Photo of Bud an Arkansas paid prison plasma donor with sister Linda a campaigner for the rights of prisoners and on the prison blood scandal. Bud, a known drug user, was infected with hepatitis C and died of liver disease
In 2003, UK haemophiliacs that had obtained their medical treatment records launched a legal case in the US against four international plasma companies for infection with HIV and hepatitis C through products known as factor concentrates. This was initiated by my husband, haemophiliac Peter Longstaff, (now deceased) a case which he and his lawyers opened up to other victims.
Haemophilia is an hereditary condition where the blood does not clot properly and throughout the 1970s and 80s those affected received injections of freeze dried plasma mixed with sterile water (factor concentrates) taken from blood donors who did have an effective clotting mechanism to help prevent bleeding episodes and stop bleeds when they occured.
Unfortunately the British government failed to invest adequately in our own UK Blood Product Laboratory (BPL) that supplied treatment to haemophiliacs. Instead of working to achieve self-sufficiency in blood products with a commitment by Lord David Owen in 1974 and recommended by the World Health Organization in 1975, the UK relied heavily on imported plasma products sourced from the blood of “high-risk” donors such as prisoners and “skid-row” donors. Unlike British volunteer donors, US prisoners were paid for their blood. Lord Owen only found out years later (much to his horror) that what he had put in place when in the Department of Health was not continued by others once he departed for the Foreign Office.
Separate to haemophilia treatment, the British government have always denied importing whole blood from the US. Whole blood cases were for many years treated as separate legal cases and an entirely different product to that used by haemophiliacs and other persons with clotting disorders. Former Solicitor-General, Lord Archer of Sandwell recognized this difference in setting up the Archer Inquiry in 2007 which was specifically to investigate what happened to haemophiliacs and their families and did not include whole blood cases who deserve their own specialists specific to the whole blood which was given to them.
US prisons, experimentation and the plasma trade
Throughout the 1960s international medical journals highlighted the dangers of using prisoners as paid donors. Sam Stein QC instructed by Milners solicitors and acting for this author and other haemophilia victims highlighted the dangers of pooled plasma and the hepatitis risk from long before this date during the opening sessions of the Infected Blood Inquiry now commenced under Justice Langstaff. Many prisoners were known drug addicts infected with hepatitis viruses before being incarcerated or if uninfected when admitted to jail, were at risk once inside through needle sharing and unprotected sex (including anal) with multiple partners.
In addition to this for many years US prisons relied on inmates for bio-experimentation, testing out new drugs, vaccines, and other viral experiments.
In 1969, Walter Rugaber of the New York Times wrote a damning report, Prison drug and plasma projects leave fatal trail which began,
The Federal Government has watched without interference while many people sickened and some died in an extended series of drug tests and blood plasma projects. The profits generated by these activities have gone to an enterprising contractor for the nation’s biggest pharmaceutical manufacturers. The immediate damage has been done in the penitentiary systems of three states. Hundreds of inmates in voluntary programs have been stricken with illness and serious disease. An undetermined number of the victims have died.
An executive of Cutter Laboratories once acknowledged, for instance, that gross contamination was apparent in the areas where the largest blood plasma operations were conducted. The rooms were “sloppy,” he observed. When a Government doctor asked why Cutter continued to reward such an enterprise with hundreds of thousands of dollars’ worth of business, the executive explained that the Stough group enjoyed crucial “contacts” with well placed officials.
An Advisory Committee on Human Radiation Experiments ACHRE report also highlighted,
It should be noted that the use of prisoners as research subjects seems to have been a uniquely American practice in the years following World War II. The large-scale successes of prison experimentation during World War II–and the authoritative pronouncement of the Ivy Committee that prison research could be conducted in an ethical fashion–seem to have given the practice a kind of momentum in this country that it did not have elsewhere. In other countries it seems that the first clause of the Nuremberg Code was interpreted to preclude the use of prisoners in experimentation. This clause begins with the assertion that the only acceptable experimental subjects are those who are “so situated as to be able to exercise free power of choice.”
