Compensation For Victims of Human Growth Hormone (Hgh) Related CJD
Some 1,800 children were treated under the National Human Growth Hormone (Hgh) programme. This ran from 1959 until May 1985 when Hgh was banned following the death of a recipient in England and two deaths in America from Creutzfeldt Jakob Disease (CJD).
The programme was initially under the control of the Medical Research Council, but from 1977 onwards was run by the Department of Health. It set out to restore growth patterns in children who would not otherwise have reached normal stature.
After the first death here, the programme was immediately stopped following consultation among the clinicians involved, and Hgh was replaced by a synthetic version. The human based product had been prepared from pituitary glands recovered from cadavers - pituitaries were routinely collected at post-mortem examination in mortuaries and it is estimated that over 960,000 pituitaries were harvested to make Hgh and/or other pituitary derived hormone treatments.
In 1992 the news generally broke that there was a risk of CJD associated with Hgh treatment, as the number of deaths rose. Sadly, we are now aware of at least 42 deaths from CJD in this group.
As the numbers of CJD deaths began to rise, we were the first law firm instructed to investigate matters in the early 1990s. We helped campaign with the families for a public inquiry but this was never granted, and as a last resort to try and find out what had happened and why, we launched the Creutzfeldt Jakob Disease litigation in 1993.
This was divided into two groups - Group A on behalf of the victims of CJD and their families, and Group B for psychiatric injury claims for the 'worried well', who can only be told they have received potentially contaminated Hgh which may lead to this invariably fatal, dreadful neurological condition, for which there is still no test and no cure.
We were one of the two firms on the Legal Aid Steering Committee running the litigation, and this was the first Legal Aid contract granted for a group action. This was also the first action brought in relation to any Hgh programmes anywhere in the world and the first successful pharmaceutical group action ever fought in the UK.
Following the generic trial in 1996, Mr Justice Morland held that the Department of Health had been negligent for failing to suspend the Hgh programme as from July 1977.
Initially, the Judge's finding only covered new entrants on to the programme. We successfully argued before the Court of Appeal in 1997 that the Judge should also be asked to consider those already receiving Hgh. The Judge subsequently accepted evidence from various clinicians, who confirmed they would also have suspended treatment for those already involved. This finding meant we were able to obtain compensation for the vast majority of families of those who had died, where either all or the majority of treatment had taken place after 1st July 1977.
The Department of Health agreed they would compensate any after-occurring cases of CJD which fell within the terms of the Judgment, and we continue to be involved with most of those who develop this awful disease.
We also won the right to put forward claims for psychiatric injury for Group B, and the trial of six lead cases came before the court in 1998. Subject to the proof of a frank psychiatric reaction to the awareness of the risk of CJD, these cases were also successful for those treated after 1st July 1977 with potentially contaminated Hgh. (A number of different preparation methods were used during the programme; more modern preparations were used from around mid-1982 and do not seem to be implicated in the crisis).
In what was the first case of its kind, Mr Justice Morland ruled the claimants had suffered psychiatric injury as a result of being told they may develop CJD, and that their fears were rational. This success paved the way for a further 40 people to pursue psychiatric claims within the litigation, as well as numerous 'afteroccurring' claims.
All the lead psychiatric cases were successful and provided a range of cases for the court. The claimants were awarded between £3,500 and £300,000, including, in one case, the largest Smith v Manchester award (for disadvantage on the labour market) made at that time.
CJD has a long incubation period; new cases of CJD are regularly reported. Provisions have been made within the Queen's Bench Division of the High Court to accommodate claims for the foreseeable future.