Current patient death and injury data are only estimates compiled by researchers. We don’t really know how many people are affected by medical harm each year. This is because we don’t have an accurate method for measurement, the systems used to measure harm are disparate, and we lack a national and global commitment to standardize metrics. There is no requirement that the frequency and severity of all medical errors, or the resulting patient outcomes, are reported to the public or even to public health authorities. Never events are usually reported at the state-level in the United States. Other sources of information around preventable error come from billing and electronic-health records but there is no system to collate all the information together cohesively to give us the true picture of preventable harm and death among patients. Additionally, death certificates mask the problems by not including “preventable medical error” as either a secondary or primary cause of death. They typically state the diagnosis or underlying condition, such as “myocardial infarction (heart attack)” or “sepsis” or “natural causes,” even when treatment or diagnostic failures were a cause. Additionally, the death certificate isn’t always completed by someone who has cared for the patient and therefore can sometimes be incorrect and very difficult to change after it is issued. The current ICD-10 coding doesn’t allow for the coding of communication or diagnostic failures, for example, the coding is currently limited to disease-states. We saw how quickly COVID-19 became urgently measured and reported in late-2019 and early-2020 and surpassed medical errors as the third leading cause of death. However, with a similar epidemic, patient harm, which has been harming and killing patients for decades, we haven’t been able to elicit action from regulators or legislators to help create surveillance mechanisms to generate reliable statistics to establish a baseline.