Editor,—We welcome the coverage given to the major, and potentially fatal, problem of medication errors within managed health care.1 We disagree, however, with the key message that medication errors are uncommon . They are endemic, extremely common, overlooked and often ignored. Observational studies of medicine administration within hospitals in the UK report an error rate of 3% to 8%.2 In contrast, Ross et al report 195 errors, collated from a mandatory error reporting policy, in 65 months.1 While mandatory reporting is a commendable principle, the reality remains that the majority of healthcare professionals will not report errors, and the majority of medication errors, will not be reported. Reasons for lack of reporting by nursing staff include confusion regarding the definition of drug errors and the appropriate action to take when they occurred, fear of disciplinary action, loss of clinical confidence …