Adverse events in medicine are frequently attributed to errors or system safety concerns. While the medical field lags behind the aviation industry, Crew Resource Management (CRM) and Medical Team Training (MTT) are slowly becoming the mainstays. Literature has proven that patient safety measures including this training improve overall patient care. Crises in the Operating Room (O.R.) are typically associated with cognitive error or system problems, but often are the result of unforeseen internal or external problems. Crisis management leadership in the operating room must progress beyond the typical CRM and MTT exercises and accept that use of Checklists work when the threat to the patient and team are fully recognized. Maladaptive behavior control and effective team leadership only occur when the principles utilized in this book are mastered. After reading this book surgical leaders should be capable of: Recognizing how human error contributes to and perpetuates adverse events; Understanding how system deficiencies can allow a simple error to progress to a catastrophe or how the system can be prepared to mitigate a mistake; Understanding cognitive functions during normal and abnormal circumstances; and Effectively lead their team through the risk management and definitive action process. While the surgeons and other O.R. team members typically self-profess an exemplary response to any threatening event, second hand observer assessment usually reveals significant bias in the ability of team members to handle a crisis appropriately. The uniqueness of this book is its firsthand instructions from military and first responders as to how any organization should respond to a crisis.