Was Neil Armstrong's death avoidable?

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    This whole thing…makes me uneasy. Does it sound like Neil Armstrong’s treatment after heart surgery may have led directly to his death in 2012? Yeah, it kinda does. Does it sound uncomfortably like his family turned this into a legal shakedown? Yeah…yeah, it really does. [LINK]

    Mr. Armstrong had undergone bypass surgery in early August 2012, and his wife told The Associated Press afterward that he was “amazingly resilient” and was walking in the corridor. But when nurses removed the wires for a temporary pacemaker, he began to bleed into the membrane surrounding the heart, leading to a cascade of problems that resulted in his death on Aug. 25.

    In a scorching July 2014 email to the hospital’s lawyers, Wendy R. Armstrong, a lawyer and the wife of Mr. Armstrong’s son Mark, noted that Mark and his brother, Rick, would soon be traveling to Florida to speak at a ceremony marking the 45th anniversary of the first moon landing.

    “This event at Kennedy Space Center will receive national news coverage,” Wendy Armstrong wrote. “Rick and Mark have been solicited by several book writers and filmmakers for ‘information about Neil that no one already knows.’” The lawyer suggested that unless the parties reached a quick settlement, the hospital would be publicly criticized for giving lethally flawed care to one of America’s most famous and revered public figures.

    The medical dispute and secret settlement, never before reported, comes to light days after the 50th anniversary of Mr. Armstrong’s moon walk drew a flood of nostalgic coverage celebrating his feat. The New York Times received by mail from an unknown sender 93 pages of documents related to the astronaut’s treatment and the legal case, including dueling reports by medical experts for the two sides. Some of the documents, though marked “filed under seal,” are publicly available at the probate court’s website, confirming that the documents received by The Times are authentic. An unsigned note included in the envelope said the sender hoped the information would save other lives.

    The legal settlement adds a grim footnote to the inspiring story of Mr. Armstrong, who avoided the limelight and never cashed in on his fame. It also illustrates the controversial but common practice of confidential settlements in medical malpractice and other liability cases, which protect reputations but hinder public accountability. And it shows how the extraordinary renown of a figure like Mr. Armstrong can become a powerful hammer in negotiations.

    On July 8, 2014, a hospital lawyer, Nancy A. Lawson, wrote to Wendy Armstrong with a blunt question: “Do Mark and Rick intend to discuss the wrongful death claim at the Kennedy Space Center if no settlement is reached by Friday, July 18?” The 45th anniversary gathering was to take place on Monday, July 21.

    In response, Ms. Armstrong said that information about Mr. Armstrong’s hospital treatment and death might prove very lucrative to Mark and Rick if they benefited from a film or book project.

    “Obviously, the information about this wrongful death claim would prove extremely useful to such projects, and the boys’ involvement would net a monetary gain far in excess of the demand that has been made for settlement,” she wrote. Wendy Armstrong’s original demand on behalf of the family was $7 million.

    Records from the Hamilton County probate court show that the bulk of the settlement, nearly $5.2 million, was split equally between Mr. Armstrong’s sons, Mark and Rick. The astronaut’s brother and sister, Dean A. Armstrong and June L. Hoffman, each received $250,000, and six grandchildren each got $24,000.

    His widow, Carol, who was Mr. Armstrong’s second wife, did not participate in the settlement. “I wasn’t part of it,” she said in an interview. “I want that for the record.”

    The specifics of his treatment are at issue, and yes, those details are very important…

    Three expert reviews of Mr. Armstrong’s medical records — one prepared at the request of the Armstrong family and two for the hospital — provide an outline of what happened after he was admitted to Fairfield Hospital, in the Cincinnati suburb of Fairfield, with symptoms of heart disease. Records do not say why he or his family chose Fairfield, a community hospital that is part of a larger group of Catholic hospitals now called Bon Secours Mercy Health, rather than, for example, the University of Cincinnati Medical Center, a larger academic hospital.

    After running tests, doctors at Fairfield decided to do bypass surgery immediately, timing some experts would later question. As a standard part of the procedure, doctors implanted temporary wires to help pace his heartbeat as he recovered.

    But when a nurse removed those wires, Mr. Armstrong began to bleed internally and his blood pressure dropped. Doctors took him to the hospital’s catheterization lab, where an echocardiogram showed, in one expert’s words, “significant and rapid bleeding.”

    There, doctors drained some blood from his heart, to prevent it from being pressed and hampered by the accumulated fluid.

    Mr. Armstrong was then moved from the catheterization lab to an operating room. The records do not make clear what doctors may have done there, but he appears to have lingered for a week or longer before dying on Aug. 25. His family announced at the time that the cause of death was “complications resulting from cardiovascular procedures.”

    The expert reviews focus on the hospital’s decision to bring Mr. Armstrong to a catheterization lab rather than directly to an operating room when he began to experience complications.

    “The decision to go to the cath lab was THE major error,” Dr. Joseph Bavaria, a vice-chair of cardiothoracic surgery at University of Pennsylvania wrote in a review conducted at the request of the Armstrong family.

    Dr. Richard Salzano, a cardiothoracic surgeon at Yale Medical Center who reviewed the case for the hospital, saw the decision to bring Mr. Armstrong to the catheterization lab as “defensible” but “certainly riskier than taking the patient to the O.R.”

    Dr. Salzano told hospital lawyers that after the bleeding began, Mr. Armstrong might have had a 50-50 chance of survival had surgeons reopened his chest in the catheterization lab, but that “the patient became unsalvageable on the way to the O.R.,” case records show.

    But man, the whole demand-for-six-million-bucks-to-keep-this-quiet…that’s really an ugly maneuver. The timing of this makes me think that the Anonymous Document Leaker was connected to the hospital, or had a bone to pick with the Armstrong boys, but at least waited for the memory of Neil to have its turn in the spotlight.


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