Ellen Frank asked,
> Some years back, some of you old-timers might recall, there was a
>discussion on pen-l of the exchange of blood and reference was made to a
>study (book?) tracing international exchange of blood from the poor to the
>(relatively) rich. Does anyone recall the reference?
Although the below story is not the specific discussion Ellen is thinking
of, it may be of interest.
Friday 11 September 1998
HIV blood came from Arkansas jail
U.S. firm linked to Clinton bought from prisoners and sold to Montreal
blood broker in '80s
Mark Kennedy The Ottawa Citizen
A U.S. firm with links to U.S. President Bill Clinton collected HIV-tainted
blood from Arkansas prison inmates in the 1980s and shipped it to Canada,
newly uncovered documents reveal. The contaminated plasma -- used to create
special blood products for hemophiliacs -- is believed to have been
infected with HIV, the virus that causes AIDS. As well, it's likely the
prisoners' blood was contaminated with hepatitis C. The story of how that
plasma was collected and found its way into the bloodstreams of
unsuspecting Canadians stands as one of the most shocking -- yet least
explored -- aspects of the tainted-blood tragedy. Its significance is
magnified by the fact that Mr. Clinton's name is associated with the story.
Mr. Clinton was governor of Arkansas when the Canadian blood supply was
contaminated in the mid-'80s. He was generally familiar with the operations
of now-defunct Health Management Associates (HMA), the Arkansas firm that
was given a contract by Mr. Clinton's own state administration to provide
medical care to prisoners.
In the process, HMA was also permitted to collect prisoners' blood and sell
it elsewhere.
HMA's president in the mid-1980s was Leonard Dunn, a personal friend
and political ally of Mr. Clinton. Later, Mr. Dunn was a Clinton appointee
to the Arkansas Industrial Development Commission, and he headed Mr.
Clinton's 1990 gubernatorial re-election finance committee. It's not known
how many Canadians contracted HIV from the plasma of Arkansas prisoners,
who were paid $7 a unit, although it's likely that several hundred, perhaps
thousands, were infected by the tainted products. At the time, U.S.
companies that fractionate blood products had stopped buying prison blood
because it was widely understood that, since many inmates practised unsafe
sex or were intravenous drug addicts, their blood posed a high risk of
carrying the AIDS virus. However, HMA found a willing buyer in a Montreal
blood broker, who then sold the plasma to Toronto-based blood fractionator
Connaught Laboratories. Connaught apparently didn't realize the plasma had
come from prisoners. Canadians learned of the prison connection in 1995,
when Justice Horace Krever's inquiry on the tainted-blood scandal unearthed
some aspects of the story. In his voluminous report last November, Judge
Krever chronicled what he knew of the prison plasma contract. But nowhere
before now has any mention been made of Mr. Clinton's name, even though the
facility in question -- Cummins prison in Grady, Arkansas -- was located
in his state during an era when the governor's office was active in
overseeing many aspects of public administration. Two new developments are
bound to focus public attention on Mr. Clinton's knowledge of the
prison-blood collection system -- all this at a time when the president is
bracing himself for the fallout over independent counsel Kenneth Starr's
report on the Monica Lewinsky affair.
This month, a new book, Blood Trail, is being released in Canada and the
U.S. It is a novel, and its Illinois publisher is carefully taking the
usual legal precaution to declare in the book that if any characters in
this "work of fiction" bear resemblance to real people, it is "purely
coincidental."
However, the book is a thinly veiled account of how an Arkansas governor
gets caught up in a prison-blood scheme gone bad, becomes U.S. president,
and tries to cover up his past. What adds to the book's mystique is that
it is written under a pseudonym, "Michael Sullivan," to temporarily hide
the author's true identity. The Citizen is aware of the author's real name,
and has agreed to keep it confidential. The author is a medical
practitioner in Arkansas who has direct knowledge of how the prison system
worked when Mr. Clinton was governor. He wishes to remain anonymous
temporarily because he fears retribution in his home state, but
acknowledges that he will be willing to reveal his name once the media have
reported details of the prison-blood collection program. At that point, he
says, he won't feel as vulnerable.
