Some thoughts on preventing medical mistakes

The recent tragic death of Jack Adcock as a result of a medical mistake got me thinking about how we should treat those who make mistakes in life threatening decisions, and how we can learn so they don’t happen again.

References:
BBC Timeline of events: https://www.bbc.co.uk/news/resources/idt-sh/the_struck_off_doctor
Black Box Thinking by Matthew Syed: https://www.amazon.co.uk/Black-Box-Thinking-Surprising-Success/dp/1473613779
BA Pilot who nearly crashed into a hotel: https://www.upi.com/Archives/1991/05/08/British-Airways-pilot-guilty-of-negligence-in-near-crash/3098673675200/
Jailed Italian Seismologists: https://www.theguardian.com/world/2012/oct/23/jailing-italian-seismologists-scientific-community