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11 “You see it in the 36 percent increase”: American Bar Association, Profile of Legal Malpractice Claims, 2004–2007 (Chicago: American Bar Association, 2008).

1. THE PROBLEM OF EXTREME COMPLEXITY

15 “I read a case report”: M. Thalmann, N. Trampitsch, M. Haberfellner, et al., “Resuscitation in Near Drowning with Extracorporeal Membrane Oxygenation,” Annals of Thoracic Surgery 72 (2001): 607–8.

21 “The answer that came back”: Further details of the analysis by Marcus Semel, Richard Marshall, and Amy Marston will appear in a forthcoming scientific article.

23 “On any given day”: Society of Critical Care Medicine, Critical Care Statistics in the United States, 2006.

23 “The average stay”: J. E. Zimmerman et al., “Intensive Care Unit Length of Stay: Benchmarking Based on Acute Physiology and Chronic Health Evaluation (APACHE) IV,” Critical Care Medicine 34 (2006): 2517–29.

23 “Fifteen years ago”: Y. Donchin et al., “A Look into the Nature and Causes of Human Errors in the Intensive Care Unit,” Critical Care Medicine 23 (1995): 294–300.

24 “There are dangers simply”: N. Vaecker et al., “Bone Resorption Is Induced on the Second Day of Bed Rest: Results of a Controlled, Crossover Trial,” Journal of Applied Physiology 95 (2003): 977–82.

28 “national statistics show”: Centers for Disease Control, “National Nosocomial Infection Surveillance (NNIS) System Report, 2004, Data Summary from January 1992 through June 2004, Issued October 2004,” American Journal of Infection Control 32 (2004): 470–85.

28 “Those who survive line infections”: P. Kalfon et al., “Comparison of Silver-Impregnated with Standard Multi-Lumen Central Venous Catheters in Critically Ill Patients,” Critical Care Medicine 35 (2007): 1032–39.

28 “All in all, about half”: S. Ghorra et al., “Analysis of the Effect of Conversion from Open to Closed Surgical Intensive Care Units,” Annals of Surgery 2 (1999): 163–71.

2. THE CHECKLIST

32 “On October 30, 1935”: P. S. Meilinger, “When the Fortress Went Down,” Air Force Magazine, Oct. 2004, pp. 78–82.

35 “A study of forty-one thousand”: J. R. Clarke, A. V. Ragone, and L. Greenwald, “Comparisons of Survival Predictions Using Survival Risk Ratios Based on International Classification of Diseases, Ninth Revision and Abbreviated Injury Scale Trauma Diagnosis Codes,” Journal of Trauma 59 (2005): 563–69.

35 “Practitioners have had the means”: J. V. Stewart, Vital Signs and Resuscitation (Georgetown, TX: Landes Bioscience, 2003).

38 “In more than a third of patients”: S. M. Berenholtz et al., “Eliminating Catheter-Related Bloodstream Infections in the Intensive Care Unit,” Critical Care Medicine 32 (2004): 2014–20.

39 “This reduced from 41 percent”: M. A. Erdek and P. J. Pronovost, “Improvement of Assessment and Treatment of Pain in the Critically Ill,” International Journal for Quality Improvement in Healthcare 16 (2004): 59–64.

39 “The proportion of patients”: S. M. Berenholtz et al., “Improving Care for the Ventilated Patient,” Joint Commission Journal on Quality and Safety 4 (2004): 195–204.

39 “The researchers found”: P. J. Pronovost et al., “Improving Communication in the ICU Using Daily Goals,” Journal of Critical Care 18 (2003): 71–75.

39 “In a survey of ICU staff”: Berenholtz et al., “Improving Care.”

41 “But between 2000 and 2003”: K. Norris, “DMC Ends 2004 in the Black, but Storm Clouds Linger,” Detroit Free Press, March 30, 2005.

44 “In December 2006”: P. J. Pronovost et al., “An Intervention to Reduce Catheter-Related Bloodstream Infections in the ICU,” New England Journal of Medicine 355 (2006): 2725–32.

3. THE END OF THE MASTER BUILDER

48 “Two professors who study”: S. Glouberman and B. Zimmerman, “Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like?” discussion paper no. 8, Commission on the Future of Health Care in Canada, Saskatoon, 2002.

54 “His firm, McNamara/Salvia”: Portfolio at www.mcsal.com.