A CHARADE was played by allowing a hepatitis C-infected man to give blood six times over 20 months following the introduction of screening, the tribunal of inquiry was told yesterday.
Speaking from behind a screen, Donor L, from Munster, said he donated blood at the Limerick Blood Transfusion Service Board (BTSB) centre 19 times between 1986 and 1993 in gratitude for a cardiac operation he had in 1980. But for six of those donations screening tests were carried out without his knowledge.
Although told in November 1993 that he had tested positive for hepatitis C from a donation made the previous July, a "media expose"' in The Irish Times last October 15th alerted him that his blood had been tested and screened since 1991.
"I was appalled that my consent was not sought, and this research was conducted in secret. I was also quite angry that my family and a lot of other people were exposed to the risk from me since I was a carrier of the hepatitis C virus," he said.
Following the introduction of screening on October 1st, 1991, he responded to a donor notification card and gave blood on December 11th He did not receive a communication that his blood was tested: The following April he was again issued with a donor notification card and again was not informed of any irregularity. The pattern continued when he donated, twice more in 1992 and twice in 1993.
"A charade would be a good description," he said, when Mr James Nugent SC, counsel for the tribunal, said a charade had been gone through every time he had donated.
A letter from Dr Joan Power, the BTSB medical director in Cork, in November 1993 informed him that he had tested positive for his donation the previous July. According to the letter, test results suggested he had the hepatitis C virus and results from a separate test at the Virus Reference Laboratory in Dublin "concurred with this opinion". "It has become apparent that a small number of people will continue to go on to have significant inflammation of the liver," the letter said.
Donor L had a consultation with Dr Power that December where he found her very sympathetic. He was referred to the hepatology unit at Cork University Hospital. He had an inconclusive liver biopsy in March 1994, because insufficient tissue was extracted. But tests showed his liver function was very abnormal.
In March 1995 he had a second liver biopsy and in August of that year began taking Interferon medication.
"I did take time out to reflect on my position vis-a-vis the side effects of Interferon and the impact it might have on my employment," he said.
But the indications were favourable since taking the medication, and the virus load had dropped significantly.
Replying to his counsel, Mr Bernard Barton, he said his understanding had been that the test on his July 1993 donation was the first on any of his donations.
There was no discussion of that with Dr Power. "I recall that period in time with great clarity. It was stressful. She did not advise me of any previous tests in that meeting of December 1993," he said.
He was told of the implications of hepatitis C, and given advice on cleaning up after using razors and on general hygiene. But he could have been in health care in the intervening 23-month period, he said.
Dr Power had been helpful and forthcoming, he said, when asked by Mr Paul Gallagher SC, for the BTSB, if she had advised him on Interferon, the risk of cancer and the possibility of counselling in January 1995.
She had not told him that she was awaiting a hepatitis C confirmatory test between October 1991 and November 1993. "If my blood donations reacted positively in repeated donations then that was fair indication, and I should have been informed prior to 1993," he said.