Blood on Their Hands

Eric Weinberg, Donna Shaw

• Publisher: Rutgers University Press
• Year: 2017
• ISBN:
  9780813576237
• Topic: Politics & International Relations
• Subtopic: Political Corruption & Misconduct
• Index: Politics & International Relations

A few short years after HIV first entered the world blood supply in the late 1970s and early 1980s, over half the hemophiliacs in the United States were infected with the virus. But this was far more than just an unforeseeable public health disaster. Negligent doctors, government regulators, and Big Pharma all had a hand in this devastating epidemic.
 
Blood on Their Hands is an inspiring, firsthand account of the legal battles fought on behalf of hemophiliacs who were unwittingly infected with tainted blood. As part of the team behind the key class action litigation filed by the infected, young New Jersey lawyer Eric Weinberg was faced with a daunting task: to prove the negligence of a powerful, well-connected global industry worth billions. Weinberg and journalist Donna Shaw tell the dramatic story of how idealistic attorneys and their heroic, mortally-ill clients fought to achieve justice and prevent further infections. A stunning exposé of one of the American medical system’s most shameful debacles, Blood on Their Hands is a rousing reminder that, through perseverance, the victims of corporate greed can sometimes achieve great victory.

1

Liquid Gold

Delano Boudreaux woke to the sound of men cursing and the smell of wet, stale sweat. He didn’t want to open his eyes. Just a few more seconds, he said to himself. A few more seconds and I’ll get up, before the guards come.¹

He rolled over on his flimsy mattress, straightening out to flatten his body against the cool concrete wall along his bunk. This will have to last me all day, he thought. Soon I’ll be out in the goddamn sun, boiling my hide, getting bitten by the Louisiana state bird better known as the mosquito. I’ll be bent over, sweat running up my spine, goose-picking grass from around the fences, and weeding around the flowers. As if the damn flowers made the prison look good.

Not that Boudreaux, who arrived there in 1979, had it as bad as most of the other inmates at the Louisiana State Penitentiary at Angola, America’s largest maximum-security prison. Located northwest of Baton Rouge, at the end of state Highway 66, Angola is a nineteenth-century plantation transformed after the Civil War into an 18,000-acre prison farm. The dormitories, which a map on the prison website says can hold up to 5,295 inmates,² spread across its rich bottomland and are surrounded on three sides by an alligator-infested stretch of the Mississippi River. The fourth side is swamp, with more gators and the world’s biggest, baddest rattlesnakes. At least that’s what the inmates—most of them violent offenders and lifers—are told. “The Farm,” as it is dubbed, has been used continuously for agriculture for more than two hundred years, and most of the inmates, except for those on Death Row, work the fields, growing cotton, soybeans, corn, and other vegetables.

Today, Angola is perhaps best known for its rodeo, an annual extravaganza that every October draws thrill-seeking tourists by the thousands to gawk at inmates clad in black-and-white stripes as they ride bulls and broncos. On the prison’s separate rodeo website, longtime warden Nathan Burl Cain, who resigned in 2016, boasted that it was “the most unique show or performance you’ll see in this country or maybe in the world.” One purpose, Cain said, was to take selfish men and teach them to worry about others.³

But when Boudreaux first got there, the prison had more of a reputation as a corrupt and violent hellhole whose murder rate sometimes challenged that of inmate deaths by natural causes. Angola was a place full of evil men, murderers, rapists, and the worst of the worst. Most would die in that wretched place, one way or another.

Boudreaux, of course, was innocent. He insisted so. Convicted of armed robbery—his brother, he said, was the only one with a gun—he drew a sentence of sixty years. Eventually, in 1999, he would be released after serving twenty-one years.

But that was years away, little more than a ridiculously distant dream on that clammy, muggy morning, as he reluctantly climbed from his bunk for another day’s work. It would be hot, of course, but worse for those inmates who toiled in Angola’s broad, open fields. Boudreaux would not be among them, for he had a bit of a scam going: he’d conned the prison medical department into believing he had a bad shoulder. That’s how he got assigned to weed-pulling duty, and while he hated it, it was a lot better than the harder labor of the farm.

He was almost ready to leave for work when he remembered something that made him smile. He wouldn’t be yanking weeds today after all. No scalding sun, no mosquitoes. No, sir.

It was bleeding day.

Twice a week, an inmate could get a “call out” from work for the whole day just by spending an hour with a needle in his arm, donating blood plasma that then was sold and used for who-knows-what. Cosmetics for ladies, somebody said. Plasma was the secret ingredient in those fancy brands they sold at department stores, the inmates had heard.

