The issue of tainted blood is an ever present concern and threat to the lives of people who receive blood transfusions in hospitals during surgery or any sort of medical procedure. This is very much the case for people affected by haemoglobinopathies such as thalassaemia or sickle cell anaemia, as they receive ongoing treatment with regular blood transfusions every year.
Fortunately within Australia today, there are in place exacting standards to ensure the quality of blood that people receive through transfusions. However, despite these high standards, there will always exist a risk in the processes of blood screening, donations, storage and transfusions. This of course, calls upon our healthcare services to remain ever-vigilant with regards the management of blood resources, as the lessons of the widespread infections of blood recipients in the 1980s and 1990s illustrate this need for due care.
It is unfortunate, that the victims of these infections have been largely ignored by both government authorities and healthcare services. There has been very little in the way of official recognition, compensation or efforts made towards dealing with the damage and fall-out of these past infections due to negligence. Successive governments have remained eerily quiet or apathetic to this human tragedy, and no serious effort to date has materialised in examining these cases. Yet what is of greater concern, is the lack of action from advocacy groups and from patients such as those suffering from haemoglobinopathies, who have been affected by these cases of medical negligence. No legal action has been forthcoming. And yet, the right of every patient, including thalassaemia and sickle cell patients, should be to have access to clean and safe blood for their treatment. We cannot be apathetic or forgetful, because it is then, people become negligent and another case of blood infections could arise. Vigilance and action is needed.
The following articles speak about the use of tainted blood in treating patients who are now fellow Australians infected with one illness or another, which they have to live with for the rest of their lives…..Truly it makes for sober reading.
The Age, 7th April 2004
The Australian Red Cross Blood Service has admitted that donors who tested positive for hepatitis C continued to give blood for several months in 1990.
In its submission to a Senate inquiry, the Red Cross said that when hepatitis C tests were introduced in February 1990, some donors whose blood reacted to the test but who had no obvious risks of carrying the disease were allowed to continue to donate blood.
The Red Cross said “false positives” meant some donors who reacted to the test were not infected with the virus. Their blood was given to the Commonwealth Serum Laboratories (CSL) on condition it be used only to make plasma treatments including Factor VIII, which encourages blood clotting in patients with haemophilia.
The Red Cross estimates at least 3400 people with hepatitis C were infected through blood products before testing was introduced. It is not known how many were infected as a result of the 1990 breach.
At the time, it was believed that the process used by the CSL to break down plasma would prevent people from contracting the virus. But the Red Cross stopped providing blood that had tested positive in July 1990, after questions were raised about whether the plasma still contained the virus.
The inquiry into hepatitis C was announced last year after allegations that the Red Cross and CSL had knowingly infected thousands of people with the virus before proper screening was introduced.
Charles MacKenzie, administrator of the Tainted Blood Product Action Group, said he had been approached by infected people who claim they had been offered money by the blood service “in exchange for them signing secrecy clauses”.
The Red Cross has declined to comment on this claim, and makes no reference to it in its submission.
The inquiry was told on Monday that CSL was aware of the risk of contracting hepatitis C through its plasma in the 1980s, but considered the virus relatively minor.
The Red Cross submission also reveals that:
The Red Cross will face questions today about its failure to implement a test known as ALT before the screening began in 1990. Victims say this test might have reduced the risk of contracting hepatitis C. The Red Cross says obesity and alcohol abuse can also elevate ALT levels, making the tests “inaccurate or inconclusive”.
But a study in the United States reported in 1981 that there was an association between elevated ALT in donors and the development of hepatitis C in blood recipients. The Red Cross at the time was concerned that the inaccuracy of the test would mean the loss of healthy donors, when supplies of plasma to the CSL fell to their lowest level in 1983/84.
The inquiry will also consider recent criminal charges against the Canadian Red Cross for failing to implement the ALT test in the 1980s.
By Carol Nader
The Age – 5th June 2004
The Australian Red Cross Blood Service has apologised for the first time to thousands of victims who received blood transfusions contaminated with hepatitis C during the 1980s. But it has not accepted liability for the tragedy.
In a private mediation session in the NSW Parliament last week, national blood products manager Brenton Wylie said the Red Cross recognised that some blood transfusion recipients contracted hepatitis C.
“This is a terrible fact, and we are sorry that this occurred,” he said. “We are sorry that for some of those recipients contracting hepatitis C, this has often resulted in debilitating symptoms of the disease.”
But Dr Wylie said the Red Cross made decisions based on the best available scientific knowledge at the time and, “we do not accept liability”.
The apology was repeated in a letter this week to the Independent Blood Council, which represents more than 700 victims of tainted blood. The Red Cross has previously expressed sympathy to victims, but has not apologised until now.
Independent Blood Council president Charles MacKenzie urged the Red Cross to make a “real sorry” by offering compensation or launching an appeal to raise money for the victims.
He said the Red Cross should be criminally charged, as the Canadian Red Cross was a few years ago. The Canadian Red Cross was ordered to pay more than $1 billion in compensation.
Australian victims will launch a legal class action against the Red Cross after the inquiry. About 400 victims have received out-of-court settlements.
Former NSW chief justice Sir Laurence Street, who chaired the mediation session, told The Age he thought the apology was an “admirable move” by the Red Cross, and based on a “sincere desire” to open dialogue.
