Implementation of a rapid response system (RRS, also known as medical emergency team) is intended to decrease or eliminate preventable in-hospital cardiac arrests. To date, published literature has not documented the desired effect, as discussed in a recent commentary. This retrospective study, conducted at an academic hospital with a long-standing active RRS, demonstrated a low overall rate of cardiac arrests. However, 19 "potentially avoidable" arrests occured during one calendar year, most of which were attributable to inadequate monitoring or failure to follow appropriate protocols (e.g., failure to give prophylaxis against deep venous thrombosis). The authors conclude that more RRS calls might not have prevented more arrests.