The doctor who led treatment provision for haemophiliacs in the State in mid-1985 told the Blood Transfusion Service Board she had reservations about its choice of pharmaceutical company to supply blood-clotting agents for haemophiliacs, but her comments were ignored, the Lindsay tribunal heard yesterday.
Dr Helena Daly, on her second day in the witness box, said she was surprised when the BTSB told her it had contracted Travenol to make factor concentrates from Irish plasma from January 1st, 1986. She expressed her views to the then national director of the BTSB, Dr Jack O'Riordan, and its senior technical officer, Mr Sean Hanratty. "I think they felt I was interfering," she said.
Dr Daly said there had been problems with Travenol products transmitting hepatitis B. She was also surprised that the plan was to get Travenol to supply 80 per cent of the needs of Irish haemophiliacs with heat-treated products while the rest would get non-heat-treated products. She regarded this as unacceptable.
The contract was discussed when she went to Pelican House in August 1985 to ask for the heat-treatment of all blood products for haemophiliacs. BTSB officials did not seem to think this was necessary, and she came away "deflated".
She said that when she suggested to Dr O'Riordan that the BTSB stop issuing its Factor 9 until it could be heat-treated, and in the interim doctors could use heat-treated product supplied by commercial companies, he got very angry. "That was not at all acceptable to him," she said.
She felt the BTSB must have known the importance of heat-treating products by mid-1985, by which time she had arrived in Ireland from Bristol to work as a locum consultant for Prof Ian Temperley, former director of the National Haemophilia Treatment Centre, who was on sabbatical in London for three months.
She said she had treated the first haemophiliac in Britain who died of AIDS before arriving in Ireland, and it was obvious something in the factor concentrates he received gave it to him. "I knew it killed one of my patients and I never wanted to see that happen again. One was too many," she said.
Cross-examined by counsel for the Irish Haemophilia Society, Mr Jim McCullough, she said her reference in documents to it being "unethical" to use non-heat-treated products in August 1985 was an overstatement as it was also considered unethical not to treat at all.
She said it was strongly emphasised at the time that patients should not go without urgently needed therapy if heat-treated concentrate was unavailable, because a serious bleed could prove fatal.
"The advice was to continue to treat patients with the best available product until sufficient heat-treated products were available. This created a terrible dilemma for patients and their treaters. Some patients were reluctant to attend the centre for therapy. Some went without treatment," she said.
Concluding her evidence, Dr Daly said her intervention to try and get heat-treated products was an "uphill struggle" and "unfortunately, it was not enough".