Agreed. The processes need to assume that humans are imperfect. Firing someone for being imperfect is pure window dressing and would do nothing to prevent the s

Agreed. The processes need to assume that humans are imperfect. Firing someone for being imperfect is pure window dressing and would do nothing to prevent the statistically inevitable next time. Instead of performative scapegoating, we should be asking how it’s possible that there is no documentation showing critical steps were done correctly.