Re last week's report of the inquest into the death of Emma Appleby (Woman died waiting for PCT to give drug trial response), we are not aware that the PCT was contacted by your reporter for a comment on this case.

The PCT has arrangements in place for specialists to provide Sildenafil for pulmonary hypertension (an unlicensed drug for this particular condition and not a trial drug) through commissioning arrangements with three specialist providers due to the complexity and safety requirements of this treatment.

St George's Hospital is not one of the preferred providers. The doctor who contacted the PCT was advised by our prescribing team of the arrangements in place.

As is made clear in the article, the inquest heard that neither the drug nor an earlier diagnosis would have saved Emma's life.

It is clearly misleading, therefore, for your headline to infer that the PCT's involvement in this patient's treatment contributed to her unfortunate death.

DAVID SMITH

Chief executive, Kingston Primary Care Trust