Haemophiliacs were led to believe that from January 1985 they would receive only heat-treated blood products that were safe from HIV when, in fact, untreated products were administered for at least another year, the tribunal heard yesterday.
Mr Brian O'Mahony, chairman of the Irish Haemophilia Society, said he inferred from a letter to the society from Prof Ian Temperley, medical director of the National Haemophilia Treatment Centre, that both imported and Pelican House-made products would be heat-treated from the start of 1985.
In reality, however, untreated products continued to be issued by the Blood Transfusion Service Board until December 1985. Untreated Factor 9 continued to be used by haemophiliacs until at least February 1986, infecting seven haemophilia B patients.
The letter from Prof Temperley, dated January 3rd, 1985, noted that recent research had suggested heat-treatment eliminated the risk of AIDS. For that reason, Prof Temperley said, the Dublin and Cork treatment centres were recalling all Factor 8 concentrates in early January 1985 and replacing stocks with heat-treated material.
The letter followed the discovery in November 1984 of the first positive test for HIV in a haemophiliac - a patient at St James's Hospital, Dublin.
Mr O'Mahony said he was shocked to hear of the case, as until then AIDS was regarded only as a "theoretical risk".
He said Prof Temperley's letter went towards drafting a circular which was immediately issued to all haemophiliacs.
Asked whether the IHS contacted the BTSB to see whether it was heat-treating all its products, Mr O'Mahony said it did not as the indication from Prof Temperley was that only treated material would be used.
He stressed the society would have raised concerns about product safety but ultimately it would have expected Prof Temperley and the BTSB to give haemophiliacs the safety product available.
He noted BTSB officials such as Dr Jack O'Riordan, the national director, and Mr Sean Hanratty, the chief technical officer, were "almost revered" by the IHS. Similarly, Mr O'Mahony said "a great deal of trust" was placed in Prof Temperley's knowledge of blood products.
Earlier, Mr O'Mahony was questioned about a conversation he had with Mr Hanratty in May 1983 at which he expressed concern about the continued use of imported concentrates and the failure to obtain self-sufficiency in blood products.
In a note of the conversation, Mr O'Mahony said Mr Hanratty recommended he discussed the matter with Prof Temperley but was "not to quote him".
Mr O'Mahony said he understood from this that if he contacted Prof Temperley he, in turn, might talk to Dr O'Riordan and, it might push the issue up the "priority list" of the BTSB.
Mr O'Mahony said he was concerned about the "seemingly slow pace" of progress in the BTSB on a project to make concentrates for haemophiliacs at Pelican House. To push the issue forward, Mr O'Mahony wrote to Dr O'Riordan in November 1983 seeking information on how much Factor 8 and Factor 9 was imported and how much each product costed.
He said Dr O'Riordan phoned him to say he might get the information from Prof Temperley but that Dr O'Riordan would not supply it.
