This is to thank Neil Armstrong for being a major part of a moment in history that everyone old enough to have witnessed it live, still can after 50 years recall where and what they were doing as it unfolded.My mother and I were doing a crossword puzzle, in the midwest the landing and subsequent first step happened in the wee hours of the morning,my dad and younger siblings were all fast asleep.When the LEM door cracked open and Neil climbed down and lept onto the surface of the moon, my mother and I sat transfixed.What could the future hold? Unlike most of the major moments in our nation's collective experiences-the Kennedy assassination,the Challenger explosion,9/11, this lunar landing was a positive event, American ingenuity showcased!Thank you Neil Armstrong for helping to give us a brave new world.
12
Neil wouldn't have cashed in on his own death, if such a thing was possible. So why did his family?
The lawyer - wife of Neil's son - suggested that unless the parties reached a quick settlement, the hospital would be publicly criticized.
Sounds a lot like blackmailing to me.
Getting money wasn't going to bring back their dad. They should not have asked for money and made the whole thing public to expose malpractice.
I believe that's what Neil would have done.
27
It is interesting to note how utterly counterproductive and damaging the absolute vilification of the management of Mr Armstrong’s cardiac tamponade is. The hospital basically settled due to fear of bad publicity. The team tried to fix the bleed angiographically and failed, thus necessitating emergency open heart surgery. Had they succeeded with the minimally invasive approach, Mr Armstrong would have had a much quicker recovery, much less pain, etc. furthermore, we would all be thinking how great the treating Cardiothoracic team was.
After this has been leaked and sensationalised in the media, how many cardiac tamponades do we think are going to be managed with an angiographic method as opposed to teams simply immediately re-opening the chest? How do we expect the medical teams to advance the management of this group when the get crucified the moment anything goes wrong? Do we honestly think that they didn’t have any previous successes in managing a cardiac tamponade angiographically? Quite simply a promising minimally invasive technique has been utterly quashed for the next several years because of this. Please look up the morbidity and mortality rates of emergency re-sternotomies before criticising the approach taken.
21
Why did Armstrong choose to have bypass surgery done in a Cincinnati hospital instead of one of the major cardiac centers?
11
Affordable Care Act (ACA), aka Obamacare tried to improve the medical care. Addressed everything except for “malpractice” lawsuits. Everyone will die at one point. Regardless of the cause of the death, find an excuse to collect millions. One can always get a paid expert to say whatever the jury wants to hear and win the case. At the end of the day, lawyers collect big and everyone else loses.
16
Just one observation. Nurses do not pull out wires without first receiving an order from the physician responsible for overseeing the care of the patient. In this case is the the nurse the sacrificial lamb? Where is the doctor????
It is amazing to me that hospitals and doctors are allowed to hide behind such meaningless words as “Complications” and “Errors” without giving a full accounting as to what exactly happened. It is important for the public to know and understand the consequences of choices they will be ask to make at some point in their life as medical issues arise.
Everyone will be faced with these choices. The Public needs to look into the experience or lack of experience a medical professional who will preform the recommended procedure has and the Public should be able to review a doctors track record. Sadly, it is next to impossible to uncover this needed information.
A settlement agreement is usually written in such a way as to hide the truth from the public while protecting hospitals, doctors and other medical professionals.
11
@Rich
EXACTLY! And what Doctor(s) ordered the bleeding Mr. Armstrong to the catheterization lab rather than the Operating Room where it is said he had a reasonable chance of survival?
THE nurse who “pulled the wires” was a participant BUT the Doctor(s) who recommended the so-called “emergency” surgery and the ultimate “emergency” care should be revealed.
Would you or your loved one choose to have cardiac surgery and post operative care at this hospital by Mr. Armstrong’s Doctor(s)?
9
@Rich That has been my point all along: that Modern American Medicine today is simply ungovernable and Nurses are performing procedures all the time that should not be 'routine' and should not be performed by Nurses since they have neither the education nor skill levels of even a Physician's Assistant. They are practicing medicine without a license so that the doctors, hospitals and ultimately the insurance providers can save money in America's for-profit system. I suspect, but don't know, that the nurse who pulled Armstrong's 'wires' did so on a schedule, and not by a Doctor's Order ( DO). Nurses have become way too big for their britches and are now becoming the targets of lawsuits with their medical establishments and doctors running for cover. In this case, we lost a national treasure because we had a nurse make a series of errors that a trained medical doctor would not have made as pointed out by other MDs in these comments. It's not the six million dollar settlement that disturbs me --although it has that disgusting relationship with that TV show-- nor the fact that it was kept quiet -- it's that for-profit health care in America already has this built into their profit-loss analysis and that today, without missing a beat, it's just business as usual for them while they continue to rape and pillage the American people for BILLIONS. That's the real 'mal-practice' here.
10
I doubt Mr Armstrong would have been proud of the behavior of his children. In 2002, my wife, age 57, WALKED into the ER after fainting and 6 days later was taken off life support. A cascade of events beginning with being given a wrong wristband on admission had ensued. Sometimes you cannot afford to be unlucky. We were skeptical and suspicious of the treatment as the hospital was scurrying to backfill. After days in a coma, we couldn’t even find a doctor. Everyone was hiding or suspiciously careful in conversation. Eventually the respirator tube was pulled.
We decided not to drag her name into the court system for money. We needed to mourn, not get even.
28
An elderly man with cardiovascular issues died quite possibly because of flawed medical care. The family felt this was wrong and threatened to sue, using whatever leverage they had. The hospital assessed the situation. There was a private settlement.
This happens every day in America. Neil Armstrong’s reputation does not suffer because of it.
I don’t know why this merited space in the New York Times.
10
This is not so much about medical errors, they always happen, as it is about the greed of Armstrong’s children. They did something that their truly humble father never did, profit from his celebrity. A truly pathetic story.
35
The major point of this article is if a national treasure in the form of a living human can be treated with such incompetence what chance do we nobodies have? At least 45,0OO people die in hospitals every year because of of human error. We believe that number is a low ball figure.
6
I am constantly amazed at how most people chose their doctor and their hospital. And most make very poor choices. I know of a woman recently diagnosed with pulmonary fibrosis. She is being seen by a boarded pulmonologist in private practice. He told her that it's "pretty much the same as COPD" and treated "similarly". Good Lord! Even I know that's not true as I have a still different chronic obstructive pulmonary disease and it's not treat the same way as COPD (emphysema). So, the friend's daughter asked me if I knew anyone at the local med school where my own pulmonologist practices, who specializes in pulmonary fibrosis. I said I had in the past, but that man left, but I would ask my doctor.
I did so and gave the info the the daughter. This physician has taken over the long-term research program on pulmonary fibrosis and various drugs and is high respected. Her mother decided to stay with her own doctor as she didn't want to "hurt his feelings" and "he goes to my church". Bad choice.
We have no idea why Neil Armstrong chose this hospital. Mercy is a chain of small hospitals spread out across the Cincinnati area. It was probably chosen as it was closest to his house.
7
It is hard for those of us who are heroic everyday without mention, to see someone who had such an awesome opportunity via the U.S. taxpayers, to walk on the moon be viewed as "special". That we value some human life over other human life, or even any life over other life, is a HUGE miscalculation of humankind. To think money is a compensation for loss of a loved one, is an elitist point of view not worthy of Mr. Armstrong and it won't mean human error will cease to exist during complicated medical procedures.
8
I can't help wonder who's idea it was that he should have heart surgery at a community hospital. Did I miss something in this story?
7
My question: how exactly does one reach the calculation that losing an 82-year old man during a risky heart procedure is worth $7 million? This is in part why we have such high insurance costs: suits that happen because they can, not because they should. American entitlement - the death of us.
20
Armstrong was eighty two. He obviously had health issues. Some of the treatment decisions might have seemed questionable . But the question how much value can you reasonably put on a man who is eighty two years old ? . I know this sounds heartless but wouldn't have been reasonable to suggest that Armstrong had only several more years of life ahead of him and that should have been a factor. In the amount rewarded to his family .
10
I remember when Republicans were in favor of tort reform. Needless to say it’s on the back burner with Trump leading the party.
3
I have settled two small claims against hospitals for poor ER treatment. I would much more have preferred not to have lasting scars and other issues due to this lack of appropriate care.
I have no problem with the Armstrongs settling with the hospital. The fact that it was willing to pay a relatively large settlement suggests that there was a serious lack of care. That should not happen to anyone, famous or not.
4
This whole business of Neil Armstrong’s family auctioning off his personal memorabilia disgusts me. I saw where the log book for the lunar landing was sold for over a million. These are things that should have been donated to the Smithsonian Air and Space Museum for all to enjoy, period, and be preserved properly. How greedy of his sons.
30
Shameful extortion by the daughter-in-law, as I see it. When I began reading this, I could smell a lawyer not far away. She was more interested in trading money for silence, playing off the fame of her father-in-law. What if 'Ned Anderson' was a janitor, would she ask for $7M and would we even be reading this?
26
Thankful another medical “mistake” is exposed. Statistics reveal nearly 30% of deaths in hospitals are due to medical “mistakes.” Better the public become aware and educate themselves before blindly agreeing to procedures at hospitals/medical personnel that have an unacceptable incidence of medical “misjudgment/errors/mistakes.”
I know the mantra “no one is perfect,” unconscionable when you’re the one who must pay price.
6
I think the lesson to be gained from this article is to very carefully select where you have your surgery. We don't know who made the decision for Neil Armstrong to be cared for at Mercy Health - Fairfield Hospital and I doubt that the secret settlement eased anyone's conscience over this decision.
4
I was deeply saddened by this revelation. It doesn't reflect well on the health professionals involved. The medical profession can be very quick to cover up their mistakes, exit the difficult case, and/or become unresponsive to patients and families when difficulties (injuries and errors) occur. I hope that this article will spur some soul searching and some consideration for greater transparency and responsiveness to patients and families who are injured by their care.
4
Great to hold healthcare providers to a heavenly, divine standard, but remember it is human medicine being practiced with all the associated risks, complications and yes, even mortality that may come along. No wondrous healing unfortunately...I can hardly criticize the physicians who did their best while agonizing to save a life, irrespective that being of a hero or another anonymous soul, only to be second guessed and grilled for their actions...
14
The outrage I feel...is wholly directed at the System. The System that only the well-connected who have a "celebrity" type bullhorn, who ever truly get a modicum of justice.
If Armstrong was a bus driver, a plumber, a hardware store employee - his sons would have got ungatz! Maybe a few thousand dollars to go away, at best.
But they had a podium. A nice one tall one, and thats why they won. I see no other reason. The Armstrong family podium was enough to out-do the Hospital, et al, ability to out lawyer them.
Celebrity is a semi-super-power to reach thousands...thats what gets you a few ounces of justice. Look at the 9-11 situation. Without John Stewart...not even politicians could get the job done.
Sad commentary on the good 'ol US of A.
You need justice, catch yourself a decent celebrity...
16
My suspicion is that those "family members" are only out to enrich themselves. Where have we come to. Shame on them.
18
Have mixed feelings. Feel badly for the Armstrong family. However, I always “cringe a bit” when large financial settlements are reached requiring confidentiality and then years later the confidentiality pact is broken after the money has been taken.
10
In the US everything is about money. Health care, legal services, education, sports, entertainment, food You name it $$$$$. Seems to be our only preoccupation. Downfall of an empire.
7
Firstly, this is not a Cincinnati hospital it is a Hamilton hospital. I've had personal experience with an elderly relative at Fairfield where the wrong sized hip replacement was installed and then had to be replaced--on an 80 year old. Subsequent long-term care led to a series of dire events for the family. This hospital has been avoided in favor of traveling to Cincinnati for any major health issues. One would not be crazy to wonder whether medicare and medicaid have anything to do with the hasty decision making at Fairfield.
3
@Newsbuoy Yes, do you have any idea why or how the decision was made for him to have heart surgery at a community hospital?
I work for a plaintiff's personal injury firm where we handle many cases like this.
It is unfortunate that this happened to one of our country's greatest heroes, but if the family is bound by confidentiality and/or is unwilling to discuss this, I don't know how appropriate it is to publish this article. Rarely do we file cases under pseudonym, and when we do we do so with the intent to protect the identity or dignity of those we are representing.
This is a tragedy, but medical mistakes happen. I don't understand why we should treat Neil Armstrong and his family any differently than the other Americans who pursue wrongful death cases. I understand that he's an American hero and the American people want to know his full story, but it seems like risky invasion of the family's privacy. They are legally bound to the agreements in the settlement they signed, which most likely applies to the beneficiaries as a whole and not individually. Let's leave the family alone. They have already lost plenty, if the person who sent the Times these records is tied back to one of the beneficiaries the family could loose even more.
2
@Claire What I don't understand is why anyone with a functioning brain -- whether Neil Armstrong, his family, or "Joe Sixpack" -- would choose to have even semi-serious surgery at a community hospital.
2
Competent doctors are needed badly in this country, but how can they come and stay here if they dont get the visas? Is it any wonder that many americans go to India to get surgeries at much lesser cost, get post surgery care, and then return back. Less expensive, and better access to good doctors.
3
Neil Armstrong is one of my heroes, as such my husband gave me for Xmas a fabulous charm bracelet Mr. Armstrong had given his wife long ago. My husband bought it from the Armstrong sons' Heritage Auction recently where they made millions auctioning off their fathers' most precious possessions. Today's article 'Public Eulogies To Space Hero Hid a Tempest' by Scott Shane and Sarah Kliff was excellent. We were surprised and saddened that his own family would sell off such heartfelt heirlooms; but at least those who bought them, such as us, will cherish them forever. It will be interesting to see if Mr. Armstrong's sons will or have used any of the $6 million hospital settlement plus the millions made from the auction towards some type of memorial for their father, the great astronaut. He was an amazing person who, as your article noted, shunned the spotlight and capitalizing on his fame. He deserves more.
12
@Diane Maybe the sons feel they were denied an inheritance because their father declined to capitalize on his fame and their actions since his death reflect a desire to compensate for that "loss."
4
Fascinating story itself: Sounds like movie material. And not just the poor care Armstrong received but the sons’ extortion-like efforts to get a big cut of the pie. They didn’t care about their dad’s legacy, only the cash.
12
I wonder if the hospital administrators and staff learned anything from their incompetence? Or were they just happy they bargained down the settlement from $7 million to $6 million and thought they were going to keep the whole thing quiet?
2
This happen to my sister 20 years ago, it is because the standard procedure does not work on everyone. My sister survived, she was way younger (32). Neil Armstrong was 82, it is sad but it happens. At that age surgery and serious accidents are big shocks to ones system. This is why so many people die when they break a hip.
7
I don’t understand the criticism of the family in this comment section.
The legal team for a hospital will drag a malpractice case as long as possible. It’s a war of attrition and a common strategy is to fatigue the family claimants.
It’s the responsibility of the claimants’ lawyer to obtain a satisfactory outcome for their client and counter the defendants’ delays. If the status of the victim as a national hero helps that cause, the lawyer would be irresponsible to use it.
4
I fully understand the actions of the Armstrong family. Medical gaffes that result in death happen every day, and in most cases the hospitals and/or doctors are exonerated or not pursued by the grieving family.
