The former medical director of the National Haemophilia Treatment Centre told the tribunal yesterday that, in hindsight, he should have recommended in late 1985 that Factor 9 made by Pelican House should not be used until heat-treated to guard against HIV.
Prof Ian Temperley described as a "rather unfortunate statement" a recommendation attributed to him in a letter dated August 21st, 1985, that untreated material be used until November that year.
He should have recommended that the use of all non-heat-treated factor 9 should be stopped, he said, although "it's easy in hindsight to say that".
The tribunal has heard that untreated BTSB Factor 9 infected seven haemophiliacs with HIV, five of whom have died. Three of the seven were patients at St James's Hospital, where Prof Temperley worked, including one man who continued to use non-heat-treated product at home up to February 1986.
Prof Temperley told the tribunal he met resistance from the BTSB over the heat-treatment of products. He first sought such treatment in December 1984 after returning from a meeting of UK haemophilia treatment directors in Britain.
This was a month after the first positive test for HIV in an Irish haemophiliac, and Prof Temperley said he was "desperate to do something".
He wrote to the blood bank's national director, Dr Jack O'Riordan, to say Dr Paula Cotter, the regional haemophilia treater for Cork, and he had agreed, with the support of the Department of Health, to purchase only heat-treated commercial Factor 8 and 9 from 1985 onwards. Prof Temperley also asked the BTSB to "urgently consider" heat-treating its own material.
He said he was "very disappointed" with Dr O'Riordan's reply in January 1985 which said the issue was being given "urgent attention".
The following month, said Prof Temperley, it was made plain to him at an annual conference of voluntary hospitals that the BTSB was not going to heat-treat its products. He said he could recall a senior board official, Mr John Cann, arguing "very forcibly" that Irish product without heating was a better prospect in terms of safety than heated products from abroad.
The BTSB management, said Prof Temperley, "seemed adamant that they knew better" than the UK doctors who were recommending heat treatment.
Prof Temperley noted that he "more or less followed the line in the UK" on the matter as treaters there had more expertise and experience. The board eventually agreed to heat-treat its Factor 9, said Prof Temperley, first by March 1985, then April and finally September that year. However, none of the deadlines was met.
The professor said he was not sure when he first became aware of someone with Factor 9 deficiency testing positive for HIV but he believed it was between January and April 1986. He was certain, however, the first time he informed the BTSB of infections through Factor 9 was in a letter dated April 22nd, 1986, in response to which the board advised treaters to cease using its non-heat-treated material.
