Some haemophiliacs are still receiving blood products in the State without any record of their treatment on a central register, the tribunal heard yesterday.
Dr Emer Lawlor said it was a "deficiency" that patients who needed treatment were not on a register and had not had all their tests done. She was commenting on the case of a patient at Castlebar Hospital for whom there was incomplete knowledge of his treatment history. The tribunal had no knowledge either of the patient's HIV status.
Dr Lawlor noted "quite a number of patients throughout the country are still not on registers" and said this was "surprising and disturbing".
In regard to Castlebar, she said it was "totally isolated" from other treatment centres in the State. There was no evidence of doctors there contacting the National Haemophilia Treatment Centre in Dublin or the regional centre in Galway about treatment protocols and this was "very unusual".
Only six haemophiliacs were treated there between 1970 and 1999, two of whom were transferred to Dublin as children.
One of the remaining four patients, identified by the pseudonym Liam, appeared to have been infected with HIV through commercial concentrate administered for a dental extraction in June 1983, said Dr Lawlor.
She was surprised he had been given concentrate as "there would have been some concern" about its use at that stage. Cryo was being used in preference at other hospitals for minor elective surgery.
The tribunal heard another patient at Castlebar received four batches of a commercial product, Haemofil, as cover for an appendix operation in 1987. Dr Lawlor said it was "striking" that so many batches were used together as there was a practice in other hospitals to limit one batch per person in an effort to reduce the risk of infection.
Again, there was no sign of any contact with Dublin, or of any record of the treatment being recorded on the NHTC's computer database.
Later, Dr Lawlor told the tribunal the infection of women with hepatitis C through anti-D - an occurrence which was investigated by the Finlay tribunal - had contributed to the infection of haemophiliacs.
A total of 23 women who contracted hepatitis C through anti-D were identified as donors whose blood went towards producing cryo, factor 9 and factor 8. She agreed the risk of getting hepatitis C through these products would have been less if the anti-D infection had never taken place.