3 years ago, my partner of 37 years who was in excellent health and did not have a prior heart condition and I went to NYU Langone as he had symptoms of a heart attack. A team of cardiology residents reviewed a possible angiogram and then recommended triply bypass surgery. I questioned them given the patient's age of 86, and was assured this was a minor issue.
My partner survived the operation and was in good shape immediately after the operation. However, he developed a rash--a sign of infection and started feeling worse. The egotistical cardiac surgeon never monitored and patient was left in the hands of nurses who failed to get him immediate medical attention.
The surgeon and cardiac support team there would have been guilty of murder in another type of setting, and there was no recourse.
NY state is one of only 4 US states that base monetary damages on loss of economic value. So in the eyes of NYS and the hospital my partner's life had NO VALUE.
The only way to change bad methods and procedures is to sue, otherwise it's just an unfortunate mistake---but the family loses their loved one!
7
Correct ethics requires matching the health issue with the best doctors for treating that condition. This appears not to have happened in N. Armstrong's case -- a serious violation.
RIP
2
I’ve had no greater childhood hero than Neil Armstrong. He was a great man in many respects, well beyond the first human to walk on the moon.
However, it is my opinion that his sons have come close to extorting $6 million from the hospital where, at 82, Neil underwent multiple coronary artery bypass surgery and subsequently died.
Normally, a hospital would dispute such a lawsuit. We all know that CABG is a risky procedure in a man of his age, especially when the immediate circumstances and his co-morbidities remain undisclosed.
However, his sons threatened to make a big stink about the hospital murdering this man of such world-wide stature, thus the hospital felt it had absolutely no choice but to cough up the cash. Somehow, I suspect that Neil Armstrong would not have wanted a lawsuit to be his final legacy. Shame on his greedy sons.
8
This is crazy. I am someone who started to become interested in astronomy and space at a young age. My interest for space travel almost made me want to be an astronaut. Obviously, hearing this is heartbreaking because he was a big inspiration of mine. I read countless books on him and ultimately became one of my idols. It's disgusting how money can control things and determine how situations play out. It's an outrage that money was the determining factor to keep someone quiet especially for a situation involving someone as inspirational as the first man on the moon
Rest In Peace.
4
How do you know he was "decrepit" before the bypass? He was 82. Advanced age does not equal decrepitude.
1
I am sorry to read that the first man on the Moon was destined to become the six million dollar man.
1
the loss of a loved one, *)
no matter at what age,
is a sad event that most of us
would want to live without, i'm sure.
we can fly to the moon,
and probably to other planets soon.
yet, no matter how hard we try & fly,
we will not escape the harsh reality
or our mortality on earth.
________
*) and no amount of money will revive a loved one lost.
[to say nothing here about the outrageous unavailability
of appropriate health care for the much le$$ fortunate.]
1
Hey, stuff happens in operations, good and bad.
Remember, you're not in Dr. ''Bones'' McCoy's little studio on the Starship Enterprise.
OBTW, why do hey always wear those masks when cutting open old people like me?
'Cause of all that dust....
It was a tragic event but we do not know the full details. When a patient experiences sudden complications there is no time to make decisions and it is easy in hindsight, knowing what happened, to identify alternatives that might have prevented the death, but in the seconds available, with the limited knowledge one has, there is often no way to know what is right. Patients of mine have died in situations where, knowing what i know now, I would have handled the situation differently. The memories will haunt me till i die. In this case the problem was thought to be a slowly developing cardiac tamponade, which can be treated by needle aspiration under ultrasound guidance more quickly than by open surgery. In retrospect the bleeding was too rapid for this to be effective. But that is easy to say now that it is too late.
15
The lesson to be learned though is this: do not have complex procedures done at regional hospitals. Stick to the large research hospitals if at all possible. Sometimes it doesn't make sense - if you have incurable cancer, it's not worth traveling the distance to go to a research hospital especially if you're not going to be aggressive in your treatment. That's the decision we made with a close relative after he was diagnosed at age 78 with a virulent form of throat cancer.
However, when my father required heart surgery, we made the sacrifices necessary to take him to one of the top cardiovascular hospitals in the region (and thankfully, one of the best in the US). Could the surgery have been successful at our regional medical center? Probably. Did we have more confidence because of the specialists and their reputation at the major research center? Absolutely.
RIP - and sympathies for his family. I'm glad they sued, and I'm glad it's on the record now.
6
@Julia Scott True, and yet, MD Anderson just got slammed for inadequate monitoring procedures involving blood transfusions, some resulting in patients deaths. NDAs must GO! We, the public, deserve to know how people and institutions operate. Large settlements are also often the only way to get big institutions to change.
Very sorry for the family - not only that they lost a member this way but that now they are being subject to u due criticisms.
2
There seems to be a deeper story here, not just that of possible malpractice on an American icon and the quiet settlement that resulted, but one of the progeny of a historic figure profiting from his celebrity.
19
6 million dollars is a rather tiny settlement for such a high profile American hero's medically negligent death. Those commenters that say the sons extorted the money dishonor the memory of the father who deserved expert care but instead died as a result of the hospital staff not being prepared for complications that should have been anticipated.
The fault in this story rests entirely with the hospital and physicians responsible for Neil Armstrong's death.
BTW- I did not read "First Man" but did just recently watch the movie. Armstrong was portrayed as somewhat detached from his family after his young daughters death. He risked his life and his families well being for his chosen career. They deserve respect as he and they clearly didn't appreciate the risks of heart surgery and recovery at the local hospital.
3
You have absolutely no way of knowing that there was anything negligent about the care this great man received. You must be astute enough to realize that without CABG surgery, his death was imminent regardless. Shame on you for your uninformed assumption.
4
How many lives could $6 million save? And how many lives would be lost if the hospital was bankrupted by a public defamation campaign by the Armstrong family?
It's a shame that privileged families with the resources to hire and maintain legal staff use that privilege to drain money from our healthcare system. No settlement will bring Mr. Armstrong back nor will his (potentially premature) death erase any of his legacy.
Instead of celebrating and cherishing his life, Armstrong's children pursued a selfish and entitled path demanding money in compensation for his death. And instead of making this public to educate and prevent future malpractice, they forcefully kept it under wraps. They thought only of themselves, not the countless others receiving potentially life-saving treatment at Mercy Health.
26
Absolutely NO 80 person needs heart surgery unless they pay for it out of pocket! Our health care system is out of control.
9
It won't take too many new cardiac procedures to make back the $6M.
3
There is no decent rationale for any court to ever approve a non-disclosure agreement in any settlement, particularly when persons have been harmed by negligence, incompetence or guile.
Donald Trump would not be president today if his trail of NDAs resulting from litigation around the country had been made public as the events occurred.
16
It’s the fault of the hospital for demanding confidentiality. Shame on them.
3
My father died of clostridium difficile after being hospitalized for breathing difficulties from COPD. He was infected in the hospital after being misdiagnosed for pneumonia, then given powerful, broad spectrum antibiotics that destroyed his gut bacteria, followed by sloppy hygienic practices by the hospital staff. My siblings and I contemplated legal action after his death, but ultimately acknowledged that our mother was correct when she said it would ruin us financially and get us nowhere. He wasn't famous or powerful, so she was convinced we couldn't win.
15
If what happened to Neil Armstrong had happened to the average, regular American citizen, I highly doubt Fairfield Hospital would be issuing a check for $6 billion dollars to the family/loved ones of that ordinary citizen.
Mr. Armstrong's death is tragic for many reasons, but what I find most appalling is that this hospital administration appeared to be more focused on keeping what lead to his death a private matter rather than investigating and putting in place a series of protocols to ensure similar mistakes from occurring in the future.
What happened to Mr. Armstrong was indeed "an accidental" rather than "an on purpose" set of circumstances. Nonetheless, his family received a healthy financial compensation whereas most other families in their place would have received legal injunctions and continuances which only rev up legal bills.
21
@Marge Keller
Sincere apologies for my typo - I meant to type $6 MILLION dollars, not billion.
...and what’s wrong with that is that many hospitals experience no consequences, and many families receive no compensation for the negligent loss of a loved one, not that in this case an institution was made to pay for its malpractice.
A dear friend of my family lost her 2nd husband just a few years ago to what seemed was malpractice performed by the hospital, in that he died from an embolism when having a catheter inserted. After the event, the doctors and staff seemed to be walking on eggshells trying to console his wife. He walked in the hospital otherwise a healthy 70 year old that day.
His wife did not sue, but his family members from his first marriage wanted to, but ended up not suing. I wonder now how many hospitals get away with it, knowing this particular circumstance.
7
@J House
"get away with it" makes it seem like the hospital intended for this to happen. At the end of the day, doctors are only human and they are doing everything they possibly can to save lives. In the event of an error, how is the hospital supposed to respond? Throw money at every grieving family that could otherwise be spent on more medical staff, better equipment or improved safety protocols to save more lives?
Have we lost all humanity? Is money really the only thing that matters anymore?
19
Why is this malpractice. It’s a known risk. Was it in the consent?
6
Interesting story .I have alway believed to go to to the best doctors/hospitals if there is time(no emergency) Amazed he did not go to the Cleveland Clinic
11
I note Armstrong's widow did not take part in the agreement. I think his sons look poorly in that their concern was money and not dispersal of the information they were protecting that might prevent such mistakes for other patients. NEVER go to a community hospital for this level of care; go to a teaching hospital! I worked in health care and at hospitals and everyone who worked at one would say this.
14
A number of readers questioned Armstrong's choice of hospital. The Society of Thoracic Surgery gave Mercy Health-Fairfield Hospital two stars out a possible 3 starts for preventing death after bypass surgery in 2016-7 (the oldest data on their website). Experts were quoted from the University of Pennsylvania, Brigham and Women's Hospital, Yale and Columbia. All those hospitals, along with the nearby University of Cincinnati, also got 2 stars.
11
This is disappointing. If you have a problem with the healthcare you received, there are channels to pursue, and I don't imagine those channels are out of reach for this family. Contact the hospital. If they don't respond, then contact an attorney. Do all of this within the statute of limitations. Threatening to talk about it at a very public event that is supposed to honor his life is extortion.
22
@Sarah L
Very much agree - see my earlier comment.
2
Aside from being very sorry to hear of Armstrong's death in this way, I'm just struck at how many lawsuits are settled secretly without guilt admissions. And I'm sick of it. Just think, but for a legal system biased to the very rich, Trump would have had to admit guilt in committing fraud for his University, his casino's money laundering, and his charity's fraud. Epstein wouldn't have been free to roam the streets, preying on young girls, and Bill O'Reilly and Weinstein wouldn't have sexually harassed so many women -- there are thousands of other example. It's not only unfair to victims and the poor, it totally prevents systemic improvements to an institution's or an individual's behavior. It harms us all one way or the other, and shouldn't be allowed. If you bring a lawsuit against someone, the results win or lose should be brought to a decision with the losing party admitting guilt.
16
@Brannon Perkison
You should preface your statements about specific cases with "In my opinion...", as they are not established as fact.
1
Mr. Armstrong faced many life threatening risks in his storied career, but to die following what today is a routine medical procedure, is just unimagineable.
Pete Conrad (3rd man on moon), another bigger than life American hero, also tragically died of a chest injury (internal bleeding from a motorcycle accident) that could have been recognized and repaired had his medical treatment been better.
It appears that for these two fallen Astronauts, life was more dangerous on earth than in space.
7
So his children accepted a $6 million settlement as opposed to exposing (alleged) negligence at the time of death....by the hospital staff? How many other patients were placed in harms way by their silence??
Neil would not be proud.
17
Sounds like extortion by the family to me.
14
“The legal settlement adds a grim footnote to the inspiring story of Mr. Armstrong,”
Nah, not really — that’s a reach and a huge overreaction!
Mr. Armstrong’s story is still inspiring, this changes nothing.
Human flaws can’t topple gods.
6
As Armstrong's story aptly illustrates, nurses are often the ones on the front lines of medical care. Their skills are a major factor in life and death when you're in the hospital. Inquire about nurse/patient ratios before you decide which hospital or nursing home to choose. Lower ratios usually mean better nurses, as they seek out employers who value them.
4
As routine as coronary artery bypass (CABG) has become--and most procedures are now done in patients who 40 years ago would have been deemed "too old" for the procedure--it remains a high risk procedure, especially if the patient needs a pacemaker for rhythm disturbance. Every patient undergoing is or should be told of the risk of death.
It may be apocryphal, but there is a story Neil Armstrong once remarked he thought his heart only had a finite number of heart beats and he didn't want to waste any exercising.
CABG is a surgical success story, but that doesn't mean it is no longer dangerous. The heart often has to be stopped and restarted, the chest opened and closed, bypass pumps (usually) are required.
It is a little rocket launch every time.
8
Actually, we lost a National Treasure because a 'nurse' removed wires - in some fashion- attached to his pacemaker - in such a way that caused a series of even worse decisions and actions ( i.e. Cath Lab instead of the OR, etc..). One Cardiac MD in the comments here has already pointed out that a nurse SHOULD NOT be removing wires from a pacemaker when it has just been surgically installed. To be clear: We have lost a national treasure because of a 'nurse' practicing medicine without a license. Just to be clear.
9
My Dad went into renal failure following heart bypass surgery in 2005 at age 82. He too had surgical complications due to drugs administered during the surgery. He never spoke a word following surgery due to breathing tubes. He died about 1 week later. Our family sued the drug maker and won a small settlement (less than 6 figures).
Not all of the siblings agreed on filing a lawsuit. To this day I am not convinced his death was due to the drug. I believe we as siblings could have been more
proactive in assisting our elderly parents in selecting a larger hospital and researching the surgeons. Perhaps the lawsuit helped assuage some guilt. Then again maybe withdrawing the drug from the market helped some future patients. I cannot judge the Armstrong famiiy’s motives.
3
Why sue the drug maker when they did administer what was apparently the wrong drug in that set of circumstances?
@Steven Silz-Carson The drug company knew their drug could cause renal failure and failed to make it public.
@Steven Silz-Carson The drug company knew their drug could cause renal failure and failed to make it public. You can read about Bayer and Trasylol drug.
1
All this is very sad to me, especially because THE opportunity was missed to bring to light the problem of the "malpractice" in the hospitals or anyway any problem with hospitals, including the possibility that they CAN make errors and these have to be accepted, if there is no bad intention of course.
I mean the society missed a bright discussion on the topic.
Why ? Because of grid ? Because of fear of bad publicity ?
I think the family (with the exclusion of the divorced wife) in the first place should have felt this kind of responsibility, but also the hospital.
My conclusion ? All this even more let me feel Amstrong as my hero !
3
Neil Armstrong was a hero to everyone around the world.
He was 82 years in 2012, already past the life expectancy of a white male. This article illustrates one of the flaws of the US healthcare system - subjecting people to unnecessary high risk procedures. Mr. Armstrong probably would have lived a bit longer if he was not subjected to a high risk procedure and the accompanying complications. Instead of taking the hospital to court, his children should have questioned the wisdom of Mr. Armstrong's physician/cardiologist for having recommended the by-pass procedure.
