Organizational costs associated with medical errors, and specifically adverse drug events, have been reported. This study analyzes such costs and also examines what proportion is absorbed by hospitals. Using claims data from a past study, investigators determined that hospitals assumed only 22% of costs associated with injuries. The authors advocate for continued efforts to improve the business case for safety interventions, partly by understanding the marginal costs associated with a given safety improvement. Legal reforms or market interventions are also suggested as mechanisms to deal with the externalization of injury costs.