In order to reach an estimate of drug-related deaths, the Adverse Drug Reaction Committee/the Norwegian Medicines Control Authority obtained access to data from the Department of Internal Medicine in a Norwegian county hospital. The criteria for classifying possible/probable cause of drug-related deaths were assessed. 6.5 deaths per 1,000 hospitalized persons were found to be probably or possibly drug-related. This figure far exceeds the numbers reported in the literature (0.9-4.4 per 1,000 hospitalized). Only two cases were detected by the clinician, one of which was reported to the Adverse Drug Reaction Committee via the spontaneous reporting system. The current criteria for assessing drug-related causes of death appear to be inadequate.