Intended for healthcare professionals

Rapid response to:

Education And Debate

Human error: models and management

BMJ 2000; 320 doi: (Published 18 March 2000) Cite this as: BMJ 2000;320:768

Rapid Response:

Re: Human error: models and management

In his highly cited BMJ article [1] (6222 citations, Google Scholar accessed 16.09hrs 22/10/2019) James Reason noted, ‘Although some unsafe acts in any sphere are egregious, the vast majority are not. In aviation maintenance—a hands-on activity similar to medical practice in many respects—some 90% of quality lapses were judged as blameless,’ attributing the finding to David Marx. [2]

We seek clarification as the cited article, 2, does not appear to make the claim. On further reading of the journal ‘Ground Effects’, we were unable to find the statement in other articles by the same author. [2-6]

1. Reason J. Human error: models and management. BMJ 2000;320(7237):768-70. doi: 10.1136/bmj.320.7237.768
2. Marx D. Discipline: The Role of Rule Violations. Ground Effects 1997;2(4):1-4.
3. Marx D. Imagine if you will...a Human Reliability Program. Ground Effects 1996;1(2):5-7.
4. Marx D. Putting Aviation Safety First: Developing an Effective Disciplinary System. Ground Effects 1997;2(2):4-11.
5. Marx D. Discipline: The Importance of Mens Rea. Ground Effects 1997;2(3):1-4.
6. Marx D. Discipline: Why Process Is More Important than Outcome. Ground Effects 1997;2(5):2-6.

Competing interests: No competing interests

24 October 2019
Simon Smith
Colm O'Tuathaigh, Tom Hinchy, Patrick Henn
University College Cork Medical School
Brookfield Health Science Complex, College Road