In another development, the Citizen has obtained copies of internal
Arkansas state police documents written by investigators who were
examining HMA in the mid-'80s. The investigators were following up on
complaints the company supplied poor medical service to the prisoners
(some had died, and one had lost a leg) and were probing rumours that the
Clinton appointees on the prison board had demanded a bribe in return for
renewing HMA's $3-million health-care contract in 1985. In the end, the
investigators accepted the explanation supplied by the board and HMA: Mr.
Clinton was "deeply concerned about HMA's past performance" and it was
decided that as a condition of getting the contract renewed, Little Rock
lawyer Richard Mays should be paid $25,000 by the firm to act as an
"ombudsman" for the prisoners. Mr. Mays was a Clinton friend who had been
appointed to the Arkansas Supreme Court in 1980-81 by the governor.
The state police asked HMA and Mr. Mays for a copy of the "letter of
agreement" outlining what was expected of him as ombudsman, but one
could not be found.
Years later, Mr. Mays became entangled in the Whitewater scandal. His
name also cropped up as one of an exclusive group of Clinton friends and
supporters who the president rewarded with unusual access to the White
House. In fact, Mr. Mays was one of more than 300 loyalists who were
allowed to sleep in the Lincoln bedroom of the White House -- a well-kept
secret until word of the reward system leaked out, sparking a controversy in
the U.S. But what is perhaps most striking about the state troopers' notes
-- based on interviews -- was the propensity of HMA's president, Mr. Dunn, to
boast of his political ties and the fact he was a "friend of Gov. Clinton."
"Mr. Dunn spoke openly and freely and explained to these investigators that
he was the financial portion of the corporation as well as the political
firm," wrote investigator Sam Probasco. "Dunn advised that ... he was close
to Gov. Clinton as well as the majority of state politicians presently in
office." Also in the police files, Dr. Francis Henderson, HMA's medical
director, described how the market for prison blood had dried up in the
early '80s, the period when AIDS emerged.
One U.S. company, Cutter Laboratories, had in 1980 cancelled its contract
to purchase prisoners' plasma, he said, adding that it was "historically" the
worst possible time to sell. "I called all over the world and finally got
one group in Canada who would take the contract," Dr. Henderson told the
state police. The state police documents even contain statements which, if
true, raise troubling questions about how HMA was able to sell its plasma
during that period. The report, written by Sgt. King of the criminal
investigation division, stated: "H.M.A. licence was pulled in 1982 for
Falsifying Records and shipping hot blood. Their licence was pulled (for)
13 months." In a related document entitled "case synopsis," Dr. King also
wrote that in
August 1983, the prison plasma centre was "suspended after an investigation
by department of Health and Human Services, an agency with the Food and
Drug Administration." "The suspension was for collecting and shipping
plasma which had been collected from donors with a history of positive
tests for (hepatitis B) ... The violations were directly related to using
inmate labour in the record and donor reject list." It wasn't until the
Krever inquiry in 1995 that some limited aspects of the prison blood fiasco
began to emerge.
In the early '80s, the Canadian Red Cross had contracts with three U.S.
companies (Cutter, Hyland and Armour) and one Canadian
firm(Connaught) to produce blood products. But not enough plasma was
collected from Canadian donors to produce the products, so some plasma had
to come from U.S. donors.
In December 1982, at a meeting with the U.S. Food and Drug Administration,
the U.S. companies agreed not to use plasma from high-risk donors, such as
prison inmates. But Connaught, because of its Canadian origins, was not at
the meeting and was unaware of the new policy.
To make matters worse, Connaught had decided it was "impracticable" to
inspect all of the plasma-collection sites itself and decided to rely on FDA
reports. Judge Krever discovered that those reports were obtained but not
reviewed by Connaught. The first publicly known signs of trouble came in
mid-June of 1983, when HMA told the FDA that 38 units of plasma it
collected earlier in the year from four inmates at the Grady prison should
not have been collected. The inmates had tested positive for hepatitis B
and it was well understood by specialists by 1983 that anyone with this
disease ran a high risk of also having AIDS. Thus, as Judge Krever noted,
there was a
"greater-than-average risk that the 38 units of plasma from the four inmates
could transmit AIDS."
