diff --git a/CHANGELOG.md b/CHANGELOG.md
index 9daaa7803..a086e69e8 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -23,4 +23,6 @@ If your change does not need a CHANGELOG entry, add the "skip changelog" label t
   ([#522](https://github.com/aws-observability/aws-otel-python-instrumentation/pull/522))
 - Support credentials provider name for BedrockAgentCore Identity
   ([#534](https://github.com/aws-observability/aws-otel-python-instrumentation/pull/534))
+- [PATCH] Add safety check for bedrock ConverseStream responses
+  ([#547](https://github.com/aws-observability/aws-otel-python-instrumentation/pull/547))
 
diff --git a/aws-opentelemetry-distro/src/amazon/opentelemetry/distro/patches/_botocore_patches.py b/aws-opentelemetry-distro/src/amazon/opentelemetry/distro/patches/_botocore_patches.py
index a415f6148..22af87af5 100644
--- a/aws-opentelemetry-distro/src/amazon/opentelemetry/distro/patches/_botocore_patches.py
+++ b/aws-opentelemetry-distro/src/amazon/opentelemetry/distro/patches/_botocore_patches.py
@@ -334,9 +334,10 @@ def patched_extract_tool_calls(
             tool_calls.append(tool_call)
         return tool_calls
 
-    # TODO: The following code is to patch a bedrock bug that was fixed in
+    # TODO: The following code is to patch bedrock bugs that were fixed in
     # opentelemetry-instrumentation-botocore==0.60b0 in:
     # https://github.com/open-telemetry/opentelemetry-python-contrib/pull/3875
+    # https://github.com/open-telemetry/opentelemetry-python-contrib/pull/3990
     # Remove this code once we've bumped opentelemetry-instrumentation-botocore dependency to 0.60b0
     def patched_process_anthropic_claude_chunk(self, chunk):
         # pylint: disable=too-many-return-statements,too-many-branches
@@ -412,12 +413,30 @@ def patched_process_anthropic_claude_chunk(self, chunk):
             self._stream_done_callback(self._response)
             return
 
+    def patched_from_converse(cls, response: dict[str, Any], capture_content: bool) -> bedrock_utils._Choice:
+        # be defensive about malformed responses, refer to #3958 for more context
+        output = response.get("output", {})
+        orig_message = output.get("message", {})
+        if role := orig_message.get("role"):
+            message = {"role": role}
+        else:
+            # amazon.titan does not serialize the role
+            message = {}
+
+        if tool_calls := bedrock_utils.extract_tool_calls(orig_message, capture_content):
+            message["tool_calls"] = tool_calls
+        elif capture_content and (content := orig_message.get("content")):
+            message["content"] = content
+
+        return cls(message, response["stopReason"], index=0)
+
     bedrock_utils.ConverseStreamWrapper.__init__ = patched_init
     bedrock_utils.ConverseStreamWrapper._process_event = patched_process_event
     bedrock_utils.InvokeModelWithResponseStreamWrapper._process_anthropic_claude_chunk = (
         patched_process_anthropic_claude_chunk
     )
     bedrock_utils.extract_tool_calls = patched_extract_tool_calls
+    bedrock_utils._Choice.from_converse = classmethod(patched_from_converse)
 
     # END The OpenTelemetry Authors code
 
diff --git a/aws-opentelemetry-distro/tests/amazon/opentelemetry/distro/patches/test_instrumentation_patch.py b/aws-opentelemetry-distro/tests/amazon/opentelemetry/distro/patches/test_instrumentation_patch.py
index e27f881aa..5880e8491 100644
--- a/aws-opentelemetry-distro/tests/amazon/opentelemetry/distro/patches/test_instrumentation_patch.py
+++ b/aws-opentelemetry-distro/tests/amazon/opentelemetry/distro/patches/test_instrumentation_patch.py
@@ -250,6 +250,7 @@ def _test_patched_botocore_instrumentation(self):
         self._test_patched_process_anthropic_claude_chunk({"location": "Seattle"}, {"location": "Seattle"})
         self._test_patched_process_anthropic_claude_chunk(None, None)
         self._test_patched_process_anthropic_claude_chunk({}, {})
+        self._test_patched_from_converse_with_malformed_response()
 
         # Bedrock Agent Runtime
         self.assertTrue("bedrock-agent-runtime" in _KNOWN_EXTENSIONS)
@@ -645,6 +646,15 @@ def _test_patched_extract_tool_calls(self):
         result = bedrock_utils.extract_tool_calls(message_with_type_tool_use, True)
         self.assertEqual(len(result), 1)
 
+    def _test_patched_from_converse_with_malformed_response(self):
+        """Test patched from_converse handles malformed response missing output key"""
+        malformed_response = {"stopReason": "end_turn"}
+        choice = bedrock_utils._Choice.from_converse(malformed_response, capture_content=False)
+
+        self.assertEqual(choice.finish_reason, "end_turn")
+        self.assertEqual(choice.message, {})
+        self.assertEqual(choice.index, 0)
+
     def _test_patched_process_anthropic_claude_chunk(
         self, input_value: Dict[str, str], expected_output: Dict[str, str]
     ):