6
I think it's beyond sad that the family went the money and nondisclosure route instead of going public which likely would have forced the hospital to improve and so would save other lives --- enhancing Armstrong's legacy instead of cheapening it.
I'm sure that the family was not hurting too badly for money and so it sounds like they were just greedy and petty.
6
$5.2 million? That's all? Come on... that's what a parolee gets when the cops freak out and shoot him for no reason. And why did the family pursue a settlement instead of litigation that would have exposed to the public what the hospital did wrong? I can't imagine they needed the money. Neil Armstrong was calculated to be worth $8 million when he passed.
2
The heaviness of treating one of mankind's hero is in itself very daunting to any medical doctor, internist or surgeon. The best approach would have been to let the medical team express regret and say they did their best, rather than litigation. The next best has been to delay the publication of this intrigue as long as possible, otherwise, the human intervention and gossip would look ugly.
A tragic case of likely malpractice for sure. But what also bothers me is the family's demand for a settlement by a certain date to avoid the release of damaging information. That smacks of blackmail.
12
@Olaf S.
Right on!
Isn't the attorney Mr. Avenatti being charged with executing the same strategy against Nike?
1
Heart surgery at 82 years of age. It's a disgrace the family can get away with extortion for a risky procedure. We are too afraid of death, too attached to entitlement.
6
So Mark and Rick Armstrong, taking advantage of their father’s notoriety blackmailed Mercy Health — Fairfield Hospital into a 6 million dollars settlement. Why not. The American dream to become a millionnaire any waay you can! Shameful...
8
Mr. Armstrong was 82 years old. He never exercised as he felt that we are born with a certain number of heartbeats and that jogging would use up those heartbeats. (Read his autobiography.)
As a trauma surgeon, I am appalled at the number of comments that are siding with the sons and this lawsuit while Armstrong’s wife refuses to say anything.
Once again hindsight seems to be 20/20. I don’t understand why nurses would be removing pacer wires that were implanted inside the pericardium but I WASN’T THERE?!
I find it nauseating that this possible medical malpractice is brought up in the court of public opinion AND that the NY Times allowed comments! Medical experts refused to make a comment as they weren’t there.
Poor judgment NYT!
11
@Nuschler
NYT revels in rallying an outcry against Physicians to sell itself much as Trump has found nationalism to sell himself
Wendy Strongarm I mean Armstrong seems like a great attorney if you want a payday and don't care how you get it.
4
If the parties to a civil litigation agreed to a confidentiality agreement, how is this properly reported as public news?
1
@Eddie F.
Because it was maybe not leaked by one of the parties to the litigation?
@C Allmon, I don't understand your comment. "...It was maybe not leaked by one of the parties to the litigation?" If 2 parties sign a contract to keep something confidential, supported by a ($6M) payment, how do the terms of that agreement become a proper subject for news reporting, no matter how it reached the publisher?
Why the outrage? Only the famous and privileged could get such a settlement for faulty care? Neil Armstrong was privileged to have a $75,000 procedure (at age 82!) paid for in large part by Medicare, while a much younger person (below age 65), with more to gain from this procedure, could easily be bankrupted by it. The real cause for outrage in this country is no procedure or intervention is too extreme or costly for the most aged and decrepit, while the majority of citizens have a costly, unreliable patchwork of health insurance.
236
@mdieri Aged and decrepit at 82 - I don't think so. It is truly scary and depressing how willing you are to write off someone of that age who probably is in relative good health. I wouldn't like to be a family member of yours if you have any say in my treatment - or does the same level of outrage apply to yourself?
52
@mdieri You're focusing on the settlement instead of the atrocious care Mr. Armstrong received. Perhaps you're right about the settlement amount. But, god knows, medical malpractice is freely (and all too often, readily) available to anyone in this country.
21
@mdieri There are plenty of 80 year olds that get CBGS paid by Medicare and other government payors.
20
This does nothing to tarnish the image of Neil Armstrong to me. He was a man of extraordinary talent and courage, as are all astronauts, who was in the right place at the right time to have such a privileged opportunity. But this story reveals a dark and shameful story of extortion and/or blackmail by his sons and daughter-in-law, which does not affect my image of the man himself. The only good that comes from this is that it may influence the way that our hospitals and medical authorities treat patients in similar situations in the future.
4
Modern medicine is complex.
It is very easy to use 2020 hindsight to decide what should have been done under difficult challenging circumstances.
We always have the information on the back end but when things are happening in real time, the right decision is not always so clear. Things seem so “obvious” in retrospect.
This is one of the major problems with the malpractice system we have. We expect human beings who are doing their best to be perfect every time.
9
I've had a crush on Neil Armstrong since I first saw him on TV in 1969.
I am still sadden by his death.
The 50th anniversary of his iconic walk on the moon was deeply shadowed by his absence.
7
Yes, this is all unfortunate but let's remember he lived to the age of 82. Having lost family who were much younger than that, I'd consider 82 years a pretty long life, and his name and legacy will of course live on for much longer than that.
19
I am 83 and I don’t consider it a long life and you won’t if you get there. My life expectancy is still 10 more years. Americans are way to willing to let doctors operate.
I’m sorry to remind you, but none of us know how much life we have left. Even more so, how much healthy life awaits us.
Population statistics mean zero to any given individual within said population. But that said, good health to ya!
Post-surgery care is a big uncovered issue for US health care systems, eg hospitals. Run more like profit centers than care centers.
6
great reporting, well written. it's not made clear exactly what would happen in the catheterization lab, but if surgery was where he ended up then obviously surgery was where he should have been taken.
the leak of settlement documents is disturbing, and gives the current dispute of the settlement by the same person who negotiated the settlement the smell of extortion. pay up or we get a book deal.
not sure what the book would be about. maybe it would explain what happens in the catheterization lab. and the moral would be -- when in doubt, go straight into surgery.
4
Consider that if the real cause of death of one of the USA's most cherished heroes can be buried in a secret plea deal, just imagine what amount of malfeasance is buried in all forms of secret deals negotiated by lawyers for all sorts of reasons.
The bar to allow private arbitration and secret deals should be much more stringent. Keeping all these secrets is damaging to the public good.
9
@Stubborn Facts
Maybe the hospital did all the right things and a bad outcome still occurred. Nevertheless they reasoned that no good could come to them if any question about their care came to a trial, no matter what the eventual jury decision. But maybe they didn't do the right things ending in the death of a patient- fame should be irrelevant- and maybe this was not the first error with similar outcome.
Hiding results is the opposite of transparency and only puts future patients at risk. Maybe the hospital has a poor record hidden by similar legal shenanigans.
Is suppressing the facts ever reasonable in cases of possible medical malpractice?
3
With a veiled threat by Ms. Armstrong that the case could go public if not resolved, the hospital had to pay. With the demanded monetary secret settlement, this was not a case of righting a wrong and preventing others from suffering the same mistake. It was an opportunistic money grab, period. It's too bad Neil Armstrong's children are not half the men he was.
19
I am not surprised but appalled that his sons are bullying the hospital for more money. They are "gold diggers in a coal mine" using their father's name to fill their deep pockets. They even sold their father's personal items to make... more money... it is a sacrilege that nobody should embrace.
Let Mr Armstrong in peace once and forever.
19
It’s too bad he didn’t go to a larger hospital in Cincinnati or to the Cleveland Clinic in Cleveland, Ohio.
6
Once again we see the rich and powerful live privileged lives. Would any of us be offered a settlement? Thank you Mr. Armstrong for making this country proud.
5
Wow. It sounds like Wendy in essence "blackmailed" the hospital for $$, using Neil's fame as a cudgel. I wonder what he would have thought of that?
Sad when family tries to turn a misfortune into a payday.
20
Certainly glad I ended up having heart surgery at the leading heart program on the West coast, and the doctor doing it was the head of the program. But the point shouldn't be that an American hero was killed by malpractice, and I suspect he would agree and point out it should never happen to anybody!
Such confidential agreements should be banned and hospitals like this should either admit their error (with limited, reasonable, liability) or be shut down.
3
I shudder when I read of secret meetings and information locked up. Democracy demands fresh air & sunlight, whether you are a hospital that accidentally harmed a man or Barack Obama issuing a presidential order making his personal actions up to 2008 a state secret of the USA.
2
What did Obama do? Serious question. I’m not familiar with that.
There were a lot of mistakes made and I rarely if ever have kind things to say about the medical profession. The first error on the part of the patient was choosing the wrong hospital but big teaching hospitals screw up a lot too. Suing for malpractice is always on the table. The settlement was achieved through blackmail. If we don't get our money we will talk about this in public. This is not an honorable way to treat a hero's memory.
7
I’m surprised by the number of criticisms of the choice of the Armstrongs to use a community hospital. I feel that people are forgetting that Armstrong was a very humble man who, when he left NASA, lived a quiet life as a professor. I don’t think he ever considered himself a celebrity. Personally, I agree that major surgery is better done at a university hospital, but it doesn’t surprise me that Armstrong trusted his local hospital and doctors.
7
As a doctor I’ll tell the public this—if negligence was done and you and yours have the opportunity to sue, do so. It’s not personal—that’s why we have malpractice insurance. If the doctor cannot take it in stride that’s on him or her. As long as that doctor learns from their mistake, they should make at least some peace with it, and should want their patient to have some compensation.
27
Interesting point, Doc. However, due to the confidentiality agreements, neither you, me, “Dr. Oz” nor the Chief of Cardio-Thoracic Surgery at the Cleveland Clinic can know if there was any negligence, nor the extent thereof. Had this gone to trial, we’d be better informed, but the family chose to pocket quiet few million instead. That’s what irks me.
1
Would not that process - suing every doctor and nurse who made an error or was negligent completely destroy the health care system ? And turn off everyone from the extremely hard job of being a medical professional ?
Would not a system of completely open disclosure of every mistake followed by a guaranteed compensation that is fair ( not 6 million when you have a nurse pulling out a paving wire which she likely has done for many years and now had a complication that was managed poorly in a 82 year old that led to death ) - the New Zealand model - and a promise that it would be discussed at the next hospital M and M and logged in the state records be a more ... open and at the same time financially capable way of doing it ?
After all - the money in the system does not go on forever and the way it works now is that some make millions and the majority suffer in silence as there often is no disclosure of the ‘truth’.
1
The hospital paid for silence regarding their treatment of a high profile person in the face of a claim by relatives of the deceased who threatened to make a lot of noise. i wonder what the case would have settled for, if it settled at all, if the deceased had been a regular person, not well known. It is in the public interest that the facts of a case like this come out, which they seem to be despite everyone's agreement to confidentiality. That's good to see.
13
Mark and Rick Armstrong were paid consultants on the "First Man" movie about Neil Armstrong and the first manned trip to the moon. They defended the filmmaker's decision to omit the planting of the American flag on the lunar surface. I wonder how much they were paid for that. They previously auctioned off 3,000 items of memorabilia associated with Neil Armstrong. Now they're cashing in on his death. What will these wonderful characters do for their next act?
19
@Dr. Reality To state the obvious, it seems that for the offspring it was far more about getting the money than, say, educating the public about a malpractice problem at a specific hospital, or using the event as a "teaching moment" for doctors and nurses generally about imminent risks during such patient crises. Neil was modest about his moon walk, but when he did speak it was to help inform. Here, his children were comfortable preventing the public from being informed. I think that Neil would be very disappointed in them.
19
The story of Neil Armstrong's death and its aftermath reveals (yet again!) a major flaw with our medical system. People may say that his family should not have sued, but how, I wonder, do they expect any reforms to be made in medical care in this country without lawsuits of this sort? The medical industry will police itself? Ha. It is an industry, not the "ministry" to which the hospital spokesman referred. Self-regulation has failed miserably, and although the PR propaganda surrounding malpractice lawsuits has obviously been quite successful, that should not be so. Lawsuits are a family's only effective option.
The problem I see with the settlement is that it shouldn't have been reached to begin with. The public needs to know what's going on at hospitals so as to make informed decisions about medical care. I have never sued a person or an entity in my life, but had my mother or any other member of my family died because of incompetent care, I would have sued and for far more money. I would not have settled, and I certainly would not agree to keep my mouth shut. I might give the settlement money away to worthwhile causes (such as patient advocacy orgs), but settling with privacy strings attached seems to defeat the whole purpose. Saying that is not to accuse the Armstrong family of any misbehavior. I imagine they were grieving and wary of affecting Neil A's hero status. But that fear of stigma is also an obstacle that should not exist.
6
@NormaMcL
Get off the high horse. There was no lawsuit. It was settled out of court in an undisclosed agreement. The public good was not served.
I'm sure the hospital staff knew exactly who they were dealing with and provided Mr. Armstrong with the best care they could but medical care is not perfect and every case has it's unique challenges. Let's hope his children use that money for something that would have made their father proud...like education and scholarships for kids not born on 3rd base. Otherwise they are doing just as IN said, "pawning off his life's mementos and threatening to slander a hospital -- in return for money".
10
As mentioned in these comments, never go to a community hospital for cardiac surgery. And always get second and third opinions whenever possible. The question I have is why did the sons push for a fast settlement by strong-arming the hospital? Had a traditional malpractice suit gone forward, would the error have been found in the courts to be a rare, but possible, outcome?
4
Bravo Mrs. Neil Armstrong. Shame on his sons. This is not what he would have wanted. Shame on his sons!
10
It's terrible to learn Mr. Armstrong's medical care was botched. I feel sorry for his wife, who somehow seemed helpless and trapped in a situation not having her approval. There's something strange about the choice of hospital, and something unsavory about that quick and secret shake-down of the hospital by the wife of the son. I wonder about their divorce, and their divorce settlement as well. This is a bad story surrounding a good person, and I'm glad the details are coming out.
9
One thing I learned from this event is that surgeons love to operate. If the operation is successful, he/she would be reward handsomely. If not, he/she still would be reward handsomely. If the patient happens to be famous such as Mr. Armstrong, then the surgeon would love to put his hands on him. For the surgeons, there is no down side but up to deal with.
2
Any one of us could suffer the same lethally flawed treatment at the hands of medical professionals and it would never face the light of day the way Mr. Armstrong's treatment has. That is bad enough. But, for this information to be kept secret because it could "forever taint the business enterprise" is unforgivable. Maybe the "business enterprise" deserves to be tainted because of the substandard care it provides. This is the kind of information that doctors and hospitals work hard to hide from the public. Protecting the business enterprise is the goal, not providing the care we should all have the right to expect when we are helpless in the hands of medical personnel. The law should be on the side of patients. Let us know the records of doctors and hospitals we depend on.
4
I'm behind the Armstrong family 100%. My vital, resilient father also died due to shoddy medical care after minor hernia surgery "leading to a cascade of problems that resulted in his death." His doctors shamelessly abandoned him when they realized mistakes had been made. (Note the use of passive voice.)
My father wasn't the first man to set foot on the Moon, but he was my hero. He lived an exemplary life. To lose a loved one is never easy, but to lose someone as a result of medical negligence is horrific.
