Let me preface this by saying that at this MMI I feel that all but one of the interviewers liked me and that in general all of the interviews went at least moderately well. At the risk of delving into too much detail, the interview in question was a discussion about diabetes patients. My interviewer and I were having a pretty good back-and-forth; the interviewer said to me, "A lot of patients diagnosed with diabetes find themselves to be upset with how much the disease controls their lifestyle." and I replied with, "Well there have recently been a lot of improvements for diabetics. While it's still no cakewalk --" then I stop and realize how inappropriate that sounded. I really didn't mean to word it that way (not that the interviewer will ever know). But then I shoot myself in the foot a second time by adding, "Not to make a terribly inappropriate pun." Somehow in the heat of the moment I thought that that would be a good way of saying, "I really didn't mean to make such a crass comment." though I immediately realized that that just made me sound even worse. Despite this, the interviewer didn't look visibly offended or anything, and the dialogue continued pretty well. Is this a kiss of death for my file? Or would the interviewer/adcoms understand that it wasn't intentional and that it was just nerves?