11.   Doctors must be guilty of intending to harm a patient, or at least acting recklessly or grossly negligent in their care.

12.   Dr. Barbara DeBuono, the state health commissioner, said there was no evidence that any patients were harmed because of tired doctors.

13.   Experts say that poorly written or carelessly read prescriptions are a common source of medical mistakes that harm patients.

14.   For example, if systems for administering drugs are designed carefully, errors will be caught before they harm patients.

15.   He also wants hospitals to identify and retrain substandard physicians before they harm patients.

16.   Health insurance executives said Wednesday the decision would harm patients by allowing states to continue to impose higher hospital rates on commercial health insurers.

17.   Hospital executives said that a strict reading of this standard could harm patients by limiting the free flow of information among the people who care for patients.

18.   Hospitals say hundreds of millions of dollars can be saved by providers without harming patients.

19.   In neither case was the patient harmed by the insects, hospital officials said.

20.   Institute officials said their ketamine studies had been suspended for lack of scientific merit following a review last month, but they denied that patients had been harmed.