Following the 2000 report of the Institute of Medicine, To Err Is Human, which documented that as many as 98,000 people in this country die of medical errors every year, medical, hospital, and governmental agencies began to consider changes in hospital systems. The report had found that errors were much more likely to result from systemic problems than from inept health care providers. Progress in reinventing hospital systems has been very slow, although some institutions have made great gains."Medical errors" may be of several types. Some lead to malpractice claims, many do not. Many people who have been severely injured by errors never file claims. Making a medical mistake is not necessarily "malpractice." There are six elements a patient must prove in order to win a malpractice case: a physician-patient relationship must exist, the care provider must owe the patient a duty of care, evidence (usually expert testimony) must be presented that there was a failure in some part of the duty of care, there must proof that the lack of care was the proximate cause of harm, and proof of evidence that harm occurred. The patient must also prove his or her assessment of damages. Solutions to the problem of patient injuries are suggested.