Initially driven by anxiety about the possibility of medical negligence cases, clinical risk management has evolved into the study of IATROGENIC DISEASE. The first priority of risk managers is to ensure that all therapies in medicine are as safe as possible. Allied to this is a recognition that errors may occur even when error-prevention strategies are in place. Lastly, any accidents that occur are analysed, allowing a broader understanding of their cause. Risk management is generally centred on single adverse events. The threat of litigation is taken as an opportunity to expose unsafe conditions of practice and to put pressure on those with the authority to implement change. These might include senior clinicians, hospital management, the purchasing authorities, and even the national NHS authority. Attention is focused on organisational factors rather than the individuals involved in a specific case.