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Dr Savidge assessed the treatment of infants and children throughout the late 1970s and early 1980s stating "The lack of consideration and disregard of the then current therapeutic recommendations for the treatment of children under the age of 4 years regarding the use of cryoprecipitate in this case was negligent...The overwhelming use of commercial U.S. concentrates in preference to cryoprecipitate or NHS factor VIII is remarkable,"

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Dr Savidge considered Dr Martin's treatment for Stephen "at these times when heat treated concentrates were commercially available was negligent."

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Information from legal claims relating to other children treated at Alder Hey revealed the same approach to treatment. For one patient a note detailed that NHS concentrate should have been preferred to commercial from about mid-1983 but supplies were inadequate to adhere entirely to this counsel of perfection.

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A DHSS analysis of legal claims acknowledged it would be indefensible if any commercial concentrate given in 1985 was not heat-treated.

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A child treated was with concentrates from 1978 onwards and records failed to identify the type of batch number.

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Dr Martin's treatment of Stephen was not atypical, it was also practiced where his brother was treated with commercial concentrates from the age of two

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The second report relating to Stephen's treatment, prepared by Dr Ludlam, noted if cryoprecipitate was not available, then NHS concentrate would be the most appropriate therapy and queried Royal Liverpool Hospital policy

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Dr Martin said that his treatment of the child with concentrate was consistent with the standard treatment being given to patients at the time

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Dr Martin described how there was no instruction to use cryoprecipitate on milder haemophiliacs and that it was generally phased out in the early 1980s.

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Dr Martin did not regard the risk of hepatitis as reason to alter any treatment regime. His aim was however to "keep children out of hospital as much as possible"

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Dr Martin had no recollection of the 24 June 1983 letter from Professor Bloom and Dr Rizza but accepted that there was no alteration in the treatment regime at the time.

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Dr Martin did not attend any UKHCDO meetings in the 1970s and 1980s by his own choice.

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Dr Martin regarded DDAVP of limited value and difficult to use with small children. He made a conscious decision not to use it despite its availability within his hospital.

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Dr Martin did "not make it [his] practice to raise the hepatitis issue with families" and similarly, did not "wish to worry parents with what at first seemed to be a tenuous link" regarding AIDS.

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A medical report on a child born in 1981, with moderate haemophilia, shows that he was treated with concentrates from the age of one and received treatment with concentrates on four occasions in 1983. The report from Dr Ludlam outlined that to justify the use of commercial factor VIII concentrate for this child it would have been necessary for Dr Martin to demonstrate several steps were taken to attempt to treat the child with cryoprecipitate

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A report from the solicitors representing the defendant health authority in the litigation recorded they were "unable" to show that cryoprecipitate and NHS Factor 8 concentrate were not available. Dr Martin "says that he gave no consideration to alternative treatment."

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Dr Winter described how at the around when the Sheffield study took place most clinicians seemed to ignore the issue of NANBH as blood products has brought such miraculous results and so the issues seemed to outweigh the benefits.

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Dr Winter stated that that the Preston paper was a key moment as the general attitude moved from mild to very concerned.

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In oral evidence Dr Mark Winter described how in the 1980s, despite the growing concern of the hepatitis virus, treatment with factor concentrates continued unabated.

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With respect to the growing prevalence of AIDS and the response of UKHCDO, Dr Winter explained how the issue with blood products was that there were constantly new viruses being discovered.

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