It is difficult to overemphasize just how common the practice became in the United States during the postwar years. Researchers employed prisoners as subjects in a multitude of experiments that ranged in purpose from a desire to understand the cause of cancer to a need to test the effects of a new cosmetic. After the Food and Drug Administration’s restructuring of drug-testing regulations in 1962, prisoners became almost the exclusive subjects in nonfederally funded Phase I pharmaceutical trials designed to test the toxicity of new drugs. By 1972, FDA officials estimated that more than 90 percent of all investigational drugs were first tested on prisoners.
By 1972, US haemophiliacs were already several years into taking factor concentrate treatment made of pooled plasma from up to 60,000 donors which in itself was regarded by some hepatitis experts such as J Garrott Allen as a highly dangerous treatment as it was launched onto the market without first finding a way to eliminate hepatitis viruses.
Haemophiliacs were repeatedly exposed to hepatitis from multiple donors from the first injection of this controversial treatment which was labelled a “miracle” treatment by many doctors as patients could inject it at home without having to go to hospital each time a bleed occured. It was not only sourced from some of the highest risk donors in society, US prisoners but with the added safety concerns in relation to inmates being the subject of bio-experimentation, a recipe for disaster.
In the UK, blood donors were not paid and were subjected to strict screening procedures under a blood collection system which in the 1970s was considered one of the safest in the world.
One of those to take advantage of the US prison system (which housed many black prisoners already treated as second-class citizens) was Dr Austin R. Stough who was said to have netted “millions of dollars” from his experiments. In those prisons where he operated amid concerns over “poorly trained staff” and “shoddy operations” it was noted that the incidence of viral hepatitis was “rising sharply” with prisoners “dropping like flies” as stated by Alan Hornbum in his book, Acres of Skin: Human Experiments at Holmesburg Prison.
Michael Byrd and Linda A Clayton in their book, An American Health Dilemma: Race, Medicine and Health Care in the United States 1900 to 2000 state,
Despite federal investigations concluding that both the technique and aparatus utilized by Dr Stough were at fault, there is no evidence that a single pharmaceutical company severed relations with him. By 1969 when the institutional, corporate, scientific, medical and ethical malfeasance became public, despite the secretive nature of events, occuring behind prison walls and sloppy record keeping, at least 544 illnesses could be fixed and attributed to the experimental operations – the CDC estimated 800. Oklahoma took over Stough’s prisoner and drug operations. Alabama halted the plasma program but continued his drug testing experiments and Arkansas authorities permitted him to continue the plasma operation without interuption.
It was against this background, that the British government chose to import blood from US prisons. Several hundred haemophiliacs eventually joined a class action lawsuit with US lawyers where their treatment batch numbers were traced back to a number of US prisons including Arkansas State Penitentiary. Judge Grady however ruled “forum non conveniens” that these cases must be heard in a British court. The plasma companies had accepted a finite number of haemophilia cases and the case was closed in the US with no more persons allowed to join. An agreement was reached and a silence clause added. It was clear from the plasma companies that British authorities were aware of the dangers from importing US plasma as highlighted in medical journals, documentaries, letters from US experts to British officials and in the media but government appeared to simply turn a blind eye. The first line of “duty of care” for UK haemophiliacs was placed by Grady back at at the feet of UK authorities. However the excercise had proved very useful in both tracing, US treatment, verifying this and acceptance of batch numbers by 4 pharma companies for this specific group of haemophiliacs.
To return to the prisons… As I wrote in my dissertation research in 2006, a study by Cohen and Dougherty (1968) study concluded that “the risk of it (hepatitis) developing in recipients of blood known to have been donated by convicted or suspected narcotics addicts was 70 times that in the controls” (JAMA, Feb 5″‘, 1968: Vol 203, No 6).
