A man admitted to a Dublin hospital for a minor operation in 1984 had his treatment inexplicably changed days after surgery and the change resulted in his contracting HIV, it emerged at the tribunal yesterday.
The man, being referred to by the pseudonym Declan, also contracted hepatitis C, and has since died.
A mild haemophiliac, he was admitted to St James's Hospital in May 1984 to have an ingrown hair removed from the base of his spine.
Opening Declan's medical records, counsel for the tribunal, Mr John Finlay SC, said it was recorded that a product from the Blood Transfusion Service Board called cryoprecipitate or cryo would be used to curb bleeding during the operation.
Cryo was used during the operation on April 30th, 1984, and it was noted on his chart that he should be given cryo daily for one week. But three days later a note on the records said: "Cryoprecipitate stopped. Factor 8 concentrate now in use. Wound clean, healing nicely".
Factor 8 concentrate was an imported clotting agent made from large pools of plasma from paid blood donors. It carried a greater risk of infection than an Irish-made product made from the plasma of voluntary donors.
Prof Ian Temperley, former director of the National Haemophilia Treatment Centre, had drawn up guidelines in late 1983 which stipulated that mild haemophiliacs should be given cryo during minor operations.
However, in evidence yesterday, Prof Temperley said this policy obviously was not adhered to in Declan's case and nobody consulted him about acting contrary to it.
Mr Finlay put it to him that there was no note of a change in the patient's condition which would have necessitated different treatment. Prof Temperley agreed.
Declan's wife, referred to by the tribunal as Deirdre to protect her anonymity, gave evidence to the tribunal last December. She said her husband had been tested for HIV by Prof Temperley without his consent, and before being given the test results, they were given the all-clear by Prof Temperley to start a family. Prof Temperley will be asked to respond to these allegations at a later stage.
Prof Temperley was questioned yesterday about the medical records of children who developed HIV and whether their treatment with imported concentrates in the 1980s was justified, having regard to the perceived risks of HIV at the time.
One set of records related to a three-year-old boy, referred to as Adam, who was given Hemofil, a factor 8 concentrate, in February 1983. He contracted HIV and died.
Prof Temperley said the boy, who had severe haemophilia, presented with a major bleed into his hip. He said at that time it was preferable to give concentrates to children as it could be difficult to give them cryo.
Mr Finlay also opened the medical records of a child, referred to by the pseudonym Bernard, who was a severe haemophiliac diagnosed HIV positive at the age of two. He was given Hemofil for a head injury in April 1983.
Prof Temperley said he felt this was appropriate because there was a danger he might bleed into the skull. However, when questioned further he said it was a "toss up" at the time as to whether a child like this would be given cryo or concentrates.
Asked by Mr Finlay if the injury could have been dealt with by cryo, Prof Temperley conceded that it probably could.