In regards to medical malpractice and litigation it has been shown for years that a simple apology can preclude lawsuits being filed, yet the apology laws in place have shown they have little influence on the increase of malpractice disclosure by doctors and hospitals. The Pennsylvania Patient Safety Authority and the Department of Health have examples of the disparity in reporting serious medical malpractice events. Pennsylvania is one of the states requiring serious events to be reported. While many “incidents” are reported, very few events are reported where the patient has actually been harmed, which are designated “serious events.” The board members of the Patient Safety Authority believe the lack of reporting is because of the “ego” of the doctors, the difficulty in defining a serious event and fear of litigation. In Pennsylvania there are approximately one-third of a million serious events and incidents reported each year and approximately half of 1 percent ever result in litigation. Numerous academic studies have shown that disclosure of medical errors result in less litigation. In fact most of the studies demonstrate that the majority of patients sue because of the lack of honesty and misleading behavior. Nationwide, state Department of Health boards need to do more to educate doctors and hospitals on the positive effects of honest disclosure to patients and their families as well as fair compensation when obvious malpractice injury has occurred.