The head of haemophilia treatment services in Cork has blamed poor record-keeping for allowing one of her patients to go untested for hepatitis C despite the fact that he had developed symptoms of the disease.
On her final day in the witness box, Dr Paule Cotter, consultant haematologist at Cork University Hospital, told the Lindsay tribunal she was sorry the patient, given the pseudonym Oliver, was missed but it was because "our records were not satisfactory".
She admitted both the records of treatments administered to patients and the patient records themselves were inadequate.
Dr Cotter said attempts were made in 1995 to contact all patients at risk of being infected for testing. However, Oliver seemed to have "slipped through". The tribunal heard that Oliver discovered he had hepatitis C only after referring himself to a GP in 1997.
Mr Raymond Bradley, solicitor for the Irish Haemophilia Society, noted the patient's medical records showed he had jaundice in June 1982 shortly after a treatment of concentrate, and that this was a classic sign of hepatitis infection. Mr Bradley put it to Dr Cotter that had any effort been made to examine Oliver's records he would have been identified as in need of testing.
Dr Cotter said the patient's chart did not seem to have been examined at the time.
Later, she defended her decision to use concentrates rather than cryoprecipitate - a safer but more unwieldy product - in the treatment of a number of mild haemophiliacs.
Regarding Mr Gerard Healy, a mild haemophilia A patient from Greenmount in Cork city, Dr Cotter said it was felt the use of concentrates in home treatment provided significant advantages in terms of improving his quality of life.
She said it was never her practice to give concentrate in a situation where cryo was appro priate, and she admitted non-A non-B hepatitis - as hepatitis C was known - was a concern. However, she said, it was not seen as a serious illness at the time.
She noted Mr Healy was transferred on to home treatment in 1981, two years before guidelines had been drawn up recommending mild haemophiliacs be kept off commercial concentrates.
Mr Healy was infected with HIV through factor 8 concentrate and died in 1998.
In the case of Louis, the tribunal heard he was infected through concentrate received in November 1982 as a two-year old after being admitted to hospital following an accident. Medical records showed the product was given to him three days after he was admitted.
Asked why concentrate was given, Dr Cotter said she had become concerned that the patient's bleeding had not stopped and there were fears internal bleeding might have occurred.
Asked whether any effort was made to administer cryo, she replied: "I can't recall."
The tribunal was adjourned until April 24th.
