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Professor Zuckerman explained in the "A and Others v National Blood Authority" litigation that he meant that the RIBA test was not genuinely a confirmatory test because it also tested for the antibody, rather than a comment on its unreliability as such.

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By 1985, Professor Zuckerman spoke of a specific test for non-A non-B Hepatitis being "awaited with breathless anticipation", thereby conveying both the importance of developing such a test and the urgency of doing so.

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Dr Alter concluded that "the discovery of [Hepatitis C] is a fundamental breakthrough in virology" and went on to urge that the Ortho assay should immediately be implemented for donor screening once licensed.

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Dr Barbara returned from a symposium in Paris, organised by Ortho, with a positive reaction reporting that the test seemed "reproducible, robust and meaningful".

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During the hearing of "A and Others v National Blood Authority", leading counsel for the National Blood Authority expressly accepted in relation to surrogate screening that cost should not be a determining factor and did not suggest that it should be a factor in considering routine screening.

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In "A and Others v National Blood Authority", Mr Justice Burton highlighted Dr Gunson's evidence, where he said in concluding part of his decision: "I have already referred to Dr Gunson's evidence, subject to the question of a confirmatory assay as to 'certainly early in 1990', in retrospect. Later in cross-examination, he said...I have now said three times - I think I did say to His Lordship yesterday - that in retrospect we should have done it a different way.'"

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After the FDA had granted a licence for the Ortho test, anti-HCV screening was still not introduced.

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In "A and Others v National Blood Authority" Mr Justice Burton said he was satisfied that the basic requirements for implementing routine screening were the carrying out of pilot studies and evaluations, the planning for counselling and implementation, and the execution of that implementation in respect of equipment, staff and building works.

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Mr Justice Burton in "A and Others v National Blood Authority" recorded that "Dr Gunson accepted that, in retrospect, the fact that no preplanning was done for a year was obviously not satisfactory. Had there been counselling procedures in place, it appears to me that the system might have been able to cope, albeit with difficulty, as the West Midlands Report had indicated in December 1989, even without the confirmatory test".

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Ortho organised a second Hepatitis C Symposium in London.

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Papers presented at the sixth meeting of the Advisory Committee on the Virological Safety of Blood included a report on the 8 February 1990 Hepatitis C Symposium.

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At the symposium Dr Barbara gave a talk on HCV and the Blood Transfusion Service which suggested that the predictive value of anti-HCV screening would be low in low prevalence populations.

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At the tenth Advisory Committee on the Virological Safety of Blood meeting it was decided that Ortho II, Abbott II or UBI tests could be used for initial screening, at the choice of individual RTCs, guided by trial results so far. Dr Lloyd's "unilateral action" was regretted, but Dr Gunson suggested that it could be "used as an extension of the trial."

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Dr Gunson reported to the SNBTS/NBTS Liaison Committee that Dr Lloyd had commenced anti-HCV testing within the past week at the Newcastle Regional Transfusion Centre.

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A follow-up note of the sixth meeting of the Advisory Committee on the Virological Safety of Blood which Dr Robert Perry sent to Professor Cash additionally noted that Hepatitis C testing was in place in Finland and Australia.

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A submission was sent to Baroness Hooper recommending that Hepatitis C antibody screening should be introduced as a public health measure.

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The submission on the Hepatitis C antibody screening test stated that it was unlikely routine screening could be introduced before 1 April 1991. The Minister was asked to agree that it should be introduced and that preparations should be made to introduce it "as soon as practicable."

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In his evidence to the Penrose Inquiry, Dr Perry said he thought that the composition of the Advisory Committee on the Virological Safety of Blood was unduly biased to virology and that "the public health perspective was not as dominant...as it possibly could have been." His observation was that "the best became an enemy of the good" and that the search was for "perfect outcomes rather than good outcomes that could meet a public health need."

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Professor Cash's evidence to the Penrose Inquiry was that Dr Gunson had told him at this time that funding issues in England were the source of the delay and that "this was a device to give the Department of Health more time, more space, to resolve these very difficult financial problems that they had."

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Professor Cash told the Penrose Inquiry that he and Dr Gunson had fallen out badly over the postponement of routine screening for anti-HCV but they "fell in again" and he subsequently wrote a letter to Dr Gunson stating that the start date in September 1991 had the Scottish National Blood Transfusion Service directors' fullest support

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