THE story was "an appalling one said Mr James Nugent SC, in his opening address to the tribunal of inquiry into the hepatitis C scandal yesterday. He would present "an undisputed story" as to the "when, where, how, who, and in what circumstances anti D became infected with the hepatitis C virus." The "why" was a matter for you, he said to the chairman, Mr Justice Finlay.
Mr Nugent, senior counsel for the tribunal of inquiry, outlined the uses of the anti D blood product in the treatment of rhesus negative mothers with rhesus positive babies. He said that such births accounted for about 5,000 a year in this State, or 8.3 per cent making it "a quite significant problem.
He detailed the background to the setting up and structure of the Blood Transfusion Service Board (BTSB) in 1965.
During the relevant period the BTSB chief medical consultants were Dr John P. O'Riordan and his successor, Dr Terry Walsh. Dr J.L. Wilkinson was assistant medical officer. The head of the fractionation department, which dealt with the manufacture of blood products, including anti D, was Ms Cecily Cunningham.
Mr Nugent examined the history of the development of technology necessary to make the antiD product from the 1940s, and its refinement into a powder form for intravenous injection.
By the late 1960s, he said, the BTSB was anxious to make the State self sufficient in anti D, and in October 1970 a laboratory was set up under Ms Cunningham's supervision to manufacture it.
In 1972 donor "AF" became the first plasma exchange patient in Ireland, with his/her plasma used in the anti D manufacturing process.
Also in 1972 the process of extracting anti D was advanced by a Prof Hoppe in Hamburg it was recommended that donations be quarantined for six months, during which the donor should be repeatedly tested. Prof Hoppe abandoned the "ethanol precipitation" part of the old method, as he considered it did not have any particular effect in preventing infection of the blood product, and he feared possible toxic effects from the ethanol.
"For some reason," Mr Nugent said, the BTSB decided to stay with the original method and not to take on the Hoppe modification. In effect in 1972 they abandoned the instructor, and decided to fly solo."
On donor eligibility, Mr Nugent drew attention to BTSB inter departmental memos from 1968, including notes for the guidance of medical officers" from 1972, pointing out that volunteers who had jaundice could not be accepted as donors. They were to be excluded permanently."
The only exceptions were to be in cases of babies who developed neo natal jaundice.
