The former medical director of the National Haemophilia Treatment Centre, Prof Ian Temperley, was accused yesterday of "abandoning" his patients and "recklessly and needlessly" exposing them to the risk of HIV and hepatitis C infection.
In a closing submission for the Irish Haemophilia Society, Mr Martin Hayden SC claimed the retired doctor had acted with "gross negligence" in a number of instances.
Among those cited were Prof Temperley's failure to inform patients of the infection risks associated with commercial concentrates, and his failure to adhere to treatment protocols aimed at limiting their use.
Mr Hayden also criticised Prof Temperley for taking a six-month sabbatical in May 1985 without making arrangements for his patients to be informed of or counselled for HIV test results. "Such a decision was tantamount to abandoning his patients at the time of their greatest need," he said.
Despite having complained to the tribunal about the burden of his workload, Prof Temperley never told administration at St James's Hospital, where the NHTC was based, about his inability to cope, said Mr Hayden.
"His desire to remain in control . . . is most evident in his lobbying for, and subsequent appointment to, the board of the BTSB in 1987, and appointment as Dean of Medicine at Trinity College Dublin."
As a result of his split functions, Prof Temperley was for haemophiliacs "at all critical times . . . either on sabbatical, unavailable or absent, pursuing other duties".
On the second day of his closing statement, Mr Hayden said the IHS recognised Prof Temperley's many positive achievements, and his unique contribution to the lives and welfare of people with haemophilia.
"However, it is the duty of the IHS to also recognise that its members were abandoned in the crisis by the very person upon whom they relied. It should be the function of this tribunal to ensure a situation where the interests and welfare of people with haemophilia should never again be consigned to the part-time attendances of just one person."
Regarding treatment protocols, Mr Hayden noted Prof Temperley had said he was guided by the advice of British haemophilia centre directors. Their recommendations in June 1983 were to the effect that people who had not previously been exposed to commercial concentrates, which were associated with the risk of HIV infection, should not be started on them.
But Mr Hayden said these, like other recommendations, were neither adhered to by Prof Temperley nor his associates.
He submitted that Prof Temperley "consciously exposed" a boy with the pseudonym Rory to the risk of infection when he moved him onto concentrates, from cryoprecipitate in August 1983. Rory was subsequently infected with HIV and died of an AIDS-related illness in 1995.
Mr Hayden said the blame for the infection of another haemophiliac, "Declan", with HIV in April 1984 also lay at Prof Temperley's door. Declan was switched onto concentrates by a junior doctor in breach of the guidelines.
It was for Prof Temperley "to ensure that his subordinates were aware of the treatment protocols and applied them," said Mr Hayden. His failure to adhere to guidelines, some of which he wrote himself, "amounts to recklessness and/or indifference. It resulted in many more infections which might otherwise have been avoided."
Other instances of "gross negligence" cited were the infection of the children of "Herbert" and "Felicity" with hepatitis C after 1985, and Prof Temperley's "overruling" of a request by his temporary replacement in 1985, Dr Helena Daly, for the NHTC to cease using non-heat-treated BTSB factor 9.
Mr Hayden said those responsible for infecting haemophiliacs "should acknowledge their responsibility as a first step in the reconciliation process." He will complete his submission today.
