All physicians "solemnly pledged in the presence of tan assembly to first and foremost, Do No Harm!" Though patient safety has been the foundation of medicine since the 5th century B.C., patient safety has now emerged as a formal health care discipline with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care. A cornerstone of the discipline is continuous improvement based on learning from errors and adverse events. Patient safety is fundamental to delivering quality essential health services. Indeed, there is a clear consensus that quality health services across the world should be effective, safe and people-centered. In addition, to realize the benefits of quality health care, health services must be timely, equitable, integrated and efficient. This panel comprised of very experienced nationally recognized pediatric otolaryngologists will combines the format for the ‘Scary Cases Conference’ which has been held at Boston University School of Medicine since 2011 with Dr. Dohar's "instructional course" given at past academy meetings on "staying out of trouble in pediatric ENT." Specifically, the format features multiple clinical case vignettes; the pitfalls encountered in the case, the medico-legal consequences of challenging decision making, and unanticipated major complications from ordinary events. As an addition given the novelty of pediatric office myringotomy with tube insertion, Dr. Rosenfeld will present safety of this office-based procedure in a case series representing one of the largest experiences in the United States.