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A letter from Dr Gunson to Dr Contreras stated that the Department of Health had not asked for any priority to be given to anti-HCV screening and that he would advise Dr Contreras of the financial arrangements to be made as soon as he could.

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A memo from Tony Martin to Dr Gunson noted that 1 June 1991 would be an achievable start date to commence anti-HCV screening for the South Thames Blood Transfusion Service.

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A letter from Dr Douglas Lee to Dr Gunson stated that the earliest date to which he could commit the North West to routine anti-HCV testing would be 1 June 1991.

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A letter from Dr Lloyd to Dr Gunson stated that the Northern Region Blood Transfusion Service would be able to start anti-HCV testing from approximately 1 April 1991.

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The Advisory Committee on Transfusion Transmitted Diseases was informed that the proposed starting date of 1991 for anti-HCV screening was difficult because it was considered essential to evaluate the new generation Ortho and Abbott tests prior to the commence of routine screening.

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Dr Lloyd wrote to Dr Gunson outlining his reasons for commencing anti-HCV testing in the Northern Region earlier than other RTCs in July 1991. He stated the decision to start testing was based on an imperfect test, but a test that was nonetheless available and which detected a group of people who appeared to be positive for the antibody. The comparative study of the Abbott and Ortho kits would not have influenced his decision as to whether or not to start testing.

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Dr Lloyd wrote to all RTC directors informing them that by 1 July all units of blood for transfusion in the Northern Region would be negative for Hepatitis C antibody. He stated that to not test now, when they had the ability to do so, would be indefensible under Product Liability legislation.

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Dr Lloyd received a letter of objection from Dr Mitchell in respect of awaiting an informed judgment on testing and Dr Lloyd's decision to commence anti-HCV screening in the Northern Region earlier than the rest of the RTCs.

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Professor Cash defined Dr Lloyd's unilateral action to commence anti-HCV screening earlier than other RTCs as both "disgraceful and mischievous".

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Dr Boulton wrote to Dr Lloyd stating that Dr Lloyd's decision to start HCV-testing earlier than the other RTCs was "breaking ranks" and "not conducive to the image of a co-ordinated Service".

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In response to Dr Lloyd's decision to commence earlier anti-HCV screening, Professor Cash suggested that the evaluation of second-generation tests might be modified to accommodate the screening programme in Newcastle.

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Dr Lloyd wrote to Dr Gunson asking "whether there was in a fact a strategy which involved delaying the introduction of tests whilst awaiting central funding for this test".

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Dr Jean Harrison, Director of the North East Thames RTC, declined to participate in Professor Allain's proposed study to test for anti-HCV in samples from blood transfusion recipients.

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Professor Allain disagreed with Dr Harrison's analysis of the ethical position in respect of her refusal to participate in his proposed study to test for anti-HCV in samples from blood transfusion recipients. Professor Allain asked if Dr Harrison's ethical reasoning was true, why did she then not start screening all her donors now? He stated that if she did not, she was just as much open to litigation until 1 September 1991, whether she entered the study or not.

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Dr Harrison replied to Dr Allain stating that she did think there was exposure to possible litigation but at that time Brentwood RTC did not have the funding, equipment or staff training to commence anti-HCV testing immediately.

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A letter from Dr Gunson to Professor Cash stated, in relation to anti-HCV testing, that for the UK it was "important that the SNBTS and the NBTS act in close collaboration since I can foresee difficulties if one of us introduced the test unilaterally".

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Dr Gunson wrote to RTC directors in England and Wales informing them the Department of Health had agreed that routine anti-HCV testing could be put into operation, saying that he sought to ensure testing started simultaneously in all RTCs, and asking them to respond with the "earliest date that you could commence testing".

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Dr Lloyd argued that although the evaluation of second-generation test kits had not yet been completed, UK screening should now start "come what may".

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400 anti-HCV testing samples per day were being processed and the test was running "consistently with the manufacturer's expectations" but it was a "considerable drain on resources."

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In the National Blood Authority litigation, Dr Gunson gave evidence in relation to false positives in results and decisions made by the Department of Health and comparisons with the USA with regards to the decision to test for Hepatitis C and its accuracy (FDA decisions also).

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