The board of the Blood Transfusion Service did not sit down at any stage in the early 1980s to consider that products it was distributing could have been connected with the AIDS virus, the tribunal heard yesterday.
Mr John Trainor SC, for the Irish Haemophilia Society, in his cross-examination of the BTSB's deputy medical director, Dr Emer Lawlor, suggested the board had given up considering whether blood products used posed a risk to haemophiliacs because when they objected previously to a licence being granted for their importation, the Department of Health still granted the licence.
Mr Trainor also suggested the BTSB was making money on the distribution of those products to hospitals and haemophilia centres in the State and it suited it not to consider the risks involved.
Dr Lawlor did not accept profit had anything to do with it. She agreed it was possible the BTSB did not consider the threat of AIDS before 1983, despite reports of the condition in haemophiliacs in medical journals in the US. She pointed out that there was no proof at the time the virus could be spread through blood products.
She said AIDS was only "a tiny black cloud on the horizon" at the time and the commonest cause of death among haemophiliacs then was bleeding.
Counsel said a patient alert was issued in the US in July 1982 by the Centre for Disease Control following a report that three haemophiliacs had developed rare and unusual infections, which turned out to be AIDS. The centre said one hypothesis was that the infectious agent might have been a virus transmitted through blood, like hepatitis.
Dr Lawlor said the BTSB would have known what was going on but the risk was unclear at the time. The HIV virus was not defined until 1983 or 1984, she said.
Counsel pointed to the different reaction to the report in the US and in the State. In July 1982 the Council of Community Blood Centres in the US set up a task force to review the information and decided to make recommendations within 30 days.
Dr Lawlor said the Centre for Disease Control in the US was not recommending any change in treatment at the time. "It's very difficult then to blame the BTSB for not doing something," she said.
She added that it was not felt the condition would be a major problem. It was only suspected that it was transmitted through blood products, which were licensed, she said.
"We were just small players trying to follow what was going on abroad," she said.
Mr Trainor asked about board members of the BTSB at the time and if they were still alive. Dr Lawlor said she did not know them all but she was not sure it would add anything by asking people to remember matters raised at meetings 18 years ago.
Mr Trainor also suggested the BTSB, in distributing these imported and contaminated blood products, would appear to have given them their seal of approval. Dr Lawlor said the BTSB was purely "warehousing".
Counsel tried to introduce a document which set out the BTSB's turnover from the distribution of these products in the late 1970s and early 1980s, but objections were raised by Mr Frank Clarke SC, for the BTSB. He said Dr Lawlor was not a numbers person but the BTSB would be happy to provide a witness who would deal with the board's finances.
Mr Clarke said the fact the BTSB charged hospitals more for commercial blood products than it bought them for did not mean it made a profit.
The tribunal chairwoman, Judge Alison Lindsay, ruled that the document could not be admitted at this stage.