Back in 1975, J Garrot Allen (US) wrote to Sir William Maycock (UK) describing one US product as “extremely hazardous with a 50 to 90 per cent rate of icteric hepatitis developing from it.” He writes of his concerns related to an emerging strain of hepatitis which is not hepatitis A or B, which appeared in “high-risk” donors. Garrott Allen stated that,
Whatever this agent may be, it still seems to be more frequently encountered in the
lower socio-economic groups of paid and prison donors…. (and) until we understand
this problem better, I would hope Great Britain would give some thought to what the
purchase of Factor VIII and IX from the United States tends to do to our attempts to
secure a volunteer program. (Garrott Allen letter, 1975)
Victims who produced evidence of being treated with US prison blood and whose cases were accepted by US lawyers are still waiting for their cases to be heard in the UK courts. This is an entirely separate case to that launched by a UK legal firm in 2017 that were granted a Group Litigation Order on “new evidence” described in media articles and claim to have been discovered by one of their clients. This is strongly disputed as not new but in fact earlier evidence discovered by this author in 2006 and part of her awarded dissertation. I have since had one of the journalists involved visit me to see the original documents and she admitted that the documents could not be “new” in 2017. Others have withdrawn the word “new”. These key documents were repeatedly ignored by government bodies, the Haemophilia Society and some lawyers for years which helped to prevent victims getting to court and obtaining justice.
Questions submitted to the UK Department of Health and Social Care
Today (November 21st 2018) the following questions were submitted to the Department of Health and Social Care under Freedom of Information regarding the use of US prison plasma and a reply should be forthcoming within 20 days. Government has a duty of care to protect both blood donors and blood recipients and neither exploit, nor overbleed nor experiment on either.
1) To ask the Department of Health and Social Care under FOI, what assessment was made of the risks and dangers from factor concentrates manufactured from the blood of US prisoners prior to importation in 1973?
2) To ask the DHSC, what consideration was taken of the fact that US prisoners were being used for bio-experimentation, were often serving life sentences, moving between prisons and could be infective with viruses for life, and that “at least 544 illnesses and deaths (to US prisoners) could be fixed and attributed to the experimental operations- the CDC estimated 800”?
3) Please release any documents regarding assessment of the above risks under FOI.
I look forward to your response.
Experimentation on prisoners did not stop despite the many safety concerns raised. As Jonathan Steele wrote in the Washington Post in 1977,
The Carter administration has decided to continue the practice of authorizing drug companies to use prisoners as human guinea pigs. The United States is the only nation that still officially approves of such experiments, including behavior control and the testing of potentially lethal drugs and vaccines on a prison population.
Hepatitis outbreaks in UK haemophiliacs
UK Haemophiliacs were at this time (1970s) regularly injecting US factor concentrates sourced from a number of prisons across the US and British doctors were dealing with the subsequent hepatitis outbreaks linked to imported treatment documented in government papers and in studies in medical journals. This was highlighted in chapter 4 of my 2006 dissertation on contaminated blood and the global blood trade which can be read on the following link,
There were many ways for unsuitable prison plasma donors to bypass safety checks according to prison campaigner Linda Miller with whom I had contact such as allegedly using a name from the local Arkansas telephone directory instead of their own. Prisoners were also alleged to be directly involved in the administration side of the programme which made such actions easy to carry out. As Linda discovered, one prisoners’s job was to resharpen needles with sandpaper for re-use, a health and safety nightmare.
Even if there was informed consent for experimentation on some prisoners, there was not informed consent in relation to haemophiliacs receiving blood from prisoners used as guinea pigs as haemophiliacs only found about the dangers years later when they were infected themselves and had not known of these earlier experiments on US inmates.
Safety of prison plasma did not improve in the 1980s, journalist Mara Leverett wrote,
in the summer of 1983, the FDA had learned that HMA had sold 38 units of plasma drawn from inmates who were known to have tested positive for hepatitis. The products were recalled, but not quickly enough.
Almost four thousand vials of product made from the unsafe plasma were sent around the world, many for use by hemophiliacs.
This was also the time of AIDS emerging with US haemophilia cases coming to light a year earlier in 1982 and concerns raised by American epidemiologist Don Francis (former Center for Disease Control) whom I met in Washington DC several years ago and US scientist and AIDS researcher Harold Jaffe who also worked at CDC, see following links,
Don Francis Pillars of Democracy, Tainted Blood video
CPAC October 19th, 2017
Harold Jaffe interview video
David J. Sencer CDC Museum, Global Health Chronicles
Dr. Bess Miller, Interviewer | 2016.500.1
The Early Years of AIDS: CDC’s Response to a Historic Epidemic |
Our lawyers have recommended both be interviewed as expert witnesses by the Infected Blood Inquiry team.