Reports estimate up to 20,000 people were infected with hepatitis C by blood transfusions and other blood products in the 1980s. Blood screening began in 1990, but the Independent Blood Council says infections still occurred until the late 1990s.
The Red Cross told a senate inquiry this year it believed 8764 Australians were living with transfusion-acquired hepatitis C.
The former Commonwealth Serum Laboratories, whose blood plasma product Factor VIII infected haemophiliacs with hepatitis C, has indicated that an apology was not forthcoming.
“Most of the people I understand had received transfusions from fresh blood in that particular instance, so I don’t really see that it’s related to CSL at all,” said CSL director of public affairs Dr Rachel David.
But Mr MacKenzie said CSL’s product infected more than 80 per cent of those who used it. “If they don’t think they should apologise, then perhaps they should remove themselves from the supply of blood products,” he said. “That’s absolutely sick.”
The inquiry’s chairwoman, Senator Jan McLucas, encouraged CSL to follow the lead of the Red Cross.
The inquiry’s report is due this month. Red Cross national communications manager Libby Day denied the apology was a public relations exercise.
(“Tainted blood” victims and their families are still outraged at the government responses to a health system failure in which blood transfusions infected people with hepatitis C. )
There’s a document on a list of submissions to the 2004 “tainted blood” Senate inquiry into how thousands of Australians were infected with hepatitis C after blood transfusions.
It’s a submission by legal firm Turner Freeman on behalf of some of those Australians. If you want to understand why people like “tainted blood” campaigner Charles MacKenzie and Medical Error Action Group founder Lorraine Long are still fighting for the Australian government to act on the Senate inquiry’s very limited recommendations, you need only look at the Turner Freeman submission.
If you want to know why “tainted blood” victims – those who are still alive – and their families are still outraged and despairing of government responses to this most tragic of human health disasters, you need only read how foreseeable the disaster was.
And if politicians of all persuasions want to know why Australians voted the way they did on July 2 – with a reasonable percentage of people giving the finger to the major parties – they need only look at how governments across this country responded when a foreseeable health system failure had a catastrophic impact on thousands of people.
Or didn’t respond, as is the case here.
It’s just one example of an institutional failure having a catastrophic impact on individuals, where those most responsible try to avoid responsibility, individuals are left fighting institutions, and governments do as little as possible.
The Turner Freeman submission documents what the Australian Red Cross knew about certain blood donors in the 1980s, whose blood donations went on to infect people with hepatitis C.
There was donor B, whose Red Cross record included a notation in 1983 that he or she was “not to donate until April 1988”, because of known risk factors.
The Red Cross record showed blood was taken from donor B on at least two subsequent occasions.
“The blood collected on the second occasion was subsequently transfused to one of our clients and infected him,” Turner Freeman told the Senate inquiry.
Then there was donor C, an IV heroin user sharing a needle in 1982, who had had “approximately 70 sexual partners”; or donor E, whose record in 1984 noted “Do not call until August 1989”, also presumably because of risk factors known to the Red Cross.
Despite the note the Red Cross took blood from donor E in 1985. It was transfused to a patient in a NSW hospital who became infected with hepatitis C.
I’ve spoken with one of those infected patients who received a blood transfusion because he had a life-threatening condition. Although the Red Cross record showed the service knew a potentially contaminated blood donation had been taken and transfused into a patient, it made no attempt to contact him. He discovered he had hepatitis C a number of years later.
The 2004 Senate report provides reasons why the federal and most state governments did not insist that blood providers use available screening methods for hepatitis C until 1990.
Before 1990 the tests were surrogates, rather than specific to hepatitis C, and because of that a small percentage of uncontaminated blood donations would have given false negatives and been discarded. This appeared to be one of the most significant reasons for waiting four years until a more specific test was available.
Another issue was the shortage of blood donations and donors. It was the 1980s when public hysteria about AIDS was at its highest and blood donors dropped from the system out of fear.
In the four years from 1986 until 1990 the public wasn’t advised, and individual patients weren’t aware, that it was possible for blood to be screened for hepatitis C, at least in a risk-reduction sense, but that wasn’t done.
Think about that. Consider what that would feel like if you were someone who contracted hepatitis C in that four years, or a member of your family.
The Senate inquiry heard evidence from women who became infected with hepatitis C after 1990 because of blood transfusions following childbirth. A newborn baby was infected in December 1990 after a blood transfusion. It saved his life, but left him with a condition where up to 20 per cent of sufferers go on to have liver failure, cirrhosis of the liver or liver cancer.
In another case a woman who received a blood transfusion following childbirth in July, 1992, was advised seven years later that she had received contaminated blood. Subsequent tests showed she was infected with hepatitis C, which explained debilitating symptoms after her child’s birth.
The Red Cross gave her the news via a letter that started “You may remember that in 1992 you received a blood transfusion. One of the donors may have been infected with hepatitis C”.
The 2004 Senate inquiry did not favour a compensation scheme for “tainted blood” victims, but recommended a national apology, a financial assistance fund and a case-managed response.
By that stage the Canadian Government had approved a $1.4 billion compensation fund for its “tainted blood” victims, Ireland also had a compensation scheme, and by March this year Scotland had set up a compensation scheme and English Prime Minister David Cameron had delivered a formal national apology.
No apology, no formal public responsibility and no action from a succession of governments who figure we have no memory.