Actors in health organizations often participate in language games which encompass clinical, professional, and organizational subject matter. Such language games intersect within the hospital environment. This paper appraises issues of clinical risk through the re-examination of the language games which formed a part of one of Britain's worst medical disasters, namely the Bristol Royal Infirmary tragedy. A textual, grounded analysis of transcripts from the oral hearings of the 'Bristol Inquiry' (n = 74) provides the paper with a qualitative dataset, within which medical language games are analysed. The paper concludes that clinical actors work within discourses of risk (McDonald et al. 2005) that are partly constructed within, and by, participation in language games (Wittgenstein 1953). In the case of the Bristol Royal Infirmary tragedy, these games manifested contrasting interpretations of risk and safety which reflected a tainted interpretation of data by different parties at different times of the unfolding tragedy. Sensemaking of reputation appears to have played an important part in the construction of these interpretations of risk.