The High Court has allowed an appeal by a man identified as MM over the refusal of his application to the Hepatitis C HIV Compensation Tribunal. The court remitted the case to the tribunal to assess compensation; it did not itself assess or award compensation.
The tribunal had refused the application in July 2017, finding that MM had not established that his hepatitis C infection resulted from a blood transfusion or blood product in Ireland. It also found that he had not met the required threshold concerning other possible sources of infection. The appeal was heard de novo, with the High Court considering the evidence and reports before the tribunal as well as testimony from a surgeon who treated patients at St James’s Hospital in 1982.
MM was diagnosed with hepatitis C, genotype 1b, in 2013. He attributed the infection to a transfusion during surgery for a perforated appendix at St James’s Hospital in November 1982. A surviving laboratory record showed that four units of blood had been requested urgently. The surgeon, Professor Gregor Shanik, said transfusion was common practice at the time and would have been expected given the seriousness of MM’s condition. The judgment records that MM could not recall receiving a transfusion.
The judge accepted the evidence and found, on the balance of probabilities, that all four units had been transfused. Two donors later returned to donate blood and tested negative for hepatitis C. The donors of the other two units did not return, so their status was unknown. Neither unit was linked to a donor covered by the hepatitis C look-back programme.
The court also considered other proposed routes of infection, including household transmission from MM’s deceased sons, who were known to have hepatitis C, and possible transmission from his brother, who had a different virus genotype. The judge accepted medical evidence that household transmission was very unlikely and found the brother’s different genotype could exclude him as the source. The judgment also addressed possible sexual and vertical transmission, while noting that the former could not be fully determined from the available information.
Having considered the evidence and the other suggested risk factors, the judge concluded that the infection was, in all probability, attributable to one or both of the transfused units whose donors’ status was unknown. The appeal was allowed and the application returned to the tribunal for assessment of compensation.