A vote of no confidence in the Blood Transfusion Service Board was tabled in February 1985 at a meeting attended by haemophilia centre directors and community representatives, the tribunal heard.
Dr Paule Cotter, a consultant haematologist at Cork University Hospital and the director of the Cork haemophilia treatment centre, said there had been a breakdown in trust between haemophilia treaters and the BTSB around this time.
She said their confidence in the BTSB diminished following its failure to produce on a large scale a concentrated form of factor 8. Doctors felt uneasy because they may have been given "incomplete information" on developments, she added. Their concern was to have an adequate supply of the safest product available. "We had reasons to be concerned about their [the BTSB's] ability to do this," she said.
The meeting at which the no-confidence motion was defeated was "very heated and acrimonious", she said.
Dr Cotter said she attended an international conference in Rio in September 1984, where a paper was presented on the effect of AIDS on haemophiliacs. "This convinced me that, whereas up to now we had hoped this problem might be confined to American haemophiliacs, there was a problem with the product we were using in Ireland and we were likely to have infections in the Irish patient," she said.
She believed she discussed her concerns with Prof Ian Temperley, former director of the National Haemophilia Treatment Centre, and with Mr Sean Hanratty of the BTSB, who also travelled to Rio.
Dr Cotter said she found it "absolutely amazing" there was no record of her raising these concerns at a meeting of the National Haemophilia Services Co-Ordinating Committee (NHSCC) in November 1984. It was in November 1984 the first haemophiliac in the State was diagnosed with AIDS.
She said Prof Temperley attended a meeting of UK haemophilia centre directors a short time later, and when he returned in December 1984 he called an emergency meeting of the NHSCC, at which a decision was taken to use only heat-treated commercial products.
She said Prof Temperley wrote to the BTSB informing them of the decision. A reply from the BTSB's former national director, the late Dr Jack O'Riordan, said heat-treatment of all products was being given urgent attention. Dr Cotter said she understood this to mean they would heat-treat products. However, the tribunal has heard this did not happen until October 1985.
Dr Cotter said one of her patients tested HIV positive in July 1985 after being treated with BTSB non-heat-treated factor 9. She had no record of informing the BTSB of the infection.
Counsel for the tribunal, Mr John Finlay SC, said the first the BTSB knew of the infection appeared to be in August 1986, almost a year later. Dr Cotter said she believed she would have told Prof Temperley of the infection but there were no documents confirming this.