On June 17, 1983, HMA told its Montreal blood broker, Continental Pharma,
of the problem. Four of the 38 units had already been sent to Connaught in
Toronto, and the other 34 units had been sold to fractionators in
Switzerland, Spain, Japan, and Italy.
Continental Pharma did not immediately warn Connaught of the danger.
Indeed, Connaught didn't learn until Aug. 18 of the problem from the
Canadian Health department, which had been told by the U.S. FDA.
The next day, Aug. 19, a Continental Pharma official told Connaught of the
problem. According to a Connaught memo of the conversation about the
four donors with hepatitis B: "They were from a prison population and had
not been truthful when their history was taken." Until this conversation,
Connaught had been unaware of the fact that it had been processing plasma
collected from prison inmates. The shipping papers accompanying the plasma
had not revealed the centre was located in a prison. They simply referred
to the source as the "ADC Plasma Centre,Grady, Arkansas," without any
indication that "ADC" stood for Arkansas Department of Corrections.
Connaught had received, in February 1983, an FDA inspection report that
revealed the centre was in a prison. But, as Judge Krever noted of the
report: "It had not been reviewed (by Connaught)." By the time Connaught
learned of the concerns about the four prisoners' plasma, it was virtually
too late. It had mixed the plasma in with huge pools of other units,
meaning just one contaminated unit would taint the whole batch. Connaught
had already sent the Canadian Red Cross 2,409 vials of blood products made,
in part, from the four prisoners' plasma. On Aug. 23, Connaught telephoned
the Red Cross and declared that it wanted to withdraw those vials of Factor
VIII, a blood product used by hemophiliacs to help make their blood clot
properly. However, the Red Cross had already sent out the product to its
blood centres in Toronto, London, Hamilton and Ottawa. Officials scrambled
to pull the product from the shelves. But in the end, only 417 vials --
about one-sixth of the total -- was retrieved. Soon after, there was
another warning from HMA about potentially infected plasma from the Grady
prison. Again, it was too late. Connaught asked the Red Cross on Sept. 6 to
retrieve 1,968 vials. Only 27 were recovered. On Sept. 7, Connaught's
vice-president told the Red Cross that the plasma that had led to the two
withdrawals had been collected from prison inmates. The Red Cross
immediately cancelled its contract with Connaught, writing that although
the company was "not directly responsible for the circumstances" and had
"acted in good faith," the problem with the plasma "leaves us with no
confidence in the quality and safety of the material."
When Connaught conducted an internal review of the embarrassing mishap, it
discovered it had also collected plasma in 1982-83 from inmates at four
Louisiana prisons. A company there, Community Plasma Centre Inc., had
sold the plasma to HMA in Arkansas. Again, just as it did with the plasma
from the Grady prison, HMA sold the product to Continental Pharma, which
sold it to Connaught. "There is no doubt that Canada's dependence on
commercial concentrates made from U.S. plasma increased the risk that
Canadians with hemophilia would be infected with HIV," wrote Judge Krever.
The AIDS epidemic had hit the U.S. earlier, and that country's practice of
paying donors increased the risk that high-risk donors (such as drug
addicts) would donate because they needed the money. "The U.S. practice of
collecting plasma in prisons also increased the risk." Unfortunately, by
early 1983, however, Canada's was facing that risk itself. American
hemophiliacs were getting their products from U.S. fractionators that had
closed the door on prison blood. "Connaught, without knowing it, became
the only fractionator in North
American that was using plasma collected in prisons," observed Judge
Krever. Almost all of that plasma, it seems, was coming from HMA in Arkansas,
where Mr. Clinton had been re-elected after being once turfed from office.
He was on his way to being known as the Comeback Kid.
Tom Walker
http://www.vcn.bc.ca/timework/