The plasma center operated conveniently in a tin and cement-block structure on Angola’s grounds. The center contained a holding cell, restrooms, a bleeding area, and storage freezers. Like others of its kind, it was operated not by the local hospital or the Red Cross but by a for-profit company whose owner paid the state handsomely for the right to set up shop at the prison. The profits for the company, Louisiana Biologics, were even greater; by the early 1980s, they were in the millions of dollars, according to documents later produced in lawsuits. Louisiana Biologics ran half a dozen or so facilities at prisons in Louisiana, Tennessee, and Florida. Many similar civilian centers, owned by other companies, operated in cities and towns across America, usually in neighborhoods where down-on-their-luck types needed quick and easy cash.

At Angola, inmates helped run many of the day-to-day operations. It wasn’t unusual for a donor to arrive at the center and have fellow inmates assist as someone recorded his name, swabbed his arm, stuck him with a needle, drew the blood, spun it in a centrifuge to separate out the watery plasma, and then reinfused the donor with his red blood cells. Each donor gave two units per visit, one plastic bag at a time, and because he was getting back his red cells, could be bled twice per week without fear of anemia.

The bags would quickly be slant-frozen—suspended at an angle—the better to preserve the precious blood proteins. Then they were boxed and placed on pallets, with bills of lading and invoices attached to track their every move.

Corporate documents and witness depositions reveal that, at the height of Angola’s productivity, a large shipment of human plasma would be picked up every two weeks from the penitentiary, loaded into tractor trailers, and delivered to a major international pharmaceutical company, Baxter Healthcare Corporation’s Hyland Division, at its manufacturing facility in Glendale, California. In the early 1980s, between 20 and 25 percent of Glendale’s plasma came from prisons, according to the documents.⁴

Once at Glendale, the frozen plasma bags would be taken to a processing room and slit open, and the precious contents dumped, thousands of units at a time, into huge vats. Rotating paddles would agitate and liquefy the plasma as it thawed. From there, the proteins would be extracted and sent on for further processing.

In industry parlance, the stuff of life could be cracked into separate and distinct components. These blood proteins, called fractions, were the raw material not for cosmetics, as some inmates believed, but for several lifesaving and often breathtakingly expensive medicines, serums, and vaccines. Manufactured at the time primarily by Baxter and three other large pharmaceutical firms, also known as fractionators, these products brought in billions of dollars globally in annual sales.

In late 1993, as part of a lawsuit filed by a patient who claimed he had contracted the AIDS virus from blood products, the manager of Baxter’s plasma operations testified about the safety of the process. The plasma, he insisted in sworn testimony, came from “a completely wholesome, diverse group of donors, including college students, housewives and folks that had jobs who would come in before work or after work, some folks who had part-time jobs and some people that were unemployed.”

Like Rumpelstiltskin spinning straw into gold, Angola’s facility churned out this yellowish plasma, opening its doors to donors early in the morning and bleeding them into the night. It had metal tables for the inmates to lie on, some so beaten up that a table once collapsed underneath a guy getting bled. Boudreaux, who took a paralegal course in prison and wasn’t one to pass up an opportunity, promptly filed a grievance on behalf of his fallen comrade.

Yes, Boudreaux and the other inmates loved what they called “the bleeding,” and not just because it was considered a day’s work. “Donate” wasn’t precisely the right word for what they did. They were paid between five and fifteen dollars per donation, as much as thirty dollars per week if they were bled twice. That compared very favorably to the four cents per hour they received for working in the fields, or twenty cents for working in the laundry.

So there wasn’t much a man wouldn’t say or do to stay on the donor list.

The blood money went into a commissary account, which an inmate could spend on cigarettes, peanut butter, sugar, coffee, and personal items. Ironically, he also might use those goods, especially the cigarettes, to bribe his way back into the plasma center, should somebody suddenly decide a certain guy’s blood was no longer fit to sell. Under federal safety regulations, donors were supposed to be excluded permanently if they had a history of hepatitis, and the potentially dangerous liver infection was common in prisons—places, after all, where high-risk activities like homosexual sex, intravenous drug use with shared needles, and homemade tattoos all were rampant. That, at least, was the rule.

But at Angola, for example, there was an inmate named Shorty who specialized in tattoos. He had fashioned a tattoo gun from the motor of an old cassette player, the barrel of an ink pen, and a guitar string. He used that contraption over and over on men throughout the prison. Still, if you slipped two cartons of cigarettes to a worker at the plasma center, he might look the other way about tattoos or needle tracks, even if he knew you’d just had sex on the prison bus, or in the honeymoon suite better known as the plasma center’s bathroom. Some inmates even had sex in the holding cell as they waited to give their blood. That cell was a social center in a rough world, where prisoners housed in distant barracks could also meet, talk, fight, or shoot drugs.

