Maybe the responsibility is too diffuse. But these "no one could have predicted this" kind of Therac-25 situations with multiple people responsible are exactly where that boss -- the one getting paid the big bucks (for the risk they take! for the difficult decisions they have to make! for the complex structures they have to oversee!) -- to actually take responsibility for the decisions inherent in the incentive structure they created in the workplace that they have total control over.

Is it? The article tries strongly to imply that the whistleblower is right and the manager is wrong, but that's never conclusively established. With the same facts presented in the article, I can paint a different story of the whistleblower trying to make a mountain out of a mole hill, and how he was obviously wrong everyone else seems to think it's fine.