12
We appreciate his contributions to the space race, but he is no different than any other man or woman. He did what he signed up for, and took the risks associated with it. Neil's status should have nothing to do with health care he should or shouldn't receive. His treatment should be treated like anyone else regardless of status. He and his family made a choice for the medical facility where he received treatment. It about choices. It is a shame his very children live without the same human decentcy as his father did when talking step on the moon for the world.
4
I'm having a difficult time wrapping my head around the timeline of events:
1. Some "tests" were run which showed coronary occlusions (I'm guessing a stress test, and probably a diagnostic cath?). The decision was made to proceed to immediate surgery, but before that temporary pacemaker wires were placed. Ok, presumably this was due to ischemia bad enough to be having bradycardia (slow heart rate).
2. Then, the decision was made to remove the temporary wires. But why? If the plan was to proceed to immediate surgery, and the patient was ischemic and bradycardic, you wouldn't remove the temporary wires. That doesn't make any sense.
3. Then, he started bleeding and developed what sounds like a pericardial tamponade. He was then taken (back?) to the cath lab for an echo and pericardiocentesis. That suggests that he was not in the cath lab at the time the wires were pulled. So where was he? If he needed immediate surgery why was he transferred to a bed in the first place, and why were his pacer wires removed?
I agree that the definitive treatment after the tamponade should have been surgery, although it must be noted that even surgery may not have saved his life.
I'm really struggling with: why were temporary pacer wires placed prior to surgery; once placed, why they were removed prior to surgery; and where was he when all of these events occurred?
4
@John
They weren't placed prior to surgery: they were placed intraoperatively, and then pulled post-op (the precise time was not disclosed in the article). Note that his wife told the AP that following his CABG, he was "amazingly resilient and was walking in the corridor". Temporary pacing wires are sewn directly to the epicardial surface before the chest is closed: "pulling" them post op, once a pacemaker is no longer required, occasionally causes bleeding, a complication which any competent cardiac clinician should anticipate.
1
If we understand that the settlement would not have been reached if it were destined to be published, and further, that its publication might legally void it, it, it seems to me that the onus is now upon those in the media who did publish it to make up the possible loss to the plaintiffs.
Physicians who do not have access to the full medical record in any medical malpractice legal case, are, or should be, ethically precluded from journalistic comments on it, one way or another.
2
ILooking at this with a global eye, I can say, without any trepidation, this country would be infinitely better off if there it was not so litigous. I don't care who, how, why or what, it is ridiculous how many ambulance chasing attorneys are out there. Obviously, I am not speaking to this specific case; as I wrote "wih a global eye". In Shreveport, Louisiana, attorney's billboards line the streets, and smother the airwaves. It is hideous, just as advertising for pharmeceuticals is. Big pharma has an incredibly powerful superpac lobby.I have watched "The Evening News" on all the major chanels and counted how many RX drug ads there were up to 7 or 8 ads! When you throw in the OTC (Over The Counter) drugs, the number has been as high as 14! All in a 30 minute show! It's like the sportscaster who said, "I went to a fight, and a hockey game broke out.", only here it would be "I watched the Evening Drug Advertisements, and news soundbites broke out." The first step we need to do is ban public advertising of drugs and attorneys. Of course, the attorney thing is a state by state issue; however, the drug ads are not: That is covered nationally, of course. We stopped the TV ads for cigarettes, and they went kicking and screaming. For me, it's not a stretch to one day start seeing ads on TV for AR-15's and 9mm Glocks!
4
This case raises an intriguing question. Did Armstrong suffer from VIP care, namely the dangerous tendency of doctors and hospitals to treat the famous differently? Why have the fluid drained in the catheterization lab if the standard approach was to do so in the operating room? If he was rushed into surgery as Dr. Jha claims, why the hurry? (As an aside Dr. Jha is a renowned for his expertise on health care policy, not for his care of patients with heart disease, so his comments should be taken with a grain of salt.)
When Ronald Reagan was shot, the tube in his chest was inserted by the physician who routinely inserted such tubes: a surgical trainee. His skin wound was closed by another trainee. His care providers treated him the way they treated every gun shot victim. A valuable lesson for both patients and care givers alike: stick to the routine. Oh, and don't demand the quiet VIP floor at the far end of the hospital that comes with the carpeting and a refrigerator and the VIP floor nurses who don't specialize in your condition.
7
How ironic that a man can survive the perils of space, fly to the moon, touch down upon the surface, return home, and ultimately receive their demise at an urban Cincinnati hospital.
I understand that the human body is a complex organism. I understand that life carries risk. But will we ever know if Neil Armstrong’s death was the result of carelessness, ineptitude, or just bad luck?
Six million dollars.
I suppose that is a cheap price to pay for supposedly killing the first human to step foot on the moon. While the hospital may prove to be blameless, I have lived too long to not recognize that gross incompetence exists at many hospitals, probably more than we know, only to be covered up by even grosser corporate politics.
I lost my grandfather to a hospital. He went in for normal gall bladder surgery and never came home. I also know gross incompetence exists everywhere and not just in hospitals. Take the Presidency for example.
Mr. Armstrong, you are now in Heaven, a celestial wanderer. To all others, you are at the mercy of those assigned to take care of you.
Maybe a better bet is for you to sign up for the space program.
4
Arrogance on the part of the doctors at the treating hospital.
It was a well known secret as soon as Armstrong passed that he should have been transferred to a "heart hospital".
2
Second-guessing medical decisions by the medically untrained is usually unproductive. My initial impression is that the family was motivated by greed and threatened to blackmail the hospital.
6
This article is an unfortunate follow up to a great man's brave and patriotic accomplishments. The headline about a stormy secret immediately makes one think about strippers and payoffs then when read it highlights how Neil's two sons went for a cash grab following their fathers death of essentially old age. I feel extremely sorry for Mrs. Armstrong who seems to be the only one really thinking of her husband's great legacy.
5
That "Mr. Armstrong, ...avoided the limelight and never cashed in on his fame...." reminded me of my hero, Marie Curie. After making many discovering that contributed to the welfare (and not so much) of mankind, she never patented her original ownership of the process to produce radium and polonium, and she avoided celebrity like the plague. She was great pals with Albert Einstein, who said that she was the only person he knew who was totally untouched by fame. Marie Curie and Neil Armstrong - they're in good company together.
7
I doubt that he was buried at sea in 2012, as the photo used is described, before dying in 2014.
3
In a world where virtually everyone is incompetent, and unaccountable, we are all doomed.
3
My takeaway from this is: for anything serious, go to a serious hospital.
1
He should of been at the University of Cincinati Hospital not at the outlying suburban affiliate and they are operating on a major organ for life, the heart!!! That hospital should have directed him there. The risks are higher for an 82 yr old heart but the medical professionals and resuscitative eforts, as a whole, are far better
4
It is a little known phenomenon in medicine that famous people often get substandard care. This also applies to doctors themselves. The aura about the person, the fear of bad publicity, the wishes of the celebrity all lead to decisions that never would be made w/ your average Joe Blow. It’s as if the attending physicians are overwhelmed by the person and all clinical judgement is lost. MD patients can be victims of this also. Since they are inside the system, they try to take control of their own care and disaster ensues.
7
If both parties signed a confidentiality agreement, is it really your place to make this public?
Is anyone better off from your story?
4
@Jeffrey Jones. Yes! Anyone considering CABG at that hospital most certainly is!
1
What an ugly mess.
2
After valve replacement an idiot nurse yanked the first of three wires from my heart. I screamed she was so mean no concern for my comfort. My wife complained never saw her again. Now I realize I could have died in that situation.
1
Shocked not shocked.
Medical error is rampant. 3rd leading cause of death.
And hospitals almost always cover up and deny, causing even more trauma to the victims. Invalidated trauma, deepens trauma.
People are sharing their medical harm experiences on the
Medical Error Interviews podcast.
https://feed.podbean.com/medicalerrorinterviews/feed.xml
4
As a physician who trained in the last ten years in both community and research hospitals, this does not surprise me.
(I recognize I paint with broad strokes.)
Many smaller hospitals are just not equipped to handle complex medical cases. Whether it’s the use of midlevels to replace actual physicians, nursing shortages, union regulations, or lack of resources/expertise is hard to pinpoint. It’s likely a combination of many factors. I will never forget the distinct lack of concern for the gravity of patient’s medical conditions as well as a lack of go-getter-ness amongst the staff (nurses and doctors alike) at the community hospital. It still keeps me up at night.
It is all our problem that with all the knowledge we have and all the advances we have made, one cannot trust that a given hospital will provide excellent care. This is why, whenever asked, I never hesitate to arrange the highest level of care for family and friends. Because it can be the difference between life and death. I honestly don’t know how people without a doctor in the family do it...
6
The U.S. astronaut corps were early, and continuing examples of the benefits of keeping fit and taking care of your body (yes, I know some of the early ones smoked). I remember being surprised at hearing of Mr. Armstrong's death at such a relatively early age, given that he was an exemplary part of that group, even given the vagaries of aging. What a shame that it happened this way. The medical recommendation to do heart bypass operations, and the odds of surviving both the operation and the immediate post-op phase might be good subjects for the 'Times' to examine as follow-ups to this.
3
This is especially tragic considering the persons involved. However, the underlying story is not infrequently told. As an MD, as well as JD, I can say this is the type of case that malpractice attorneys spoon over.
Tremendous loss (life); questionable indications for surgery; and, likely a breach in the standard of post-op care...
4
Question: What is the title given to the medical student who graduates at the bottom of his class in med school? Answer: Doctor.
6
My mother died from complications of a heart procedure. No one came to her beside, she wasnt in a special recovery room. They never checked her blood counts which clearly showed she was bleeding internally. My family also sued but back then (32 years ago) you only got what the deceased was worth. mind you the hospital had over 10 irregularities. all they got fined was $10,000 . and i will put the name of the hospital out there WINTHROP in Nassau county.
10
Any patient can have a bad outcome at any facility. When one has the benefit to choose a hospital and a surgeon, both eh family and family can get second and third opinions, look at outcomes data and make the best choice possible. Yes, you will still be at the mercy of the the entire staffing at that time, but you know you does the most procedures with the best outcomes. Here, it seems needlessly rushed. The family was right to ask for an inquiry and then accountability. There were fatal mistakes here, not just ordinary medical errors.
1
Anyone who has a heart condition should be treated in a hospital that specializes in cardiac care, not a local community hospital.
This is especially true for those in poor health or with complex cardiac issues.
11
Kids profiting from a fathers death. Despicable. The error was defendable. The outcome tragic. Blood money. How do they live with themselves.
17
With the American healthcare system they way it is the 6 million probably will only cover the botched hospital fees. I bet he was cold before the family started getting phone calls for payment.
1
Six million dollars for not doing anything wrong. Yea right.
2
Errors occur in medical care. They can be minimized but not prevented. When it comes to cardiac procedures, the patient and the family must take responsibility for seeking out the best quality care, which includes those who do many of these procedures. It seems unrealistic to award the children of an 82-year-old $6 million. Would an actuary value the remainder of his life at this amount. I doubt it. The hospital settled to avoid adverse publicity. This is now public. Nobody is innocent in this story, but the family does not come across well.
17
@Sisyphus
No, some errors are entirely preventable. The science of patient safety and the prevention of patient harm from adverse events and medical error prove that. If it is that hospital's protocol to take similar patients to the cath lab first and not the OR, that might have changed.
2
The biggest issue it seems is why was the cardiac bypass surgery done emergently given the description in the article. However, from my perspective as a physician it is unclear if the hospital did anything wrong. The family’s emails are outright blackmail and carefully designed to extract the maximum from the hospital. The hospital may have made the wrong call in cath lab versus OR, but these are high pressure situations with numerous variables to consider. The bottom line is that CT surgery, especially in a 79 year old, is inherently dangerous and prone to complications. It should never be considered routine. There is no irony in his death as some have put it as by the time he developed pericardial bleeding his situation was certainly more precarious than it ever was during the moon landing.
As far as community versus academic hospital, having worked in a big academic hospital for many years and seen medical errors by the staff and residents, I think many community hospitals might be a better choice for these commonly performed (but not routine!) procedures. Outcomes are often worse at many of the big name academic centers. In part they have a more difficult patient pool, but that’s not the whole story. If you need a pancreaticoduodenectomy or cutting edge immunotherapy, go to an academic center. But with more common surgical procedures, you just want the guy and facility that performs it the most. That’s often a community hospital.
8
Absolutely! Get your Whipple or skull base surgery at an academic center, but have your hip fracture fixed or cholecystectomy at a local hospital.
1
Neil Armstrong and the entire Apollo 11 team represented the finest this country had to offer. I was 8 years old when Mr. Armstrong set foot on the moon and like so many, was riveted to the black and white TV in our home. Last Saturday, I watched the special on BBC America covering the mission. For two hours I relived a time of hope and promise that brought the world together. For a while I was able to forget what our world has become today. His passing was sad, especially under the circumstances that have come to light. But I would rather remember Mr. Armstrong as the beautiful young hero he was in 1969, a man who fueled the dreams of a generation.
7
You keep this secret all these years. That is sick. What a sick, sick country this is. An HIV medication Tivicay costs $1,844 a month. Sick.
4
When one is in perfect health and discovers some biological imperfection that is symptomatic of aging due to advances in technology the last thing one should do is have major surgery. Doctors, hospitals, and families frequently downplay the serious side effects and complications of surgery in a somewhat selfish desire to want to prolong life, or in the case of hospitals, increase their profit margins.
5
I am shocked and appalled to find out that one of my childhood heroes died this way.
You can blame his kids or Fairfield Hospital or both but this is not the story that Neil Armstrong would want as a footnote to his legacy.
123
@John E.We are not talking Legacy here. That will always be there. We are dealing with here is poor judgement. All involved must be exposed for the benefit of all.
14
@ghgsw An 82 year old man? Seemed like extortion for a settlement on the part of the family.
6
@B The worth of anyone's life does not decline with age. That's a horrible assumption. An 82 year old who is otherwise healthy and sound of mind has all much right to live as anyone younger.
16
My Dad had quintuple bypass at 71. They said if he didn't hav e the bypass he would be in a wheelchair within a month. He died at 72 after a great yearn running around like he always did. I hope I make it to 82.
I wonder if Mercy Health-Fairfield changed any systems in place as a result. Did anybody learn anything? How many times does this occur every year in the country? What was done and what were the results?
This is a straightforward medical issue. It is not a diagnostic zebra. It is a recognized complication. What are we doing to prevent it in the first place, or barring that, confirming the diagnosis and subsequent treatment more rapidly?
Science got Mr. Armstrong on the Moon. Science can save future lives, but only if we use the science of system management, counting things that matter, and knowing what to do with those counts.
7
The most important question here which is completely unaddressed is who decided to have the most famous American alive go to a community hospital for major surgery when logically Armstrong would have been admitted to any of the finest hospitals to be treated by the most acclaimed surgeons in the nation. Was this Neil Armstrong's personal decision or did others make the decision for him. And in either case why this hospital ?
11
Life is really bizarre. A man like Armstrong, who went through so many risky missions (from the X-15 hypersonic tests up to the Moon), killed by something that was ways less dangerous than his daily job.
