The monograph "A Tale of Two Stories: Contrasting Views on Patient Safety" by R. I. Cook, D. D. Woods and C. Miller resulted from a workshop on Assembing the Scientific Basis for Progress on Patient Safety held under the auspices of the National Patient Safety Foundation and sponsored by VHA and AHRQ. Tale of 2 Stories pdf

Accident report on the SOHO mission interruption contributors include software, human-computer interation, and organizational factors. SOHO Board report html

The early preliminary account which used human error to downplay the system and organizational factors is at Preliminary SOHO report html

For a complete analysis of the contributors and lessons, see Nancy Leveson's work: Leveson on SOHO