The deaths in Chhattisgarh during a state-sponsored family planning camp held in November 2014 show, yet again, that the lack of checklists and an ad hoc style of functioning can and does result in disaster. This article explains the need for standardisation and protocols in key government processes and talks about the pathetic conditions in which medicines and surgical supplies are procured in public hospitals as well as the failure of state agencies to detect and prohibit sale of substandard drugs.