There were over 109,300 adverse incidents reported in the Health Service Executive last year with 497 listed as extreme, and 158 as major, according to new figures.
There were 469 deaths, and of these, 160 were suspected of having died by suicide.
The incidents include near misses which do not involve harm, falls, medication error, pressure ulcers and other categories.
The data shows that overall, a total of 81,323 incidents were categorised as negligible.
The HSE said that the percentage of serious incidents with an outcome of death reported represents 0.6% of incidents and "is not outside the international norm."
The number of extreme events is down on the 2023 figure of 548.
Many of the details were released by the HSE, in answer to a parliamentary question from Aontú Leader Peadar Tóibín.
The figures on deaths were obtained separately by RTÉ News.
Extreme events are those that lead to death or major permanent incapacity, an event which impacts on large numbers of service users or members of the public, or an event that leads to permanent psychosocial functioning incapacity.
The figures for last year represent an increase of around 1,700 incidents on the 2023 figure of 107,628 incidents.
The HSE said that the majority of indents resulted in no harm or low-level harm.
It said it has been working for some years to increase the level of reporting of incidents, no matter how minor, in the health service.
The data is recorded on the National Incident Management Systems (NIMS) in 25 acute hospitals, and the incidents include patients, staff and visitors.
The HSE said there are data limitations and anomalies of the NIMS incident data, which include the potential duplication of incidents, variance in reporting and limited data validation.
In 2023, the HSE dealt with 1.8 million inpatients and day cases, 1.4 million emergency department attendances and 3.6 million outpatients.
The HSE said it is actively encouraging incident reporting by its staff.
It added that high levels of incident reporting, in particular near miss reporting and no harm incident reporting, are a good indicator for a positive patient safety culture.