Indeed, in all the years that Boudreaux was a donor—until the last remnants of the nation’s prison plasma machine were dismantled because by then nobody, not even those gullible foreigners who trusted everything American, wanted inmate blood anymore—he estimated that he’d seen a real, honest-to-God doctor at the plasma center maybe once. The exam, he said, went something like this:

DOCTOR: How you doing? You hurting anywhere?

BOUDREAUX: No.

End of exam.

So at a time when the screening tests performed on donated blood and plasma were insufficient, when health experts including those from the United Nations were warning that prisons were “often ideal breeding grounds” for HIV,⁵ when thousands or even tens of thousands of plasma units were combined into a single industrial vat for the sake of saving on manufacturing costs, Boudreaux wasn’t asked if he was having sex with other inmates, consensual or otherwise. He wasn’t asked to remove his shirt so somebody could check for needle marks, tattoos, piercings, or blood-brother ritual cuts. If anybody did ask, he’d deny engaging in such behaviors. For the eighteen dollars he made each week, who wouldn’t?

Not long after he got out of prison in 1999, Boudreaux was diagnosed with hepatitis C, a potentially deadly form of the virus that causes liver cancer in some patients. He claimed not to know when or how he got it.

He certainly wasn’t the only one. In the 1980s, there were about a dozen plasma operations in U.S. prisons, mostly in southern and western states, on average paying between $5 and $8.50 per donation. Between 30 percent and 60 percent of all inmates were donors.⁶ Besides Angola, other centers were in places like Raiford State Penitentiary in Florida and Tennessee State Penitentiary in Nashville. Many were operated by businesspeople with ties to local politicians.

So in the 1970s and early 1980s, just before HIV was discovered, if 20 to 25 percent of the industry’s raw plasma came from prisons, what about the rest? Much of it, according to corporate and government documents, was collected not at Red Cross blood drives or community or hospital facilities, but at commercial plasma centers. Many if not most of these centers were located in lower-income communities as well as skid-row neighborhoods, including areas frequented by IV drug abusers, alcoholics, homeless people, prostitutes, and illegal immigrants, populations at higher risk for infectious diseases. Maybe these donors were motivated by the desire to help one’s fellow man, but most simply needed the money.

So the for-profit plasma centers thrived not just in prisons but in areas close to transient hotels, homeless shelters, and social services. Court exhibits and depositions included numerous examples. There were centers in Texas border towns, where impoverished Mexicans came across the Rio Grande River and sold their blood. They were in neighborhoods like the one in Akron, Ohio, where in 1974, city health officials determined that at least fifty people with hepatitis had sold their plasma, and lawyers representing hemophiliacs learned that women hired to draw blood there were poorly trained, with some of them moonlighting as go-go dancers at a nearby bar. And they were in places like Johnson City, Tennessee, where the center’s manager told FDA inspectors in 1984 that some donors were so poor he would lend them shoes so they would be in compliance with the state health code.⁷ He quickly added that he refused to lend anyone his shirt.

Except for the prisons, much of that network still exists today.

Blood centers also operated in several poor regions of the Caribbean, Central and South America, Asia, and even sub-Saharan Africa, believed to be the birthplace of the AIDS virus. Corruption was not unusual, and these centers rarely if ever were inspected by the U.S. Food and Drug Administration. In 1978, a center in Nicaragua was burned down by townspeople angry with its owners—dictator Anastasio Somoza and his business partner—who were believed to have helped plot the assassination of a local newspaper publisher.⁸ Somoza later fled the country and was assassinated in 1980; his partner also left Nicaragua, and reentered the plasma business with the wife of a politician in Belize. Another center, in South Africa, was found to be smuggling plasma out of the country by deliberately mislabeling it as an animal product, then relabeling it as human blood when it reached its destination: the European factory of a major U.S. blood-products supplier. The ruse wasn’t discovered until after the product had been manufactured and sold. The suburban Philadelphia company involved, Rhone-Poulenc Rorer Inc., and its Armour subsidiary, called themselves the victims, saying they thought the plasma came from Canada. But they did not issue a product recall, and patients continued to use it without knowing of its origins.⁹

Even some of those who sold their plasma for more altruistic reasons unwittingly took part in what would become a public-health nightmare. Some plasma centers, for example, recruited heavily for donors in the gay communities of large cities, especially among men who had been infected with hepatitis B. Ads in newspapers targeted at the gay community proclaimed, “We need a few good arms!” and “Do your share!” and “Help stamp out hepatitis B!” and “Donors urgently needed!” These plasma donations, the ads said, not only would earn them as much as thirty-one hundred dollars per year but “at the same time, you’ll be helping to contribute to the health and welfare of other gay men and women.” And this was true, because their hepatitis antibodies and antigens were used in research and production of lifesaving vaccines and serums. But ins...