This Agency for Healthcare Research and Quality–supported study discovered that claims without clear evidence of error do occur, but most fail to receive compensation. On the other hand, the majority of expenditures toward litigation occur in cases of errors in which compensation is awarded. Investigators reviewed a random sample of more than 1400 closed malpractice claims to better understand the prevalence, characteristics, litigation outcomes, and associated costs, all of which are presented in detail. Based on their findings, the authors advocate that limiting frivolous litigation will have significantly less impact on case load and litigation costs compared to streamlining the process for claims that clearly warrant compensation and belong in the system. Their conclusions are supported by a past effort at understanding the relationship between malpractice claims and adverse events due to negligence. In addition, a past case study presented the tension between malpractice claims and patient safety initiatives with a series of proposed targeted reforms toward a more effective system.