6
Medico-legal issues aside, the irony in Armstrong's story is that someone who participated in one of the most high risk and hazardous human endeavors, space exploration, died from complications of a commonly performed surgical procedure.
5
Bypass surgery is commonly performed but far from risk free. Putting aside the the facts of this one case, there is not a single hospital anywhere that can promise survival in a 82 year old. Immortality is something still out of modern medicine's reach.
7
I can see the public interest in health care, but a significant part of the reporting seems to me an invasion of the privacy of the Armstrong family.
3
I am a physician. Cardio-thoracic surgeries are extremely high risk surgeries, even with the advance in modern techniques. Also the patients and their families are informed of the risks and sign an informed consent. And hospitals who perform cardio-thoracic surgeries are closely monitored on the success rate of favorable outcomes. I'm sure the Cincinnati-Fairfield hospital was well vetted by Neil Armstrong, his family, his family and all his admirers to whom he is their hero. Shame on his sons to sully Neil Armsrong's legendary image and his pivotal place in the history of mankind. And for money!
24
@NNI Your point about Armstrong 's sons essentially profiting from the tragedy of their father's death is an excellent one. The photograph of them preparing to auction off items that had been of personal value to their father is quite telling. Had they really understood the depth of meaning of their father's place in history, those items might have been donated to the Smithsonian or some other institution where they could have educated future generations about that courageous, magical momement in July, 1969. I was 9 years old. I remember going outside with my father and looking up at the moon and thinking - "There are people up there." Even at 9, it was pretty mind blowing.
10
Inexplicable decision not to go at the very least to the very best hospital in Cincinnati, if not further afield than that. My sense is that refusing to expect or demand any special treatment was part and parcel of Mr. Armstrong's makeup. But it's not "special treatment" to research and get yourself into the best possible situation for serious medical conditions.
4
Turns out the man who walked on the moon was just like us. My parents received poor medical care from exhausted residents making life or death decisions, dirty hospitals, and doctors who wouldn't recommend necessary tests because they would have to battle insurance companies. Yep. Healthcare for all.
8
I have had several friends, & parents of friends die due to botched issues. My parents ,who were part of the WW2 generation were the ones who never questioned authority figures ,including doctors & hospitals. You didn't do it according to my mother.She suffered through several unnecessary medical issues.
That's why I asked my Doc of 40 years "Is that why they call it a practice ? Because you are Still practicing "? He didn't laugh too much at that one.
4
Neil Armstrong never “cashed in” on his fame, which is one of the things I truly admired about him. Sure looks like his kids didn’t hesitate to cash in on his fame, though. This settlement makes me sick. First of all, mistakes, unforeseen circumstances, twists of fate, complications, whatever you want to call it, happen in life. Unless someone was completely negligent or malicious, why are we suing each other? Second, if an 82 year old average Joe receives the same care and dies as a result, his kids don’t walk away with $6 million. And finally, that $6 million didn’t just fall out of the sky, that money will be made up for by charging other patients more. Anyone wonder if his kids cared more about their dad’s legacy than their own selfish greed? I don’t.
21
Many of us have seen. and had to sign, the waivers of indemnity that hold medical service providers faultless. If that industry is going to maintain a position of innocent non-accountability, then accept a remuneration fitting your lack of confidence in your skills.
Doesn't it seem that there is a certain lack of accountability?
3
These guys literally stop the heart, perform surgery on it, and restart it for a living. They do this regularly, maybe multiple times a day. Each time it’s very risky and they might lose the patient.
They do these procedures because there is no choice and usually it is successful, but given our litigious society and virtually no tolerance for safety risk in other industries (auto recalls for a 1 in a million defect, caution hot warnings on McDonald’s coffee cups following lawsuits) it is a wonder that these procedures are done at all.
5
Armstrong, an admittedly fine person, did consent to serve as a spokesman for Chrysler during the 1970s, so to say that he never cashed in on his fame is debatable.
9
"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."
What a horrific story. I understand the pain Mr. Armstrong's family endured and the sadness of his loss.
One of my favorite cousins had gone into the hospital for knee surgery - nothing complicated or tricky. The surgical nurse administered an incorrect amount of a particular drug which caused his death. His family sued for malpractice, won and anonymously donated the money to various charitable organizations.
I realize that 6 million dollars is a ton of money. I keep thinking that Mr. Armstrong never "cashed in" on his fame. I wonder if his family kept that in mind when payment was made. I make no judgments, simply wondering out loud.
Even after all this time, my heart still breaks for the Armstrong family. Profound condolences.
11
If the sons truly care about their father's legacy, and weren't seeking to "shake down" the providers then donate the proceeds to their father's favorite charity, on his behalf. But, they won't. Greed is powerful stuff.
13
So many “sophisticated” (self serving?) commentators zealously defending doctors; actually deeply resentful plebeian dare questioning their “better’s” judgement/credentials.
3
A better headline would have been :
"Neil Armstrong's family Strong-Armed a hospital into granted it a six million dollar settlement."
15
82 years old wasn’t good enough ?
Typical entitlement attitude.
9
@Ed Whyte - What are you talking about? This isn't about entitlement, this is about the tragic death of an 82-year-old American hero, an apparently modest man who will go down in history for his unprecedented achievements. The last thing the late Neil Armstrong was about was entitlement. Jesus God, Ed. Get a life.
2
@Ed Whyte Say WHAT? Are we now putting expiration dates on human beings after they have lived an "appropriate" or "acceptable" number of years? I find your comment both insensitive and apalling. As the saying goes, ironically - "Who died and made you God?"
3
As public policy we need to make non-disclosures illegal in cases of claimed medical malpractice. Valid claims will still be settled by the fear of losing a lawsuit. You can even make up for that issue by trebling damages or adding plaintiffs legal fees to damages.
8
Apparently NYT readers hate inherited money more than hospitals and insurance companies put together.
3
We have a national myth: America is a meritocracy, anyone can get ahead and we all start on a level playing field. Inherited wealth makes a mockery of all three tenants without even addressing how that wealth was amassed. And I don't mean a few thousand bucks. I mean enough $$$ so that multiple generations never have to work and still live a better life than most working people. And all the power that goes with their unearned money. No wonder people hate it.
4
@Carr Kleeb You can tell yourself that all you want but the poverty rate for people who finish high school, get a full-time job and wait until age 21 to get married and have children is 2%. In how many other countries do first generation immigrants have the opportunity to become billionaires? The jealousy ridden hate directed towards people because of money is disgusting.
I had emergency double bypass surgery when I suffered a heart attack. It came out of the blue as I was working outdoors and probably became dehydrated. I called 911 and an EMT crew was at my house in eight minutes. I was stabilized and in cardiac surgery within an hour. The procedure took more than five hours. I was in recovery for four days and closely monitored.
I wonder what the nurse that attended Mr. Armstrong was thinking when she removed the wires. In my case, I had four incisions below the major chest incision that opened me up for the bypass operation. Wires came from these four incisions and served to keep the heart working properly. They were only removed near the very end of my hospitalization. Whatever the nurse and the other hospital staff did that resulted in quick loss of blood pressure in Mr. Armstrong, they seem to have made a series of irreversible, wrong decisions that led to his premature death.
It’s been five years since my bypass surgery and I am glad to say I am healthier now than I was the minute before my heart attack. My advice for medical staff is to pay better attention to the patient and his/her condition before making a fatal error. I was fortunate. Mr. Armstrong was not.
The quiet financial settlement seems to have been primarily done to protect the hospital’s reputation. Shame, shame. People need to know when there is a major screw-up in patient care.
21
If this was a clear case of malpractice, why did Mrs. Armstrong disagree with the settlement?
12
@MS
It really is none of anybody’s business.
1
"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. "
In other words, Neil Armstrong's daughter-in-law attorney and family extorted a large settlement from the hospital by blackmailing the hospital. with the threat of damaging publicity.
The family dishonored the memory of a man who shied from publicity, and whom I doubt would have supported its actions.
The family should be ashamed. If the family believed that the hospital was guilty of malpractice, it should have pursued a malpractice claim though the channels available to ordinary Americans.
The family's actions constituted extortion and blackmail.
I think the hospital should pursue a course of action against the family for blackmailing the hospital .
26
@DJS But the hospital caved in. The time to stand up to the extortion was when they received the threat. By settling, they covered up their mistake and prevented a transparent systematic review of what went wrong. They aren’t blameless in this story.
1
I wonder if a similar incident had happened to a senior citizen, an elderly black or a Hispanic. would there be such a drama . people in Hospitals, clinics, cars , die everyday, yet we tend to glamorize the rich and or famous. Yet it was unfortunate that he died due to alleged less than normal surgical intervention.It seems Name, importance, race and wealth dictate whom is important or not. May he rest in peace and the Family enjoy their new found wealth..
6
It is shocking to think that rather than expose medical malpractice in an effort to help other people facing similar cardiac surgery, family members would accept money to not go public with their allegations. Is that what an American hero would do?
21
Unfortunately medical care and decision making is almost never black or white - there are a lot of gray areas. If it was that simple then a lot of people would be doing it. It surprises me when a lot of experts give their opinions how something should never have happened .These experts should be asked how many times in their own medical careers did something go wrong - I suppose it is always someone else's fault!
9
I always admired how Neil Armstrong NEVER used his fame for monetary gain - quite different from today's politicians. He didn't seem to pass that virtue on to his sons however since the shameful story of blackmailing the hospital to pay up or they will use a public anniversary ceremony to highlight their lawsuit. Also love how they split the spoils of the settlement - $0 to his widow (Sign the document or you are fired as executor!) and 45% to EACH of them - scraps to everyone else. Nice!
22
On any of 1000 occasions in life, Armstrong could have thrown around his name and celebrity as threats to make money or to gain myriad privileges wherever he went. He apparently steadfastly declined that strategy. In death, his daughter in law decided to use his celebrity to extract $6 million from a hospital system and maybe some doctor's insurance policies. For what? Did they start a foundation for cardiac wellness? Did they make sure the decision makers were reeducated? Did they buy ad campaigns (they could have done this anonymously) teaching the public about cardiac tamponade? They got the cash and kept it quiet. If Armstrong was the moral hero everyone claims, who "never traded" on his celebrity, the family appears not to have honored him with their extortion tactics. Don't get me wrong: threats of bad ink are used regularly to extract settlements-- just not by the legacy holders of so-called moral heroes who, in fact, wind up diminishing the name and reputation of their hero by their own banality.
18
I have often wondered what if any solace there is in suing for malpractice. The person is lost to us. Gone forever. Is it anger that fuels the decision? Is it the need to stick up for someone we love. The sadness that permeates this story is palpable. What is it like to work in a hospital and know and have it known that you made a bad call and cost a life. I can't imagine and I don't find an answer in this story.
5
My father died at age 62 in the hour after his surgeon completed coronary bypass surgery. That was 40 years ago, but the mortality rate for all surgeries has not changed: 1%. From my prospective, Neil Armstrong was a lucky man. He lived long enough to know his children as adults and enjoy his grandchildren.
I have never heard of the hospital where he died, but it’s about a 10-minute helicopter ride from there to Christ Hospital in Cincinnati. This is considered to be one of the leading hospitals in the region.
5
@flipturn
No guarantees at any hospital, especially for a patient in their 80s. My father died during a complicated heart surgery at that “leading” hospital.
3
Surprised that he did not go to the VA hospital. But then again, maybe not so surprised after all. Neil was famously suspicious of the spotlight and the fame. That could be a reason why he chose a small local hospital. But it is a cautionary tale. Go to a hospital that has a reputation for the procedure you are about to have performed.
6
Not the proper ending for this man's life. Greed, 1, decency 0.
11
Some people would call the actions of the family’s attorney extortion.
17
Regardless of the motives of all involved after Mr. Armstrong's death, his reluctance to babble on about his achievements, or even cash in on them, is something to ponder with awe in these noisy times.
9
If you term it “payout” like it’s some kind of simple transaction “Oh he died. Let’s make money on that.” Then yes, it seems crass and greedy. If you consider that no one in the family spoke on record in a way that takes one side or the other, then it’s a private legal matter We know virtually nothing about how the family feels. That it’s in the news and can be judged by a world making comments on the NYTimes’ website, assuming greed and nefarious behavior, then all of this is more a demonstration of our troubled society having to scream about every event recklessly than what really happened to this national hero.
7
I hope my sons would do the same. Armstrong should have had years ahead of him instead it was cut short due to incompetent.
@Don Siracusa
He was 82 years old
3
@Vail,
Hey thanks, I'm 88. Mr. Armstrong, and respectfully add, 6 more years would have been nice. My three great grand children were born within that period. But I get your point
The real question is why he wasn’t going to the Cincinnati VA?
2
82 year old man dies of complications after major heart surgery, hospital’s fault: maybe, maybe not.
14
This story says so much about healthcare in America and greed. To all those wondering why he/the family went to the local hospital instead of the larger one at the U of Cincinnati are missing the point. Here was a humble man who didn’t capitalize on his fame and lived in a small town in America, choosing his local hospital that he trusted. He had no way of knowing the care would be sub-par, but would he have chosen any differently??
5
An 82 year old man dies after a complicated and risk-laden procedure.
Two kids wrestle a settlement from a private hospital, preseumably NOT to donate the funds to a museum dedicated to a man taken from us too soon.
A widow, probably possessed of more wisdom, demures.
A leading liberal paper states that all of this should come out for the common good (and to wave more red meat before the trial lawyers who need more money).
And the whole process insinuates that single-payer healthcare either would have prevented such a death or been more transparent concerning its circumstances.
All the while we ache, as a population, for the right to end life...except when deeper pockets hold gold coins for the shaking.
Do we really believe the government, as provider, would hold up well under a flurry of wrongful death suits?
Well, at least some of the grandkids got a few bucks...maybe bought a car or renovated a bathroom. And to think that the young had all those years to live and could have paid for education expenses...
The odor of exploitation always hangs in the air.
We are a deeply conflicted culture most in need of a compass rather than a new watch or calculator.
18
Is this the legacy of a great man: Greed? What does the money do for them? Is this what Mr Armstrong would have wanted? This story shows how far down our nation has sunk in the morass of materialism since the generation that sacrificed so much in the WWII and post war era.
8
A search of the PUBMED data, a medical literature search service supported by the US National Library of Medicine, identifies several citations related to bleeding after pacemaker wire removal in cardiac surgery. One study from a German center identified an incidence of 0.18% in 4244 cardiac surgery, two of which were fatal.
(https://www.ncbi.nlm.nih.gov/pubmed/28122567). In another retrospective review, the incidence of less than 0.1% (9.7 cases per 10,000 surgeries). Mortality outcomes were not reported in this abstract, which emphasizes that the changes indicating this is happening may be subtle and easily missed. (https://www.ncbi.nlm.nih.gov/pubmed/23117906) Several other citations date back decades. I do not know what the incidence of this complication is at the hospital where Mr. Armstrong's surgery was done or whether anyone had seen it before. It is easy to speculate on causes of the outcome in this case, but I don't know the resources, the people involved and above all, I wasn't there.
A proper response is for the hospital is to conduct a review to see what went wrong and try to correct deficiencies. While the desire for a large settlement is understandable, if $6 million jeopardizes staffing levels or otherwise destabilizes the hospital, it may feel "just" but will do more harm than good.
