positive was discarded."
She "clearly disagreed" with the views of the then chief medical officer of the Department of Health, Dr Niall Tierney, and Dr Rosemary Boothman, a consultant in the Department who was also on the BTSB board, that there were no ethical grounds for introducing screening at an earlier stage due to lack of concrete information.
Dr John Bowman, a medical director of the RH Laboratory at the Winnipeg RH Institute in Canada, told the tribunal that over one million doses of anti-D had been administered by the institute since the late 1960s with a 97 per cent success rate and not a single reported case of viral infection.
He agreed that in any production system the degree of monitoring of donors was of critical importance.
The plasma they used in manufacturing anti-D was never taken from donors undergoing a plasma exchange programme, he said.
