Of 7,423 medical inpatients, 16 (0.22%) died of drug-associated causes. The overall mortality for all medical inpatients was 6.5%. Eleven of the 16 patients who died of drug-associated causes had been terminally ill; the rest had been seriously ill before the fatal drug reaction occurred. Half of the patients had had either hematologic malignant changes or lupus nephritis. Antineoplastic drugs, azathioprine, prednisone, and heparin sodium were the most frequently implicated drugs. In other studies, we have found widely differing incidences of fatal drug reactions, due to a number of different drugs; these disparities are probably related to variations in the types of illnesses among different hospital populations and to varying interpretations of the term "drug-associated death." Extrapolation from the available data to a national incidence of drug-associated deaths is not possible. Drug-associated deaths are relatively uncommon and usually occur in the cases of severely or terminally ill patients treated with potentially highly toxic drugs.
(Arch Intern Med 136:872-875, 1976)