Also, in most cases, these settlements ultimately are hospital overhead and come out of the pocket of the public in the form of higher insurance costs.
9
Exactly. In 22 years of practice as a cardiologist I have never witnessed bleeding after removing temporary pacing wires. It is a low risk procedure done at the patient’s room. But once you have bleeding around the heart after surgery the proper action is another surgery, not the cath lab. I wonder what the performance numbers are for this hospital (sorry, ministry).
5
@Panagiotaropoulos
Thanks. Would just add that this is where the details we don't know -- and can't know -- become important. While this is outside my area of expertise, I would ask if the OR was available. Were other surgeries going on? Was cardiac anesthesia available? Did they recognize immediately that he was bleeding? Was there some other explanation that would prompt reasonable people to make the choice to go to the cath lab that has nothing to do with clinical competence? The only thing we know for sure is that the had a very rare complication of his procedure with a catastrophic outcome, which is tragic. We also know that it has happened in other settings with catastrophic outcomes and that this is published in the medical literature as part of the process trying to educate physicians to prevent it from happening again. This is really all that is fair to say here.
1
There is hope readers.
The truth comes out eventually.
One day the world will learn just how corrupt the 45th president was, how Russia played an important role in getting him the presidency, how many people he swindled, how many women he sexually assaulted, how much money he made off of his presidency and how each and every republican lawmaker who stood silent and complacent while they allowed this to occur.
This includes senator Mitch McChinless’s role in all of the above.
They can run, but the truth finds away out.
It may seem like it but it’s NEVER too late for the truth.
2
@Manderine
Way to hijack the discussion. Was waiting for that inevitable comment. Thanks for not disappointing.
12
These no disclosure settlements are to the detriment to the public and should be illegal. I’m not saying the people affected shouldn't be compensated, they should. But the withholding of medical malpractice, the #3 cause of death among the older population, helps no one but incompetent medical practitioners. Who’s going to suffer when these people are allowed to continue to make easily preventable mistakes?
Doctors, you are not infallible, and need to place your feet firmly on the ground and take your medicine.
4
It is beyond me to see the value of the NYT reporting on this. The matter was tragic, but it was between the Armstrong family and the hospital. How in any fashion does splashing and sensationalizing this story, on your front page, doing anything helpful for anybody.
Other than make people feel angry, scared, dismayed, hesitant to get care, hesitant to get care in that hospital, synical. What is the purpose? Other than to fuel further the angst you propagate day in and out.
While this situation is tragic for the Armstrong family, it is not for the readers of this paper. Our sympathies and condolences should, appropriately go out to the family. Neil was a courageous hero. Of world wide proportion.
But the fact, the data, is healthcare results have never been better in this country. We live longer, cope with disease better, diagnosis earlier, provide care to more people, than ever before.
By the way I am neither a physician, hospital administrator, insurance president or attorney. Just a citizen.
5
Excellent reporting. Botched treatment. I suspected it all along.
Its not that Neil Armstrong died after poor decisions by a hospital staff that probably should not have been performing that procedure at that moment. Its not that his family sued those culpable for the American hero’s death. The most disturbing aspect of the reporting is the shakedown by the lawyer prior to the Kennedy Space Center event. If that doesn’t smell of extortion, what does? In close second is that fact that no widely-distributed public health benefits comes from such lawsuits. There is no followup as to changes the hospital may have made to its protocol of if any changes or disciplinary actions were even taken. Confidentiality helps only the malfeasant.
19
The death of Neil Armstrong at the Cincinnati hospital is very tragic. It however shows the reality of concomitant risks present in our medical care system.
I personally know one of the experts cited in this article, having grown up with him. He is a medical professional of the highest caliber. His review of case documents and conclusions as to the type of care received by Mr. Armstrong tells me the case is complex, and rests on details of Mr. Armstrong's intrinsic medical condition.
Many medical procedures, especially cardiothoracic surgeries, have high risks that often cannot be curtailed. Sometimes decisions must be made in minutes, with little certainty of what is transpiring inside the patient. In rare cases, decisions lead to negative outcomes even death. It is difficult for laypersons to fathom the complexity.
However, this story tells of a situation where a hospital was treating a patient with cardiovascular disease, due to treatment complications the patient died, and the patient's worldwide notoriety allowed that patient's family (sons and daughter-in-law) to use coercive threats to "shake down" the hospital for money.
Irrespective of whether inherent risks or avoidable errors led to Mr. Armstrong's death, his family's behaviors appear irresponsible, and taint his image. Mr. Armstrong was a man of utmost standing. Yet his children are doing what he never did -- pawning off his life's mementos and threatening to slander a hospital -- in return for money.
491
@IN--I don't agree with your characterization of Armstrong's family, and I also don't agree with your statement, "It is difficult for laypersons to fathom the complexity" of medical conditions and treatment. This patronizing attitude is what allows the medical industry to protect its own and to draw a curtain around the record of mistakes and poor treatment by doctors and hospitals. Patients must accept on blind faith that a surgeon they choose has the expertise required to do no harm, yet medical mistakes are made every day. Patients can "fathom the complexity" of procedures and should have access to the records of medical professionals and facilities. Our lives may depend on it.
80
@IN
How badly did they behave? Had they immediately made their concerns public, instead of handling it privately, they would have recieved more money, and the hospital would have been damaged far more.
They were consulting on movies, and books to celebrate their father prior to his hospitalization. Including this as his final chapter would simply be honest.
Helping the hospital cover up this flaw in their care seems the only dishonest thing here. Surgery is complicated, but so is rocket science. NASA has been quite open about their failures, despite the inherent complexity of space flight. Surgeons should strive to do the same.
35
@Ms. Pea. Our family used the services of an ortho surgeon for many years, starting when he was a fairly young but board cert MD. He worked on many members of our family, and dozens of people we referred to him. Then, in almost a cascade, we discovered he wasn't at all what we had promoted him to be. A relatives shoulder surgery, botched. Twice. We discovered others who had problems inc one who had the wrong size/shape knee replacement who will now never walk properly again. The reason we discovered all of this (there is more I won't go into) is because when I went there, with what turned out to be a chain of bad events, this man and his partners used what we now know to be voodoo "medicine" for a badly shattered foot, ankle and lower leg. No, a special "shoe"-- a shoe, not a CamWalker etc- was never going to "fix" it, neither was pouring some "special soak solution" on the subsequent skin breakdown going to heal it--- after a year and a break with the practise and hospital the leg was amputated. I should have had Armstrongs daughter in law as my lawyer, I was greeted enthusiastically by legal teams only to have them fizzle out, and was not able to recover a dime. Is this a simplistic view? Yes. But I am the one who, thru no fault of my own, now bears the burden of dealing with a prosthetic leg, decreased mobility, pain, and high costs, while the MD is still "practising" on patients, who are, like us, now not informed of his very mixed outcomes.
40
A tale of greed and extortion. What shameful behavior on the part of the heirs.
11
Easy for you to say, it was not your father. Anger is a strong motivator that leads to where no one can say.
3
@Robert
Anger and sorrow can take many directions. We've all had our share. I am not sure extorting the hospital for a payout resolved anything other than to put money into the pocket of the heirs. Furthermore, as a result of the payout and the nondisclosure agreement - the world did not get to know about what had happened, which possibly would have prevented others from experiencing the same sort of tragic occurrence. It's hard for me
to see their behavior as anything more than a money grab.
1
Secret settlements should be outlawed in medical malpractice cases. And sexual assault/harassment cases.
6
So the kids used blackmail to get a fat settlement for themselves. Accidents happen and Neil Armstrong would never have used this misfortune to get money for one. He risked his life his entire career and never would have sued because of an accident. Yet his money grubbing kids blackmail the hospital to settle or they would use the information in a book (also for their own gain). Apparently the kids didn’t inherit anything near ‘the right stuff’.
14
The very same hospital botched a routine gall bladder operation on my 89 year old father. He died.
2
No surgery is “routine” when you are 89. That age alone increases the risks.
10
Goes to show you.Our socialistic health care in Canada is probably not so bad after all
5
@richard addleman
I'm sure this happens in Canada and the rest of the world. This wouldn't be news but for the name of the patient.
4
This all smells of extortion.
9
All I can add is that when my mother needed open heart surgery, my sister and I made sure she got the best care available, which I believe is at a teaching hospital. We are forever grateful to Dr. Smith, then chief of cardiovascular surgery at Columbia, for doing her surgery and for her post-operative care. Complications can arise at any hospital, you have to put yourself in the best place to deal with them.
3
@RandieRu
The affluent and educated should always have better options than the poor and ignorant.
Our Congressional health care coverage is evidence that the powerful always eat first. And it’s why Socialism always falls short of its loftier goals.
1
Ah yes, lawsuits, legal procedures and the world's most expensive medical system combined with the "blame game". As the two sons of a former astronaut who had reached 82 years of age, maybe they should have reflected on the fact that heart surgery combined with a certain age may entail a degree of risk.
Maybe the Armstrong family should have conducted more research on where Neil's survival chances were greater following a complicated heart surgery. America is really a two tier society these days, celebs and wealthy get one type of treatment, the rest have to be lucky and patient.
10
@Marc Faltheim. Maybe they- being laypersons- did not have TIME to do extensive research, as it seems the treating hospital decided.immediate surgery was the "only" option. And then botched it. As Armstrong was busy bleeding to death should one of his sons been googling better hospitals? What would you have done.
There has been for some time a federal database that contains information on many physicians who are claimed to have injured a patient through prefessional negligence. Whenever payment is made by, or on behalf of (e.g. insurance), a physician pursuant to a claim of malpractice, the law requires that information be reported to the database. Hospitals have access to the database which they check before granting privleges to a physician who applies to practice in that hospital. I have always believed that information in the database was public record but have never tested that belief.
1
Surely Neil Armstrong was a great person and true hero deserving competent care... but let's not lose sight that well over 100,000 (250K per a recent Johns Hopkins study) people die needlessly each/every year due to medical error in the U.S.
The "medical-industrial complex" would like us to believe that the main reason for unaffordable medical treatment is malpractice insurance/tort awards... yet that somehow doesn't compel/propel them to address the issue (i.e., medical error mortality rates in the U.S. are among the highest of all OECD countries, and the most dangerous place to be in the U.S., on average, is a hospital).
It's true that tort reform is needed (e.g., punitive damages should be awarded to the Treasury - not the claimant, gross negligence should be made a viable standard, frivolous suits dismissed more regularly, more providers should be banned from practice, etc.) but it's a minor (far less than 5% including true "defensive" medical procedures) of total medical costs and serves as an important deterrent.
2
An interesting discussion of medical care appropriate for the age group of Mr. Armstrong is “Elderhood” by Louise Aronson, M.D., an expert gerontologist with many years experience in this field. The main thesis is that medicine does not distinguish between middle age, old age, and very old age (e.g. 80-plus). And, of course, the training doctors receive needs to take this fact into account. It does not currently. Medical care appropriate for middle age may not be, and is often not, appropriate for the very old. Interestingly, a distinction is made between the pediatric patient and the adult, but not between the functioning adult and the very old.
While this may not be important in this case, the aging of the population and the growing number of the very old makes the recognition of these differences of paramount importance. Those of us in this age group (and our loved ones) need to accept that death is inevitable. The aim for us should not be the prolongation of life if this means a lingering, pain-filled existence. We should not have to use our scace resources and those of our survivors because either we or our doctors insist on life at any cost.
I srongly recommend this book, especially to seniors and their families.
Norma S. Gausrwe
12
@Norma Gauster Unless we choose to try to prolong our life on our own accord, even in very old age, lest dangerous impulses (“Medicare expenses are over plan by 20% for the Northeast this year”) lead people in power to make decisions for “the good of the system” rather than to preserve the life of the patient. Any turn away from life preservation as the main end of medical care, except in cases where a patient has some prior written directive any place to dispense with lifesaving measures after some point in their lives/medical care, would undoubtedly lead to perverse and dystopian outcomes for our medical system and our way of life, particularly for elders.
1
To re-Commenter
It is sad that we dwell on a situation that is not the norm, i.e. nefarious motives on the part of relatives or the medical community. It is a fact that most of our medical costs are devoted to the end-of-life years. These costs are not borne by the individual alone. Most are borne by insurance, private and federal and affect all of us. I am in my 80’s. I would hope that I would take that fact into consideration when making decisions re. my medical care. I trust my doctor and I think she will act according to my wishes and will not make the decision for me. I am certain that the same is true of my family. I take every opportunity to reiterate my wishes to my doctor and to my family. Shouldn’t everyone?
1
His family diminished his stature. Greatly.
19
Children of great men are usually a disappointment....
26
Trying to make money off Dad's death is conduct unbecoming Armstrong's family. Armstrong lived a long, full life with more success than most people even dream of and his name will be in the history books until the globe cooks itself. His family's tawdry money-grubbing (so American, these days) is shameless. May he rest in peace.
23
An interesting question is what they did with the money. If used to enrich themselves then shame on them. If they used it for charity or research to benefit space or healthcare then perhaps their hearts were in the right place.
14
@MR There is nothing wrong with them doing whatever they would like with that money.
2
Neil Armstrong died. We all die! I think that the 6 million dollars made his going away a lot easier for his family... Much like in life - winning the Moon lottery made him famous - his death was a jackpot for his kids... As they use to say in the sixties: 'Only on America'...
8
For the the cloak-and-dagger, and the strong possibility of hospital culpability, the Armstrong heirs took advantage of the situation sensually blackmailed the hospital. The language in her letter about Neil being a national icon makes the strategy pretty bald-faced. Sad as I am that Neil left this earth too early (no pun intended!) I think this paints the family in a poor light...
8
Many wrongs don't make one right.
Malpractice is one thing; heroism is another (Armstrong was doing a job when he stepped on the moon); his descendants want to right a wrong is yet another. Are they really driven by greed? They can answer that.
Greedy descendants are a dime a dozen these days. So Gates and Buffett et al are smart enough to bequest their immense fortunes while they are alive.
10
I am really shocked that our government thru NASA does not have a special medical team to look after these astronauts.
While they worked for NASA - there was never a shortage of specialists.
You would think these men would rank same - if not higher - as an ex POTUS for whom many medical facilities are made available.
If nothing else, I hope NASA does offer specialists to remaining moon walkers should their family request one.
As an aside, I find it distasteful that his sons "salvaged" their own finances thru death of a true American - if not a global - hero.
I say this because of their rush to auction off Mr. Armstrong personal effects.
That was a very wrong step to commercialize this great man.
5
it seems that Neil did not in till in his children the humility he had. He never cashed on his fame but they did.
