An estimated 8,000 children in the United States are dependent on mechanical ventilation at home. Despite technological advances for home monitoring of ventilated patients, the preventable death rate among these children has not changed significantly during the last 2 decades. Analysis of the data indicate that the primary causes of preventable death in ventilator-dependent children at home are inadequate training, improper response, and a lack of vigilance by the clinicians who care for them.