DISCUSSION at the tribunal yesterday centred on the three mothers infected from an anti-D batch at the Rotunda in 1977.
Prof Lewillis Barker from the US, an expert on virology, agreed he would have "reassessed everything" had he been at the BTSB and heard such reports at the time. Pressed by Mr James Nugent SC, for the tribunal, he agreed "a programme of action should have been undertaken" when information came to light.
Two Dublin doctors told the tribunal they became suspicious of BTSB manufactured anti-D when some of their patients developed inexplicable jaundice-like symptoms in 1977. Dr Dermot Carroll and Dr Garrett May said the cases were not related to any outbreak of hepatitis A. Tests had cleared them of hepatitis B and yet some of them continued to show chronic symptoms.
What their patients all had in common was injections during the previous months with anti-D.
Dr Denis Reen, senior biochemist at Crumlin Hospital when patient X was being treated there on a plasma exchange programme in
1976-1977, could not explain how 54 litres of her plasma was used by the BTSB.
He was aware approaches were made to the BTSB about using the plasma, mitigating her treatment costs, but thought this had been rejected. Nor could he explain how the plasma, stored in one litre and two-litre bottles at Crumlin, came to be put into 600 ml packs before going to the BTSB.
In fact, the first time Dr Reen became aware the BTSB had been using patient X's plasma was in April this year when shown records by the legal team preparing Mrs Brigid McCole's High Court challenge.
Dr Eamon McGuinness, patient X's gynaecologist, explained they had agreed to try the plasma treatment for her next pregnancy after she had had a miscarriage. They commenced the plasma exchange at Crumlin on September 28th, 1976, eight weeks into pregnancy.
On the "14/15th week (November 4th) of gestation" it was noticed she was jaundiced. "Her plasma was distinctively green," he recalled, "not the usual buff, brownish tinge."
The plasma programme was suspended for a week. He remembered discussing the matter with Dr Walsh at the BTSB, by phone.
Dr McGuinness did not become aware the BTSB had used patient X's plasma until 1994. Dr Walsh said neither he nor the BTSB were told patient X was jaundiced.
Dr McGuinness was "shocked" at this, and demanded both go to the Minister for Health.
Later that evening Dr McGuinness spoke to colleagues who assured him of their recollection also that the BTSB and Dr Walsh had been told. That night Dr Walsh rang to apologise, and said the BTSB had been informed.