The text makes a suggestion that rolling a Despair during a Medicine check may result in inflicting wounds unintentionally through 'a truly terrible accident'. What do you think of adding the line "or even causing the death of the patient"?
We see this happen in RL especially during an already risky surgery and it certainly would add an increased amount of tension and drama to the task providing for perhaps some good role-playing opportunities related to the check itself and/or its results, positive or negative.