A UK journalist Christine Doyle writing in the Observer from the US also warned of risks to UK haemophiliacs in January 1983 see following article,
“Widow claims contaminated blood warnings were missed” (March 14th, 2018)
Susan Douglas another British journalist also wrote an article warning of the risks to UK haemophiliacs from imported prison blood in the Mail on Sunday on May 1st 1983 but as I highlighted in my dissertation,
The Government reacted to the article by stating that the evidence presented by
Douglas was “too slight for immediate action.” The Press Counsel went on to censor the
Douglas report as “extravagant” and “alarmist” (Douglas, 1984). This had the effect of
temporarily closing down some news stories on AIDS but haemophiliacs had begun to
question the risks associated with their treatment and once again were met with the
repeated response “not to worry.”
What we now know also is that warnings given by Dr Spence Galbraith (Public Health Laboratory Service, UK) to Ian Field (Department of Health and Social Security) on 9th May 1983 to withdraw US treatment off the shelves due to concerns over AIDs were ignored and the treatment remained in use. US lawyers were able to confirm years later that at least one of the prison plasma batches my husband Peter received contained an HIV positive donor. He also received plasma from Arkansas State Penitentiary during a period when the prison system was deemed “unconstitutional” but no treatment was recalled in the UK. As Kelly Duda highlighted in a letter to Peter’s former QC, Stephen Grime for the High Court,
John Andervont, a former inspector and retired director of Blood Center Licensing for the FDA, remembered catching inmates performing phlebotomies at the Arkansas prison. Bill Douglas, a former Arkansas inmate infected with hepatitis C, who sold plasma regularly at the time Longstaff (my late husband) infused Cutter Lot NC 8196, stated: “They didn’t care. If you could crawl to get there you were able to give blood.”
Peter was also infected with hepatitis B and C having received his first factor concentrates in 1973.
When my husband did discover more about the history of prison blood, he promptly went on treatment strike refusing human plasma until he died. He took a legal case to the High Court to fight for synthetic Recombinant treatment in 2003 that did not use human plasma but was denied this on the grounds of cost. (He was then exposed to variant CJD through British blood which could have been avoided had he been given Recombinant when he first wrote asking the local health trust for this in the Spring of 1996, months BEFORE his first exposure to v CJD.)
However although the High Court judge did not dispute evidence of past safety failures in relation to imported US treatment, the ruling stated that each UK Health Authority could chose how to spend its funding in relation to treatment products (known as post-code lottery) and to change this would have costing implications far beyond haemophilia patients.
Campaigning on contaminated blood is always revealing new information. Some years ago I received several e-mails from a former prisoner who claimed he had been injected in a prison experiment by Dr Stough as a young man and had been friends with his son. He alleged Stough had encouraged him to participate in experimentation offering a reduction in his prison sentence. The man believed from the conversation with Stough that he had been injected with some strain of hepatitis virus and recalled being told not to worry as it would be years before he experienced any symptoms though his stomach might “blow up” in the future. On reflection he thought this may have been a reference to ascites and the heavy fluid retention associated with advanced liver disease. As many years had now passed he was currently concerned about experiencing extreme fatigue and debating whether to get tested for hepatitis viruses.
Torture of prisoners
Alongside prison experiments there is also the alleged torture of US prisoners to consider. Torture is illegal, so where would that leave a government that bought in blood from prisoners subjected to abuse and torture? These allegations going back decades continued throughout the 1980s and 90s.
Back in 2001, I handed in a letter at number 10 Downing Street to then Prime Minister Tony Blair accompanied by the late Lord Morris of Manchester first minister for disabled persons and other haemophilia campaigners. The letter was from Linda Miller, the sister of an Arkansas prisoner who had been a plasma donor, a known drug user who was infected with hepatitis C and alleged both human rights abuses and gross safety violations in the plasma programme. Government failed to address any of the issues raised!
