What was the growth hormone scandal?

Early 1990sone of the most resounding health scandals in the 20th century breaks out in France. Between 1983 and 1985more than 800 children, develop the neurodegenerative disease known as Creutzfeldt-Jakob. following one or more injections ofgrowth hormone, a treatment that allows them to grow taller. Problem: These synthetic growth hormones are made from the pituitary taken from corpses which are contaminated with prions (infectious proteins). 115 children die from it. After a very long legal process, a first trial opened only 17 years later, in 2008. Seven defendants appeared before the 31st chamber of the Paris Criminal Courtprosecuted for “manslaughter” And “aggravated deception“. But what really happened? Whose fault is it? Back to the growth hormone affair.

Summary of the case: key dates to understand

► From 1983 to 1985: 1,698 children received one or more injections of batches of growth hormones harvested by France Hypophyse in collaboration with the Institut Pasteur. These children need these growth-promoting injections (in other words, they need them to grow) because they are in hormonal deficiency. Over the next few years, approximately 800 children among them develop Creutzfeldt-Jakob disease, without being able to identify the cause. The link between growth hormone injections and the development of Creutzfeldt-Jakob disease is beginning to be made. These treatments with growth hormone indeed come from pituitary glands levied on some corpses which were potentially contaminated with prions, proteins responsible for Creutzfeldt-Jakob disease. “All stocks have been destroyed and only an even more purified hormone is used. We can think that the contamination stopped in May-June 1985 (..) From 1992, we should no longer see new cases appear.“declares Pr Jean-Claude Job, President of the Association France-Hypophyse in an interview relayed by the INA. However, there remain the children treated before 1985, some of whom received a contaminated product.

► In December 1991the parents of Ilyiassil Benziane, a child who died of Creutzfeldt-Jakob disease after receiving growth hormone since 1983, file a complaint with constitution of civil part. A first judicial inquiry is opened.

A treatment that has claimed the lives of more than 100 children

► During the following years, the deaths of children follow one another (approximately about ten each year). Complaints from parents as well. The affair exploded in the media and the court takes up the case. The judicial inquiry and a report by the General Inspectorate of Social Affairs dated 1992 make public serious dysfunctions around France Hypophysis. Nevertheless, the case ran into legal difficulties for years linked to the entanglement of medical and administrative responsibilities.

► In 200817 years after the case was made public, a trial opens before the 31st chamber of the Paris Correctional Court. 7 defendants are tried for “involuntary homicides” And “aggravated deception”. All are personalities from the medical world:

• THE Professor Jean-Claude Jobpresident of France-Hypophyse (the association that collects pituitary glands)
• THE Professor Fernand Drayformer head of hormone extraction at the Pasteur Institute
• THE Dr. Henri Cerceauformer Director of the Central Hospital Pharmacy (PCH)
• THE Dr Elisabeth Mugnier, responsible for the collection of pituitary glands in morgues
• THE Professor Jacques Dangoumauformer Director of Pharmacy and Medicine of the Ministry of Health
• THE Dr. Marc Mollet, other manager of the central hospital pharmacy
• THE Dr. Micheline Gourmelen, doctor

During this trial, Professor Luc Montagnierfamous biologist nicknamed “the discoverer of AIDS”, is expected as witness for the prosecution. In particular, he explained to the court thathe had warned in 1980 of the possible health risks of growth hormone. “The problem with this disaster is that there was a dilution of responsibilities. It would have been necessary at the time for there to be some kind of director, a leader, who would follow all the steps“, he says.

► After the triala dismissal order takes place, for the case to be dealt with at a future hearing. In her order for reference, the judge noted that contamination of treated children “was only possible because of the multiple faults characterized at all stages of the French organization of treatment with growth hormone extracted from human pituitary glands. Gross faults of recklessness and negligence were disclosed with cumulative effect.”

► Between 2010 and 2011A second trial opens, but there either, it does not identify the culprits. A general relaxation is pronounced, which provokes the anger of the families.

► The January 7, 2014: seized by victims, the Court of Cassation annuls the hearing judgment of May 2011. A new trial must be held to determine whether there is civil liability persons prosecuted. The civil parties are appealing after partial cassation of a judgment of the Court of Appeal, for the “irremediable harm” suffered. They are claiming a total amount of approximately 10 million euros. But the request is refused by justice. However, the State decides to cover the allowances, the amount of which is significantly lower than that requested by the families.

► In October 2015the Paris Court of Appeal re-examines – almost 30 years after the events – the civil liability of a director of a laboratory of the Institut Pasteur and a doctor, the last two people still alive prosecuted in the case. Most of the protagonists of the drama being dead. It’s about Professor Fernand Dray responsible for developing pituitary powder (gland containing growth hormone) and the former pediatrician Elisabeth Mugnier who ensured the collection of hypophyses for France Hypophyse.

► January 25, 2016: end of the judicial epilogue. There Paris Court of Appeal exonerates the last two people continued: the “recklessness and negligence” observed having been committed “as part of their professional mission”, their public liability could not be initiated. They do not owe compensation to the families of the victims.

Why was there no culprit in the growth hormone affair?

After the trial, no individual condemnation has ever been retained. For what ? Simply because of the state of scientific knowledge at the time regarding the risk of contamination, considered insufficient. The court considered that the professionals involved in the case had no no individual responsibility in the organization of the samples and that there was onlyA “cumulative effect” in other words“multiple faults characterized at all stages of the French organization of processing”.

What is the number of victims and deaths in the affair of the growth hormone?

Difficult to define with precision how many victims, the business of the growth hormone made. At the start of the 2008 trial, the number of children who developed Creutzfeldt-Jakob disease was estimated at 800 and among them, 115 children would have died. Others still remain today under the threat of developing the disease whose the incubation time can exceed 30 years.

What is the disease associated with the growth hormone scandal?

This is Creutzfeldt-Jakob disease, a incurable neurological disease. It is due to let’s prayinfectious proteins responsible for encephalopathy that cause rapid and fatal degeneration of the central nervous system. This disease often begins with non-specific disorders, such as depressive or anxiety symptoms. Then, memory, orientation or language disorders set in. Then appear dementiaof the balance disorders or sight, tremors, epileptic seizures. Its evolution is rapidly and systematically fatal, reports Public health France. Its cause may be genetic (a mutation of the prion protein gene, the E200K mutation being the most frequent), or of origin sporadic (of random occurrence, without mutation or exposure to an exogenous prion found). But in the case of the growth hormone thing, the cause is infectiousin other words, secondary to contamination.

Sources: National Audiovisual Institute (INA) / Growth Hormone, Evening 3 (April 23, 1990) / Public Health France “Creutzfeldt-Jakob Disease”, January 2, 2023 / Inserm “Prion Diseases & Creutzfeldt-Jakob Disease “