From: Charles Medawar
Date: 17 October 1998 1700
To: Dr Munir Pirmohamed
Re: Drug-induced iatrogenic illness

Dear Dr Pirmohamed,

Nearly six months have passed since I wrote to ask for the evidence on which the estimates in your BMJ article were based and I am wondering if you will soon be in a position to respond. Your email of 6 August said you expected to get back to me in the near future, but that moment has passed. I appreciate you are extremely busy; me too.

Since writing to you I have learned of a proposal, from a very good stable, to carry out a pilot study into the extent of drug-induced illness in hospital. Extrapolating from conservative US data to hospital treatment in England (not the whole UK), this team suggests that "iatrogenic injury potentially ranks third to heart disease and stroke as a cause of death, even though not necessarily the sole cause". This underlines the significance of the questions I asked about the basis of your own estimates of incidence in the UK compared to the US.

I'd be grateful if you could respond soon to the questions I asked (copy letter attached), or indicate by when I might expect to hear from you.

Yours sincerely,
Charles Medawar


From: Dr Munir Pirmohamed
Date: 26 October 1998 15:55
To: Charles Medawar
Re: Drug-induced iatrogenic illness

Dear Mr Medawar,

I have written a reply to you and I have first given it to Professors Breckenridge and Park to make sure they agree with what I have said. Once I receive their comments, I will e-mail you the reply as well as send it by surface mail.

Apologies for yet another delay!

Munir Pirmohamed



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