Haemophiliacs would not have coped with a return to cumbersome forms of treatment to assist blood clotting after imported clotting agents in a more concentrated form, which were easier to use, became available, the tribunal heard.
The earlier treatment, cryoprecipitate, was made by the Blood Transfusion Service Board (BTSB). It usually had to be administered in hospital, while imported concentrates could be used by the patient at home.
Though difficult to use, cryoprecipitate was perceived as safer than imported clotting agents because it was made from voluntary blood donations collected in the State in the 1970s and early 1980s. Imported clotting agents were made from the blood of paid donors.
Prof Ernest Egan, a consultant haematologist at Galway's University College Hospital (UCHG), said the imported concentrates liberated haemophiliacs. They enabled them to travel and be more active.
"If somebody had lived through the problem of administering the cryoprecipitate product and then moved on to these newer products, and they were asked to return to the cryo products, I don't think it would have been coped with," he said. "If we knew the relative risk factor of one versus the other - and we didn't - perhaps that could have influenced people's choice. People might have taken the added inconvenience."
Prof Egan said in evidence on Thursday that he felt there was a "significant risk" associated with imported clotting agents. He advised the National Drugs Advisory Board in 1984 that their use should be restricted to critical cases, and not used widely for home therapy.
The tribunal has heard that imported clotting agents were responsible for the vast majority of HIV and hepatitis C infections among haemophiliacs in the State. More than 220 haemophiliacs contracted either or both diseases.
Mr Michael McGrath SC, counsel for the BTSB, said Prof Egan had complained that the products he received from Pelican House in 1986 were not what he ordered: they were heat-treated to kill viruses, but not made from blood donations which had been screened for the HIV virus.
Questioned about this, Prof Egan said he had been given to understand they were made from tested donations, but they were not. He believed all products made at Pelican House after October 1985 were made from the blood of screened donors.
He added his main criticism of the BTSB was its failure to inform him of a change of policy at the National Haemophilia Treatment Centre in December 1984 when, after a teenager was diagnosed with AIDS, it was decided that only heat-treated products would be used. Prof Egan was not informed of this and continued to use the product that had not been heat-treated. However, none of his patients developed HIV.
Prof Egan said none of his patients required high purity Factor 8 clotting agent and he treated them with cryoprecipitate, which could not be heat-treated. His hospital, UCHG, had no record of a delivery of factor concentrates until 1986, he said.