There are also concerns regarding treatment of prisoners that have spoken publicly about the prison plasma programme such as the case of Rolf Kaestel who was transferred from Arkansas to another prison after being interviewed by Kelly Duda for his documentary on prison blood, Factor 8: The Arkansas Prison Blood Scandal. As Duda confirmed in 2014, “I spoke with an assistant attorney general in Arkansas who confirmed for me at the time that the transfer was indeed a retaliatory action against Rolf for speaking out.”
More on his story can be read here,
“Free Rolf Kaestel: The prisoner who blew the whistle on a prison blood scandal linked to Bill Clinton”
Arkansas has a long history of alleged abuses including torture highlighted by Thomas Murton who discovered 3 skeletons at Cummins prison farm in early 1968 and published his Accomplices to the Crime in 1969 after attempting to reform the prison system against much opposition. His real life experience was turned into a Hollywood dramatization, a film named “Brubaker” featuring Robert Redford in the role of the prison governor. Little did I imagine when I first saw the film in 1980 that I would have my own connection to Arkansas State Penitentiary in later life through my husband!
I have always stated that had the abuses in the main US prison system been investigated then the US might not have got away with the abuses in Guantanamo and elsewhere. US torture instrument the Tucker Telephone (developed in Arkansas State Penitentiary, named after the Tucker Unit) was used to supply electricity to the genital area of prisoners. A modification of the Tucker Telephone was allegedly exported abroad to other prisons such as Abu Ghraib and Bagram.
As American Civil Liberties Union (ACLU) showed recently (November 13th, 2018) the CIA also had a vested interest in experimenting on prisoners. ACLU recently tweeted,
“thanks to a victory in our lawsuit against the CIA, we obtained secret documents on the torture program. They include a detailed, first-person account of the top CIA medical professional responsible for torturing prisoners.”
Now more than ever it is important to ensure that this dreadful episode in both US and UK blood history and experimentation is not forgotten. Documentary maker Kelly Duda who is from Arkansas (and knows the political climate there well) was invited to give evidence to the Archer Inquiry in 2007 regarding his film focusing on the plasma programme. I recommended Duda a long standing contact of 20 plus years who had interviwed inmates to Lord Archer. Duda claims to have been threated during the making of his documentary. He has assisted other countries in their search for the truth on the prison blood trade and it is hoped he will also be called upon to discuss his findings at the current Infected Blood Inquiry.
To quote ACLU as to why there must be investigations into past prisoner experimentation and torture,
“The truth is that CIA torture left a legacy of broken bodies and traumatized minds. Today, with a president who has vocally supported torture and a new CIA director who was deeply complicit in torturing prisoners, it’s more important than ever to expose the crimes of the past. Recognizing the roles played by the lawyers, doctors, and psychologists who enabled torture is critical to making sure it never happens again.”
A multitude of people failed to protect both US prisoners and haemophiliacs receiving their blood, safety violations and serious abuses occurred. Arkansas State Penitentiary has selectively obliterated part of its history on the prison website. As part of the healing process it is essential that this episode in history is no longer swept under the carpet by governments but discussed openly in order that such atrocities never happen again. Those infected and affected need to finally find some peace to continue what is left of their already shattered lives.
They were cheap and available: prisoners as research subjects in twentieth century America (British Medical Journal: 1997;315:1437)
Poison from the prisons (March 11th 1999)
Law suit for infected blood 2003 (Guardian, June 4th 2003)
Bloody Awful: How money and politics contaminated Arkansas’s prison plasma programme (Arkansas Times, August 16th 2007)
Arkansas Bloodsuckers: The Clintons, Prisoners and the Blood Trade (Counterpunch, September 4th 2015)
Carol Anne Grayson is an independent writer/researcher on global health/human rights/WOT and is Executive Producer of the Oscar nominated, Incident in New Baghdad. She is a former Registered Mental Nurse with a Masters in Gender Culture and Development (Distinction). Carol was awarded the ESRC, Michael Young Prize for Research 2009, and the COTT ‘Action = Life’ Human Rights Award’ for “upholding truth and justice”. She is also a survivor of US “collateral damage”.