13
As his sons prepare to auction off his personal items 5 years after his death, I cannot help but wonder what their motivation for this lawsuit might be. Armstrong was 82 years old and, while mistakes may have been made, I am not convinced and there are questions in my mind about the need for a lawsuit. You don't treat a geriatric patient the same as a forty-year-old. Every time you open a body surgically, it is a trauma and there is a risk. Having operated on his heart, did the doctors think opening his chest again was too risky? Once a person's blood pressure drops to dangerous levels, the preference is to stabilize them before carting them to the anesthesiologist and cutting them open. Further, at 82 the flesh becomes fragile. the hospital settled because " No institution wants to be remotely associated with the death of one of America’s greatest heroes.” No, Mr. Armstrong would not have had a "very long life post-surgery"; he was old, he died, and his family feels entitled to a pay-day. Would that Eric Garner's family were able to benefit from his wrongful death so richly.
20
@Me I agree with much of what you have posted,I believe in a story that I recently saw concerning Eric Garner, his family accepted a $6 million settlement.The story that brought this to my attention was Bill Barr's decision to not allow Federal charges against the NYPD officer.This was the most tragic and senseless abuses of authority I have witnessed in a very long time, that Barr ruled as he did only compounds the cover-up!
I clearly recall viewing Neil Armstrong stepping onto the moon and the excitement of seeing it live on TV. It's sad that a one time resilient astronaut died in this manner, but what seems to be lost in this controversy is that fact that the hospital may have provided inadequate care that contributed to his death.
I understand the hospital's desire for a secret settlement, but if I or a family member were contemplating using this hospital I would like to be confident that we would be getting the best possible care.
I believe this still needs to be resolved so that Neil Armstrong's death was not in vain.
3
America has the best healthcare providers, facilities and researchers on Earth. Yet it doesn’t achieve the best outcomes. America doesn’t break the top ten national systems by any objective analyses. There are numerous reasons for this suboptimal performance but the fixes are there. Our elected officials should listen to the population more than industry lobbyists.
5
The line that jumped out at me was "the patient became unsalvageable." It seemed rather cold and inanimate,
I suppose they selected a hospital close to home, as opposed to The Ohio State in Columbus, The Cleveland Clinic, or the closer Cincinnati. It would be interesting to know the hospital statistics for this type of complication. They are an important part of the puzzle.
"Unknown individual" is a term that makes me nervous. The paper is a pawn in someone else's game. While interesting to know, this information wasn't something I needed to know. One has to wonder about the motives of the sender. What did that person have to gain?
8
A national hero died, possibly too early, possibly not, and his two children and a daughter-law-law got a payout through extortion. I wonder how humble Neil would feel about it?
24
“'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."
How is this not blackmail?
23
Good point. Didn’t bulldog attorney Michael Avenatti just get indicted for similar alleged tactics?
1
The lessons here? 1) When possible, get a second opinion. 2) Go to a facility, especially when it's nearby, that has extensive experience in the procedure/area of care you need. Opt for an academic medical center whenever possible. The superior results will far outweigh the likely less aesthetic patient rooms and facilities. 3) Ask your surgeon how often she/he has done this procedure and what are the outcomes?
17
I always promote academic medical centers - (a) they have similar nursing but often go after higher degrees eg Magnet status, (b) they have cutting edge medicine you may be able to access and (c) you have junior people who are super smart who are thinking hard about your problem with the senior person (student, intern, resident) - I would rather have 4 people diagnosing me than one...
1
Why are nurses removing wires from a heart?
14
There is such profound tragedy in this. We could trust Armstrong to do whatever it took to get three humans to the moon and back safely, but he could not trust a health care system he was paying to keep him safe. The great gift our country gave back to him. Some pencil pusher at his health care provider decides to send Armstrong to a lab instead of an operating room in response to an emergency, no doubt as a cost cutting measure. If one of the biggest heroes in the history of mankind can be victimized by our so-called great system of capitalist health care in this way, you are a fool if they think they have your back.
5
“We choose to go to the moon in this decade and do the other things, not because they are easy, but because they are hard,...” —JFK
Care, diligence and deliberately managing out human error allowed Neil to make that singular giant leap for mankind, realizing one of man’s primal aspirations. Carelessness, negligence and a snap decision led to his demise. Take heed.
7
We as a society should honor Neil Armstrong by making his death a turning point to fix health care. Not because it is easy, but because it is hard.
2
Now take the case of Ned Anderson, who dies from an apparently avoidable medical error. The hospital and the family of the deceased settle, and keep things under seal. End of the story.
However, Mr. Ned Anderson is very rich. I'd say, deal is a deal, end you can't reopen the case because the patient is rich.
In the next scenario, Mr. Anderson is very known and beloved. Actually, Mr. Anderson is Mr. Armstrong, who was the first man to set foot on the moon. Due to an apparent error Mr. Armstrong dies, and the family settles with the hospital
Doctors are bound by the oath of Hippocrates (help everyone equally), not by the oath of helping rich and famous people first or better.
It saddens me that the relatives of Mr. Armstrong start blackmailing the hospital. They are willing to sue the hospital "into the stone age". The hospital is likely to go bankrupt, and many more people will die because they cannot receive the care the need.
Don't sue other people to their death
8
Why wasn't he just taken to the renowned Cleveland Clinic? A medical aircraft could have flown him to Cleveland in little more than an hour.
8
I wonder how many secret settlements Cleveland Clinic and other”prestige” hospitals have entered into....
4
The secret agreements lie at the heart of the problem. They are only there to “ protect “ business not real people. I wonder who made sure they became legal? Not real people thats for sure.
6
"The hospital [Mercy Health — Fairfield Hospital] insisted on keeping the complaints and the settlement secret"?
Malpractice, criminally deficient medical care. combined with willful secretiveness to make sure the fact of the occurrence itself (leaving aside the specifics) didn't come to light to "damage the hispital's reputation"?
Pure evil.
6
I have found American doctors arrogant, know it all and if you express little disagreement they demonstrate lack of emotional maturity. Many times I have to refused diagnosis, prescription .... first was negated by second and third opinion and second was vetoed by pharmacist - a heavy dose of opioid. I am sure if I had followed their advice I would have been barely able to walk and addicted to opioid if not on other drugs.
The doctors need to come down from their high horse. This menace can be solved and looking forward to the day where vast majority of the issues are solved by Artificial Intelligence and you need go see a doctor who can be second guessed by a machine.
4
I am a CV-ICU physician and removing pacer wires is a fairly common, daily thing in Cardiovascular ICUs. Some surgeons due to these rare bleed issues, cut them and don't remove them. Most fall off, but can still be seen as small clips on a C-xray.
But, when they're removed, in a small percentage a pericardial bleed happens, it can be safely taken care of, and back you go to the OR. Nurse always watch closely post wire removal, they know this can happen.
Although, rarely does it become a sudden cardiac tamponade (blood collecting in the sac and compressing on the heart, as seems to be the case here), then this becomes an emergency. If your center does enough CABGs (heart bypass), you will encounter such cases, and in last 8 months, our team opened the chest twice by the bedside and relieved the pressure. Had we been even a few more minutes late, those patients would be a mortality figure now.
Needless to say, stuff like this happens everywhere, I saw it happen in Stanford, at Univ. of Toronto, etc.
The difference is how "fast and well prepared" are you to take care of these emergencies. And that only comes with experienced staff and training...
49
Laying down judgements on the people involved is really risky at this late date being that no one on this thread was present at the time and doesn’t actually know the fine details that could explain each person’s actions. But from what I can gather from reading the article, I might say that the only person who might be above reproach is his wife..who didn’t find it necessary to participate in the settlement.
11
Look what happened to Joan Rivers..
Her medical team was so busy taking pictures of themselves while she was under that they failed to give her the proper care she derived and she died from a procedure that should have been simple and straightforward.
It's a horrible thing to receive poor medical care, or lazy monitoring and it probably happens a lot more than we would like to think.
If these famous people were so poorly served, imagine what happens to the rest of us.
13
Between 250-400k medical ERROR death per year. They got my Father and my Grandmother and now are getting me by denying safe and effective pain control MEDICINE for the fake "opioid crisis" (an illicit, street multi-drug issue at best) designed solely as a money grab for Attorneys General and satellite investors. The whole nation now is naked to uncontrolled severe pain, so drive safely, don;t get that surgery and don't get cancer or any painful disease or condition, like arthritis...
3
Medical error was, is and presumably will remain the third leading cause of death in the United States for a very long time, and probably in all other industrialized countries, too. Medical error with fatal consequences is rarely a single event but rather a chain of errors (communication breakdowns on all levels, diagnostic errors, poor clinical judgment, and inadequate medical or surgical skills), eventually leading to irreversible patient harm and death. Based on the information publicly available Neil Armstrong's death is just another classic example of this error chain. It goes without saying that most people are deeply affected by the fate of one of the true heroes of the 20th century - he was my childhood hero and source of inspiration, too - but I would argue that he and his memory is best served by our unequivocally efusing to judge, comment, validate, or critize unless we are granted full insight into all of Neil Armstrong's medical data - which is clearly not the case. Quite understandably people are blaming the institution in which the coronary artery bypass graft was performed, but I would like to remind everybody that medical errors leading to harm and eventually death can occur in almost any healthcare setting including tertiary care hospitals, high-volume academic centers, surgery centers, clinics medical offices, nursing homes, pharmacies, and even at patients’ homes. - Buried at sea, but his spirit will always walk on the moon. RIP Neil Armstrong, true hero.
6
The Armstrongs probably also sued the cardiologist and cardiac surgeon. The total settlement may have been much more than $6M.
4
@GH. I don't "get" the attitude displqyed by so many here that because Armstrong was a "humble" man his family are "evil" for suing. The proper care was not given, and whether or not you like the wording of the letter sent by their lawyer (who should not have been the DIL!) this would be the same option for thee and me. And many families have sold off effects- Were the Kennedy kids trashed after Jackie died and they sold things? Bacalls children did too.
1
Eighty two?
That is six years after the average age of death for a Caucasian American male.
It is hard for some folks to realize that we all have the diagnosis of death.
No lawsuits, money from hospitals attempting to save lives, sweaty surgeons, or other well meaning health care providers, will change that diagnosis and outcome.
14
Beyond the individual human tragedy for this family are some deeper and uncomfortable truths about American medical care. The first is the wide differences in quality of care. Whether you live or die depends on where you live and whether you have the financial means to seek out high or even higher quality care. Neil Armstrong could have gotten better, but for some reason didn’t. Many don’t have any choice.
Then there is also the stark reality that American medicine is a business that is driven entirely by profit. The actions of the hospital and their lawyers demonstrate that their concern is not for the role they played in killing a human being, but the impact that owning up to their incompetence would have on profits.
9
When my husband was a medical resident 40 years ago, he was quizzed by an attending cardiologist on just such a scenario: “After cardiac surgery, a patient drops his blood pressure. What do you do?” There was only one answer: “Crack his chest.” My husband is not a cardiologist, but he says this is such standard procedure that if a case like Neil Armstrong’s arose in his hospital, the discussion about what to do would take no more than 30 seconds.
14
Career of working in hospitals. It was quietly passed on to never leave a family member alone while in hospital.
13
sounds like the Armstrong family didn't do their surgical homework. first, he should have gone to the Cleveland clinic to get a second opinion. did they not do that? if so why not. don't really want to hear that. were they listening to their heart and not their head when the cardiovascular surgeons wanted to operate? I am sure he had the best insurance money could buy-the insurance that congress people have.
if you have not investigated the diagnosis that the surgeons gave them- you should never take the first diagnosis that the surgeon gives the patient.
I am not taking sides here. Where was the blockage and what percent was it. When we had a pt in the cath lab we had the heart room set up for possible open chest case. every hospital that does open heart bypass surgery has that. what neil developed was cardiac tamponade which can be relieved in the cath lab by inseting a needle into the pericardium to withdraw the blood and then proceed to the operating room which is always set up around the corner from the cath lab.
As far as neil not even needing the surgery (unless it was thw widowmaker then that I blame on the family for not being in a place that specializes in that type of surgery.
2
It can not be the job of patient and family to police crisis medical decisions. Blaming a patient's family for that is horrendous and unprofessional.
5
"An unsigned note included in the envelope said the sender hoped the information would save other lives."
How would the release of this information save other lives? Is the lesson learned that when you have heart surgery go to Johns Hopkins Hospital, the Cleveland clinic, etc.?
Although Neil Armstrong would have been welcomed in any of those medical institutions, most of us, because of our medical insurance (or lack thereof), or our general financial situation, would not have had that option.
Although I have no objection with the Armstrong sons being compensated for their loss, I think the lesson here is that Neil Armstrong lived a humble life and his decision to go to this small hospital was inspired by his humbleness. Unfortunately, it didn't work.
Although of great public interest, if I were the NYT, I would have sat on this story. It unnecessarily tarnishes Mr. Armstrong and his family.
2
I'm surprised frankly the settle is so low. heart care needs to be less about the doctor's ego and more about the patient. the lesser facility should have known they were know the best place and should have sent the patient, any similar patient based on health care need not fame, to a more competent facility. this kind of care is inexcusable.
1
The real question isn't were mistakes made. That appears to be obvious. In 2012, I sincerely doubt bleeding after removal of pacing wires was not unknown. Be interesting to read the surgeon's notes as to why a return to the OR wasn't indicated. After all this was a surgical death (within 30 days of the original surgery). The real question is were those mistakes reported to oversight agencies, reviewed, and protocol changes made to make sure it didn't happen again? Or swept under the rug? Nationally, by the time of this event, the transparency of admitting your mistakes openly to prevent a repeat in the future was supposed to be the common practice. Clearly that only happens when it won't cost the hospital millions. No matter how you look at the health care system in the U.S., the solution to it's major shortfalls is simply a matter of following the money. What would also be most interesting would be to see how frequently this hospital has been sued. Are you more interesed in a snapshot in time or the bigger picture?
7
What a tragic end to a person, let alone a monumental person like Armstrong.
But, I am sympathetic to the doctors also. Our culture of having to find someone to blame puts their profession under so much pressure than any other profession I know. Take my profession for e.g.- a data scientist. Many models we write for various systems in finance, industry, security, aviation tend to misbehave more often than the error rate of an average doctor, but despite the severity (believe me when I say some mistakes can impact millions leading to ruining the lives of many) of those errors we never have to deal with the kind of pressure that doctors deal with. You may say their profession involves human lives. But they are humans after all and for the occasional error they make, they also save thousands of lives. But how often do you see them thanked for what they do? If it were up to be I would say they should get the same respect as the people in uniform get in this country. (The other thankless profession is teaching).
9
Medicine is not an exact science were it so the question of "will I live or die" would be a textbook answer.
Diagnosis and the treatment of a medical condition is not cut and dry. Second opinions are the norm.
Post operative complications and death do occur.
Rest in peace Neil Armstrong. Yours was a well lived life.
16
Our hospitals are wonderful places-but they are also dangerous places. We can minimize, but not completely remove, the danger by going to the best hospitals and use the finest doctors. However, even those actions do not prevent malpractice from occurring. Whether we like it or not a surgeon who does hundreds upon hundreds of the same procedure, and no matter how renown he is, will at one point in his practice commit malpractice. That does not mean someone will die like Armstrong, but there will be malpractice. We are human beings and we make mistakes, things go wrong, they cascade and result in terrible outcomes. We try to learn from these errors, correct them and move on. What happened to Armstrong should not have happened-but he was just at the wrong place, wrong time, wrong everything. For the most part our system of justice allows compensation for the wrong. The settlement was the right thing.
