Are four prominent French doctors criminally responsible for the deaths of 250 hemophiliacs and the infection of 1,000 more by knowingly giving them AIDS-infected blood products?
For three weeks, the four officials with the French National Blood Transfusion Center and Ministry of Health have been defendants in a dramatic trial at the Palais de Justice in Paris, attended by a tragic chorus of emaciated hemophiliacs who claim to be victims of the doctors’ negligence.
Opposition political leaders have attempted to widen the case to include senior officials in the governing Socialist Party, whom they accuse of a cover-up. Due to widespread popular concern about the transfusion case, French President Francois Mitterrand was compelled in his annual Bastille Day press conference last week to defend his fellow Socialists--including Laurent Fabius, the premier at the time of the alleged cover-up--against charges that they participated in a whitewash of government responsibility.
But the most emotional testimony has come from the four doctors themselves. They have sought to explain how contaminated blood products continued to be distributed to hemophiliacs in France six months after an American blood-screening test and heat-treatment process--which prevents contamination--were perfected and introduced in the United States and other countries.
Hemophiliacs around the world, because they require regular transfusions of pooled blood products to provide the Factor 8 blood-clotting agent they lack, were among the earliest listed as being at high risk for contracting AIDS.
That was especially true before March, 1985, when the U.S. Food and Drug Administration approved a test to screen for antibodies to the HIV virus. The test, first marketed by Abbott Laboratories in the United States, allowed blood banks to check donors, recipients and existing blood supplies for the virus.
About the same time, a heat-treatment process pioneered in 1983 by another American company, Baxter Healthcare Corp., had won near universal acceptance in the scientific community as an effective way to inactivate the AIDS virus in blood products, such as the clotting proteins.
Nevertheless, the French National Blood Transfusion Center, directed by Dr. Michel Garretta, one of the defendants in the trial, continued to permit the distribution of unscreened blood products until October, 1985, more than six months after the United States, Canada and several other countries had stopped the practice.
A letter written by Garretta and dated June 26, 1985, introduced into evidence in the trial, called for the “normal distribution of non-heated (blood) products as long as they are in stock.”
This prompted one of the representatives of the French Assn. of Hemophiliacs, a civil plaintiff party in the trial of the four doctors, to accuse the responsible officials of dispensing contaminated “leftovers” to victims of the hereditary blood deficiency.
In testimony last week, Garretta, 48, a darkly handsome mustachioed physician who had previously been defiant in his self-defense, admitted he had made serious errors starting in April, 1985, after he attended an AIDS-related medical convention in Atlanta, by not immediately purchasing the American heat-treated products.
“Today, it’s clear,” Garretta said, “I should have bought massive amounts of heat-treated blood from abroad. I didn’t do it. It was a mistake. I’m aware of it today.”
In his defense, he said that the problem of the contaminated blood was widely known throughout the French government. “Everybody knew about it, including me,” he said. He said he had been too weak to confront his bosses.
The six-month delay in switching to safe blood products was, at the least, a major administrative error with deadly consequences for France’s 4,000 hemophiliacs, more than half of whom are now believed to carry the virus that causes AIDS.
But was it also a tragically fatal case of Gallic pride? There is some evidence that some officials wanted to wait for a French screening system and heat-treatment processes to be developed rather than use American ones. A 179-page report on the transfusion scandal, presented in 1991 by Michel Lucas, inspector general for social affairs, noted with alarm the competitive commercial interests at play in the blood business during the key period 1984-86.
Hemophiliac organizations and AIDS activists have urged that the doctors and other members of the French medical leadership be charged with the more serious crime of negligent homicide.
“In my opinion they are murderers,” said Joelle Bouchet, mother of a 16-year-old hemophiliac who was infected with the HIV virus after a transfusion of Factor 8 blood from the French national center. “They contaminated children week after week. They killed people just to make money.”
But proving the more serious criminal charges would be difficult. The chief reason is that without a prior blood-screening test to determine when a hemophiliac was infected, it would be impossible to prove that it occurred during the critical six-month period.
Garretta and National Transfusion Center colleague Jean-Pierre Allain, 43, are charged under fraud laws; they are accused of deliberately misrepresenting the quality of blood products to hemophiliac clients. Jacques Roux, 69, former French director general of health, and Robert Netter, 65, former director of the public health laboratory, are charged under a statute entitled “non-assistance to persons in danger.” All the charges carry heavy fines and the possibility of a maximum of five years in prison.
The trial is being played out under high security at the massive, central Paris Palais de Justice. Outside, demonstrators chant for action against senior French officials. Some carry placards showing Mitterrand, his face emblazoned with a bloodstained handprint.
Inside the somber, wood-paneled courtroom of the 16th Correctional Court is a chilling scene. The four defendants, all medical doctors, all former senior officials in the French national health care system, sit amid their teams of black-robed lawyers before the three-judge panel headed by a balding, short-tempered magistrate, Judge Jean-Louis Mazieres. Facing the defendants, in the raised state prosecutor’s box, sits their relentless accuser, government attorney Michele Bernard-Requin; his last name in French means “shark.”
To one side, arranged in rows like primary school pupils, are the teams of private attorneys retained by the hemophiliacs’ families.
Finally, occupying most of the benches in the large gallery of the court are the several dozen hemophiliacs and their families. Several, eyes dark and hollow, are clearly in the later stages of AIDS. Some have estimated that 15 of them will die during the six weeks the trial is estimated to take; certainly many will die before the judges release their verdict in October.
Generally, the hemophiliacs are silent during testimony, although when Garretta spoke, someone shouted: “Three hundred deaths!” But their presence and the atmosphere of looming death--contrasted with the legal machinations of the four healthy defendants and their lawyers--has given the trial an almost unbearable gravity.
Yet, on a recent day of testimony, Ludovic Bouchet, 16, sporting a New York Mets baseball cap and a photograph of rock idol Prince taped to his shirt, managed a broad smile as he watched the proceedings. Bouchet, tall, olive-skinned and in the awkward, coltish stages of adolescence, has AIDS, with lung problems and painful rashes.
But except for a painful bruise on his right shoulder, a hemophilia symptom, Bouchet said he feels fine. When things get boring in court, he confided, he just thinks about all the good music he loves.
On this day, he was still aglow from a Prince concert he had seen a few days before in Paris. “ Grandiose ,” he said, “ spectaculaire! “