The modern day lawyer has to work across departments,
cross-region and with clients from many different industries. Whilst ongoing legal training typically focuses on the technical and academic issues, ‘softer’ skills in leadership, teamwork
and error management are too often neglected by the industry
LEGAL CASE STUDY
In 1989, Prudential Insurance Co. of America, a unit of Prudential Financial Inc.,
sued three law firms, including Dewey, Ballantine, Bushby, Palmer & Wood,
for a clerical mistake in a line that reduced a $92,885,000 interest payment to $92,885.
More recently, an error on one page of a lease document prepared by Stroock & Stroock & Lavan LLP for a real estate developer, permitted approximately 40
potential condominium purchasers to rescind their contracts because a closing
date was listed as 2008, not 2009 as intended.
Both of these minor drafting errors show that diligent professional lawyers can make minor errors, with huge financial consequences.
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4 Individual Masterclasses
WIDER INDUSTRIAL INCIDENTS
Hillsborough - Football Stadium Disaster
Human error: Poor communication, lack of sharing mental models
A crush resulted in the deaths of 96 people and
injuries to 766 others at the 1988–89 FA Cup
semi-final match. The opened exit gate led to
a tunnel marked "Standing", which led directly
to the two already overcrowded enclosures.
Healthcare - Drug Error
Human error: Auto pilot thinking resulting in poor attention to detail
An administrative error led to the prescription being wrongly transcribed as 5 mg in the patients note.
An experienced nurse on the ward did not question the unusually large dosage.
4 hours later a 5 months old baby died of cardiac arrest.
BP Deepwater Horizon - Oil Spill
Human error: Multi tasking, interruption management and loss of situational awareness
A BP owned oil rig in the Gulf of Mexico, operated
by Transocean, exploded, killed 11 employees and caused an environmental disaster - considered the largest accidental oil spill in US history.
The control room staff failed to monitor well pressure for over 40 minutes. They failed to notice an influx
of hydrocarbons which eventually resulted in the disaster. They were at the time distracted with other tasks.