Intravenously Given Ethacrynic Acid and Gastrointestinal Bleeding

To the Editor:—  Slone et al prior to publication of their "event analysis" of data derived from their surveillance program,¹ graciously reported to these laboratories their suspicion that the intravenous administration of ethacrynic acid is associated with an increased incidence of gastrointestinal bleeding. The opportunity was provided to visit the two hospitals from which these cases were reported. It is our judgment, after reviewing the patients' records, that a number of factors important to consideration of this possible association are controversial, or have been ignored.Slone and colleagues noted an association between ethacrynic acid and gastrointestinal bleeding in 32 patients. Twenty-eight patients' charts were available for review. One was checked out to another department, and three were not provided because the patient was not known by name or hospital number at the record room. This may reflect key punching or other data recording errors.Progress notes, physicians' orders, and