The four physicians and the pharmaceutical
company at the centre of Canada's tainted blood public-health
disaster were acquitted on all counts on October 1 in
Ontario Superior Court.
"There was no conduct that showed
wanton and reckless disregard. There was no marked departure
from the standard of a reasonable person," said Ontario
Superior Court Justice Mary Lou Benotto as she read
her verdict on the 18-month-long trial. "The events
here were tragic," she said. "However, to assign blame
where none exists is to compound the tragedy."
Victims of the infected transfusions
were outraged at the decision. "We're going to be reading
it carefully to understand how she possibly could have
suggested that what they were doing at the time, the
decisions they were making, were somehow professional
and reasonable," John Plater, a member of the Canadian
Hemophilia Society who contracted both HIV and hepatitis
C from tainted blood, told reporters.
MDs
EXONERATED
Former Canadian Red Cross director Dr Roger Perrault,
Dr John Furesz, Dr Donald Wark Boucher, Dr Michael Rodell
and Armour Pharmaceutical were all acquitted of four
counts of criminal negligence causing bodily harm and
one count of committing a common nuisance. If convicted,
the doctors would have faced a maximum of 10 years in
prison.
The charges stemmed from a five-year-long
RCMP investigation that wrapped up in late 2002. It
alleged that between July 1986 and December 1987, Armour
and the four doctors were negligent in their distribution
of the company's product HT Factorate, a clotting agent
for hemophiliacs, believed to have been tainted by HIV.
Four people were infected with the virus in that time
and 65 are alleged to have been exposed. Three of the
four infected patients are now dead.
In total, more than 1,000 Canadians
were infected with HIV and 20,000 with hepatitis C due
to tainted blood in the 80s, over 3,000 of whom have
died.
Although no individual was found
responsible, the scandal revolutionized the country's
blood services. In 1998, control over Canada's blood
supply was removed from the hands of the Red Cross and
eventually placed in the care of two new organizations,
Canadian Blood Services (CBS) and Héma-Québec.
Before the Superior Court verdict
was read, executive director of the Canadian Hemophilia
Society David Page said he hoped this trial would remind
Canadians of the costs that led to a safer blood system.
"This was the biggest public health disaster in the
country," he said. "It should not be forgotten."
PUBLIC
FALLOUT
Public confidence in the national blood system was at
a meagre 50% when CBS took over. Since then, CBS has
raised confidence to over 80%.
In an interview with NRM,
CBS CEO Dr Graham Sher says this is in large part due
to investment in technology and the adoption of a precautionary
principle. "Since 1998 we've acquired state-of-the-art
screening for hep C and B and created a financial model
to help us deal with risks that haven't emerged yet.
Even if a test isn't available we're now able to act
quickly to put precautionary measures in place."
CBS has the capacity to respond
to the emergence of new threats through a contingency
fund, a powerful mechanism allowing it to wield large
sums of money to act quickly without requests for funding
from its financiers, the provincial governments. Dr
Sher says a prime example of its effectiveness was demonstrated
with the emergence of the West Nile virus. "We didn't
know much about West Nile in 2002 until evidence from
a transplant indicated it could be transferred through
the blood," he says. "In only nine months we had a full
screening process implemented to identify unsafe donors."
CBS has also taken precautionary measures to screen
out simian foamy virus and malaria.
IMPACT
ON DOCTORS
The tainted blood disaster has sensitized physicians
to the risks of blood transfusion, says Dr Denis Cournoyer,
a hematologist and ethicist at the McGill University
Health Centre who served on Héma-Québec's
board for two years. "Although the risk of infection
transmission has been reduced enormously in the past
decade, there is still a measurable risk in receiving
blood products. One in every two million units might
be tainted," he says. "It's a life form and there's
an inherent risk that will never be brought down to
zero. Doctors should always be balancing the benefits
to the risks of using blood and blood products."
"We have done enormous amounts
in the past decade, but patients should only get blood
if they absolutely need it," confirms Dr Sher. "Counsel
your patients when they need blood or after the fact
if they have been in an accident. Let them know they
received blood and make them aware of the risks."
THE
NEXT STEP
This case doesn't end the litigation over the scandal.
Dr Perrault faces a second criminal trial pending in
Hamilton. It looks into whether appropriate measures
were taken by senior officials to warn the public and
to screen out donors infected with HIV and hepatitis
C. In light of the Superior Court's October 1 verdict,
Dr Perrault's lawyers are working to have the second
case dismissed.
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