Isabel Gal

Isabel Gal (1925 - 2017), was a Jewish Hungarian paediatrician who was responsible for highlighting the link between use of the hormonal pregnancy test Primodos and severe birth defects.

Dr

Isabel Gal
Born1925
Died2017
London
NationalityHungarian
CitizenshipUnited Kingdom
EducationUniversity of Edinburgh Medical School
Alma materUniversity of Budapest
Known forPaediatrician known for establishing the link between hormonal pregnancy tests and severe birth defects.

Early life and education

Born in Hungary in 1926,[1] Isabel was the daughter of Geza Gunsberger, a merchant from Nagybánya,[2] and Irma Hacker, from Austria. Gunsberger worked first for a timber merchant and later founded a lingerie company. During the Holocaust, Gunsberger was deported to the Mauthausen concentration camp,[2] where he died. Isabel, along with her mother and sisters, Erica and Lia, were sent Auschwitz concentration camp, all four survived the war.[1] After the war, Isabel returned to Hungary and studied medicine at the University of Budapest. Qualifying as a doctor, she worked as a paediatrician at Bokay children's hospital in Budapest.[3]

In 1953, she married Endre Gal, a mathematician, whose father was a timber merchant who Isabel's father had previously worked for, and in 1956 the couple's daughter Katinka was born.[1] Later in 1956, with the Hungarian Revolution underway, the family left Hungary together with Isabel's mother Irma, and fled through Austria to England where Erica had settled after the war.[1]

Career

In the UK, Gal retrained as a doctor at University of Edinburgh Medical School and her husband taught mathematics at Imperial College London.[3] After re-qualifying Gal worked as a paediatrician at Great Ormond Street Hospital in London, and Queen Mary’s Hospital for Children in Surrey,[4] and as a clinical lecturer at the Institute of Obstetrics and Genealogy, at Imperial College London.[5] Throughout her career Gal published extensively on pregnancy tests, oral contraceptives and vitamin A.

Primodos

In 1967, while working at Queen Mary's Hospital for Children, Gal published an article in the journal Nature, highlighting a potential link between the hormone-based pregnancy test Primodos, manufactured by German drug company Schering AG, and congenital birth malformations. Gal found that from a group of 100 women who had babies born with spina bifida, 19 had taken Primodos, whereas in a control group of 100 women with healthy babies, only four had used the drug. She hypothesised that the high does of hormone in the pregnancy test, might have interfered with the foeto-placental unit.[4] In the article, Gal also noted that the pregnancy test used the same components as oral contraceptive pills which might also constitute a similar risk.[4]

Gal took her findings to the Department of Health and the Committee on Safety of Medicines however neither Schering nor the UK government acted on her research.[6][7] It was not until 1975, when further evidence emerged supporting her findings, that the Committee on Safety of Medicines issued a warning about use of the drug,[4] and it was 1978 before Schering withdrew the Primodos, by which time it had already been banned in several other countries.[8] One reason for this inaction was that the government did not want to discourage women from taking the newly available oral contraceptive pill.[9] In a 1997 book,[10] Bill Inman who had been Senior Medical Officer at the UK Department of Health and Social Security at the time and who corresponded with Gal about her findings, wrote:

On the one hand we had Dr. Gal's suspicion of a possible danger to the foetus and, on the other hand, a very real danger that publicity might cause a woman to stop using oral contraceptives or other preparations that were important in the treatment of a variety of gynaecological disorders. I was advised not to discuss these possibilities with anybody in case the idea that the HPT problem might have much wider repercussions inadvertently slipped out, though I can hardly believe that many people would not have thought of it themselves.

in 2017, Inman was found to have destroyed documents relating to the case.[6]

Gal believed that she was discriminated against and blacklisted for voicing her concerns about hormonal pregnancy tests and their potential link to the oral contraceptive pill. Her position Queen Mary's was terminated, she was unsuccessful in securing another senior post and eventually left the medical profession.[3][4]

An Independent Medicines and Medical Devices Safety Review, led by Baroness Cumberlege, published in 2020, vindicated Gal's original research, finding that "avoidable harm" resulted from the use of Primodos, and concluding that the drug should have been withdrawn from use in 1967.[11][12]

Later life and death

Later in life Gal lived with her husband Endre in Teddington, south west London. She died in 2017 at the age of 92.

Media

Thames Television produced a documentary titled The Primodos Affair in 1980,[13] and in 2020, Sky News produced a documentary titled Bitter Pill: Primodos, which highlighted Gal's role in identifying the dangers of the drug.

References
  1. Montuschi, Mike (2018-03-13). "Isabel Gal obituary". The Guardian. ISSN 0261-3077. Retrieved 2020-10-13.
  2. Nevek = Shemot = Names. Bar Shaked, Gavriel., ‏בר־שקד, גבריאל., ‏יד ושם, רשות הזכרון לשואה ולגבורה. Jerusalem: Szól A Kakas Már. 1990–2005. ISBN 965-308-018-0. OCLC 32131123.CS1 maint: others (link)
  3. Judah, Jacob (20 August 2020). "The Holocaust survivor 'blacklisted' for warning about 'birth defect' pill". The Jewish Chronicle. Retrieved 13 October 2020.
  4. "Is this the forgotten thalidomide?". The Telegraph. Retrieved 2020-10-13.
  5. Doyle, C (1977-10-03). "Babies scare denied". The Observer.
  6. "Primodos: Sky News exposes pregnancy drug cover-up". Sky News. Retrieved 2020-10-14.
  7. Connor, Laura (2020-08-23). "Heartbreaking tragedy of brave medic who discovered Primodos birth defect link". mirror. Retrieved 2020-10-14.
  8. "Primodos was a revolutionary oral pregnancy test. But was it safe? | Jesse Olszynko-Gryn". the Guardian. 2016-10-13. Retrieved 2020-10-14.
  9. Olszynko-Gryn, Jesse; Bjørvik, Eira; Weßel, Merle; Jülich, Solveig; Jean, Cyrille (2018-10-23). "A historical argument for regulatory failure in the case of Primodos and other hormone pregnancy tests". Reproductive Biomedicine & Society Online. 6: 34–44. doi:10.1016/j.rbms.2018.09.003. ISSN 2405-6618. PMC 6234516. PMID 30456319.
  10. Inman, W. H. W. (William Howard Wallace), 1929- (1999). Don't tell the patient : behind the drug safety net (1st ed.). Los Angeles, Calif.: Highland Park Productions. ISBN 0-9675812-0-6. OCLC 43822542.CS1 maint: multiple names: authors list (link)
  11. "First Do No Harm: Independent Medicines and Medical Devices Safety Review" (PDF). 2020.
  12. "Government should consider 'redress' for victims of Primodos pregnancy test drug, Theresa May says". The Independent. 2020-08-23. Retrieved 2020-10-14.
  13. "The Primodos Affair (1980)". BFI. Retrieved 2020-10-14.
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