I do not agree that keeping the settlement secret prevents the hospital from being held"accountable". Holding the hospital accountable should be viewed in the over all care that the hospital gives-not a single incident of malpractice. I know nothing about the hospital that Armstrong went to-but I would not throw it off the cliff because of what happened. One would need to dig deeper to see if this hospital was not qualified to perform the procedures that resulted in Armstrongs death.
6
Although I’m trying to keep central in my mind how the family felt at the time, I can’t get over thinking this feels more like greed and sounds like extortion rather than the family wanting to make sure the doctors and hospital were held accountable and to ensure this didn’t happen to anyone else at that or any other hospital. How can keeping this incident a secret help anyone but those who were paid? I think Mr. Armstrong would be very disappointed in his sons.
40
First, there is no nothing such as a wholly preventable death. There it is though the possibility that differ in actions may have resulted in a better chance at life.
Having a surgery is always a life threatening procedure. There are light day surgeries that we consider a less likely to result in death, but then days surgery is rather new isn't it? The only day surgery that I knew about when I was a child was the extraction of wisdom teeth. Cardiac surgery is rather scary simply because if anything goes wrong there's not a spare heart to take over and save the patient. Regardless, these types of medical N.D.A.s should and never be made. These sorts of things only happen in medical facilities for and strictly for profit. The only persons it can hurt our future patients. Every single solitary patient care facility should be an open letter to the public at all times. Dangerous doctors, inattentive medical staffing, and causes of deaths should be within that public's reach. Let us not for get that capitalism preaches to us that competition will weed out the poor choices; N.D.A.s circumvent that only reasoning. I remember when the tobacco industry used N.D.A., I remember when certain core manufacturers also used N.D.A. I think it's time for that nonsense to stop.
12
Anyone with a lick of sense knows that an 82-year-old man can drop dead at any time. How ungrateful to blame doctors and nurses who were trying their best to prevent that.
14
Read the Cincinnati Enquirer coverage of this unfortunate event - hospital was negligent in decisions of treatment.
3
Mr. Armstrong had a fabulous career and led an admirable life. He was a pilot, a scientist and a hero. He escaped an early accidental death time and time again.
While all this was happening, he and his wife had to endure
the loss of their daughter which in my estimate is the cruelest experience anyone can have.
So why did this person die. First he apparently had coronary
artery disease that was viewed by his cardiologist as best
treated by CABG. He apparently chose the hospital and though it was a community hospital, its morbidity and mortality was in the public record. People die at university
hospitals as well as in community hospitals. He was 82. We don't seem to know much about the procedure, for example did it require cardiopulmonary bypass or was the entire procedure done "off pump." Did he need transfusions of blood or blood products in the operating room. Was intra-operative bleeding a problem. Did the bleeding occur immediately when the wires were pulled or did the patient first have an arrhythmia or arrest and get CPR. Pulling pacemaker wires does not usually cause catastrophic bleeding, but CPR can when done soon after surgery. What did they find when the chest was opened ? Was the bleeding from the thin walled right ventricle or somewhere else like one of the bypass grafts that had been damaged during the CPR. Unless things turned around immediately the chest should have been opened to diagnose and treat the problem. Bad situation in all cases.
17
I can’t help but wonder why he chose a local hospital, when he could have gone to the renowned Cleveland Clinic in OH, or any of the best hospitals in the country. For so many, that choice doesn’t exist.
13
Mr. Armstrong risked his life to push the boundaries of science and mankind yet medical practitioners failed to apply standardized care needed for his survival on earth. The former is acceptable. The latter is not.
10
Very sad story, tragic for the family and, as a physician I can say, agonizing for all involved. But, I'm weary of 'celebsploitation' – ordinary people die of medical complications/misjudgments and everything else everyday. Irrespective of malpractice suits, they're allowed to go to their graves in peace. ...as a biographical footnote, ok, but save the fanfare for remembering Mr. Armstrong's life instead of his death.
5
The medical details are interesting.
Might some introduction to the laws on extortion also have been relevant? The lawyers' letters to the hospital seem odd to me.
12
All respect to the Armstrong family. Experimental medicine happens all the time. In 1969 there were so many variables that could not be calculated.
Radiation is probably the biggest one. The consequences are always going to be greatest when medicine or a procedure is tested in space flight.
I am not a pilot.
Morgan
A death that seems avoidable should receive the same sort of investigation an aircraft crash receives. If the investigation cannot decide what happens, it should give the main possibilities of what happened, and the probability of each possibility (including the possibility that the other main possibilities are all incorrect).
Such an investigation would be advised to avoid hiring or talking to lawyers whenever possible. The existence of a mistake and the legal culpability for that mistake are two different questions.
The fact that we have an abundance of lawyers, who all need something to do, probably has to do with the way medical accidents are handled.
2
His modesty, courage and the awareness of the enormous responsibility his mission demanded embodied the best of the human spirit. If Trump represents the nadir of America's presence in the world, Neil Armstrong represents the summit.
7
Having worked in three hospitals as a psychologist and rehabilitation counselor I can attest that most hospitals have clay feet.
The confidence we often have for medical care is sometimes not justified.
I encourage everyone planning for any medical treatment to take the time to carefully research the doctors and hospitals before making a choice. Neal should have picked the University of Cincinnati.
20
Gotta chuckle at the idea that elitist hospitals are necessarily better. They do have better and more lawyers.
2
Whatever the merits of their case, it sure sounds like the Armstrong sons were engaging in extortion against the hospital.
63
@KC: mostly this appears to have been conceived and carried out by MARK Armstrong's WIFE -- a malpractice attorney!
Ergo, their family got their share of the settlement -- at least $1.5 MILLION -- PLUS Wendy Armstrong's "cut" of the lawyer fees as lead attorney -- another $1.5 million -- so they got DOUBLE what the other brother got.
2
Interesting that the hospital's physicians defend the post-hemorrhage failure to rescue - while the family's experts disagree using fundamental and cardio-thoracic principles...
"We made a mistake" should have been the hospital's mantra that would have helped restore the public's trust that they continue to betray...
8
This story makes me wonder if Mr. Armstrong would approve of the events that transpired after his death. I think probably not. I wonder further if anyone asked him/her-self that question before proceeding down the legal path. It is unfortunate because this whole thing is a blemish on his wonderful contribution to humanity. It would have been better, all in all, if this story had remained buried.
16
@Scott Werden. When it is you, or a loved one, in a similar situation, let's hope.the doctors and nurses remember what happened to Mr. Armstrong and do the CORRECT procedures. The reminder that if you don't not only can people DIE, but also lawsuits can make for nasty bedfellows, is the reason why these things should NOT be buried.
3
As someone whose mother died as a result of four careless medical mistakes in three days* at a highly respected hospital, I fully support the decision of the Armstrong brothers to hold the hospital accountable in the most vulnerable areas -- financial and
reputation.
Medical negligence is a horrible way to lose a loved one, especially considering the trust we give our doctors.
My family's experience with the arrogance of the medical profession has made me question virtually every subsequent decision, and my skepticism has served my family well. Patients and families today should be vigilant in overseeing their own care, and voice any doubts.
Whoever leaked Mr. Armstrong's records has performed a public service.
While we do not know how this American hero would have recovered if he had surgery to correct his bleeding, this information should serve as yet another warning about the quality of medical care in this country in the 21st Century.
This is indeed a tragic footnote to the humble, noble life of a man whose dedication and courage helped unite the peoples of this planet in the realization of our shared humanity and future.
*The mistakes were corroborated by physicians who were informed of the medical choices and results and were not involved with the hospital. They had nothing to gain or lose by giving an honest judgement.
12
I am not a physician but reading the comments from physicians, it seems to me that this was a case of medical malpractice. If so, the Armstrong family was justified in seeking compensation regardless of Armstrong's age.
17
The question is not whether the family was entitled to compensation or not, but whether they obtained that compensation in a morally defensible way. The family apparently chose to use Mr. Armstrong's fame to increase their financial gain, and by doing so prevented the details of this medical malpractice from being known publicly. They chose their own financial position over the public interest, which is best served by hospitals being transparent about the way they operate, even when it comes to their mistakes. The way the family did this comes close, as others have commented, to extortion. How far the apples have fallen from this majestic tree.
10
He was 82 with a serious heart condition.
Sounds like a shake-down to me.
28
The letters to the hospital are about as close to blackmail as anything I've ever seen in real life.
If the hospital messed up, which it certainly seems to have done, then they should pay and talk about it publicly. But the members of this family used their fame--actually their father's fame--to bludgeon them, and quite brazenly.
63
A humble, superhuman man was KILLED BY INCOMPETENCE of 'medics" at a parochial hospital. I am shocked the family did not get at least a second opinion, before the surgery, from the Cleveland Clinic (OH), a national leading CARDIAC facility - only 248 miles from Cincinnati(OH). If he could walk under his own "power' into the hospital, he was bamboozled to rush the surgery. As shocking: the pacing wires were removed by a NURSE, not a cardiac surgeon, and not IN/vicinity of the OR -precisely b/c of the bleeding risk, and need for a sterile OR if the chest has to be urgently re-opened, to start. There are only 4 (FOUR) minutes, before the brain damage. A loved one was killed the same way (suffered the horrendous resulting multiple organ failure before death) at a DC area leading hospital, accredited for heart transplants. Idiocy ruled.
The 'local" OH hospital found an easy PREY - they need certain amount of surgeries /year to stay accredited. In NYS a cardiac surgeon has to perform 200 bypass surgeries/year to be considerd a "specialist".
Out of 50 States, ONLY the NY State keeps the bypass and angio- score of ALL the NYS hospitals, and INDIVIDUAL cardiac surgeons. The online reports are issued every 2-3 years for at least 25 years. Never get a bypass by the Dept. Chief - his mortality rate usually MUCH higher than the underlings who just DO it !
People do test drive to buy a car - WHY only the NYS keeps the statistics and issues reports, accessible to EVERY person in need?
22
It was highly likely Mr. Armstrong was too unstable to be moved to another facility for a second opinion (which one should ALWAYS get, if possible).. we don’t know how urgent this surgery was because we aren’t furnished with data to analyze. Also, opening a chest in some environment other than a sterile environment is generally not a problem. I’ve seen a lot of chests opened in the ER while doing trauma care. It’s a last ditch effort to save a life. Must be done NOW.
However, I agree with this writer, always always go to the best hospital FIRST. Like Cleveland Clinic or other academic faculties affiliated with a medical school.
7
Armstrong was a true American hero. I wish he had been buried at Arlington National Cemetery rather than at sea. But of course, I respect his and his family's decision. He certainly deserves a public memorial.
11
Time for non-disclosure agreements like this to end. Too many dark deeds and bad choices get swept under the rug in situations like this.
20
This enormous settlement is a good example of the unfair way medical malpractice works in the US. Because the alleged victim of poor care was a man of not only great fame, but actual hero status, the family was handed a pile of money to stay quiet. In contrast, when I lost a relative to inept medical care (conflicting medications, prescribed for the wrong diagnoses, which caused her death), I I had no recourse. No one cared what happened to her.
Lawyers in other areas have learned to play the fame card, too. A few years ago, a California man drove his Tesla into a cyclist, and killed him. The family of the deceased sued the driver (he was a wealthy man), but they also sued Tesla. That drew national attention to the case. The family got a huge settlement.
I’m certain that this was not about money for the Armstrong family. But this is not how malpractice claims should work. Private settlements protect the doctors, the medical facilities and the insurance companies. They do nothing to improve care for others.
6
@Passion for Peaches How can you be so certain that this wasn't about money for the Armstrong family? It seems pretty clear that the family got a larger settlement in exchange for allowing the hospital to keep this a secret. The family had the option of making the claims public and thereby put more pressure on the hospital to do right by future patients.
17
@Doug Piranha, I was just giving them the benefit of the doubt. But the letter the daughter-in-law-law lawyer wrote to the hospital lawyer dies not speak well for motivation.
6
My heart goes out to his family for having to deal with this kind of poor medical care.
But with all due respect (and admittedly, there's a lot due him) people all across the United States have to deal with the results of medical malpractice every day.
Two and one-half years ago my mother fell and broke her hip. That didn't have to be a nightmare, but after she developed an antibacterial resistant infection from her hip replacement in the hospital that was overlooked there (and was then *ignored* and festered in the nursing home afterwards), it became one.
It took ten (10) surgeries and over 2 years of high powered antibiotic treatments to save my mother's hip - and leg.
We got no acknowledgement, no apologies, and no settlement.
Everyone can suffer from poor medical care. Even astronaut heroes.
13
As a practicing attorney, the contents and timing of the attorney's letter comes dangerously close to the line of blackmail. Personally, I'd chose to steer much farther away from such an ethical conundrum.
35
@Robert Stewart
Ethics in this day and age---that statement almost gave me a heart attack.
3
@Robert Stewart; AND WORSE….she was the WIFE of Armstrong's son -- and would get a big share of any settlement as his spouse -- PLUS her fees as an attorney.
2
Some commenters here discount the effects of America's litigious society in healthcare costs-- neglecting the cost of defensive medicine. I say this as someone who's dealt with medical error.
My sister was harmed by an error and I won't deny the experience was horrible, and that I was quite angry.
But on talking with the doctor and hospital, we all realized the problem was a systems issue. The human body is incredibly intricate and even the best doctors cannot master all of it-- and the medical procedures-- even if they could stay awake 24 hours, 7 days a week. So errors are unavoidable. The doctor in this case was not incompetent, he just had an incredibly tough call amid 100's of other complex patients, and good doctors' fear of malpractice lawsuits costs the USA 100's of billions of dollars in defensive medicine.
I saw the solution amid engineering conferences in Europe and South America in countries with universal healthcare. Most of them had a "no-fault compensation fund" for issues of medical error or adverse outcomes. Most of the pressure for massive malpractice suits was gone since patients weren't drowning in medical bills, errors were acknowledged and more training provided, and social welfare would assist patients who'd suffered harm.
The doctors and nurses are the ones trying hardest to care for patients in a broken US system bloated by administrative and Big Pharma costs. Such massive malpractice lawsuits hit the wrong targets, and make the problem worse.
47
Wow, the first man on the moon went to a second-rate hospital when he had been an aeronautical engineering professor at the University of Cincinnati for many years. I performed research for NASA and the stories I heard at Johnson Space Center were that Armstrong did not exercise because he believed hearts have a finite number of beats in them. However, I agree that he needed to go immediately into surgery once it was discovered he had internal bleeding around his heart.
2
@Mark
READ AGAIN!
The bleeding was a result of the botched post-op procedure : removal of the temporary pacing wires installed/ inserted during the surgery (which was NOT an emergency).
So whatever you've 'heard' was just a GOSSIP.
@serrrendipity
The stories at Johnson Space Center were from the Astronaut Office about 25 years ago. Neil Armstrong did not believe in exercise and consequently lead a sedentary life which contributed to the development of his heart disease!
2
His life force lives on in us all. He can never really die.
5
The medical community perpetrates butchery almost daily and keeps it all hush-hush when the incompetence is exposed.
3
A year ago the Armstrong boys auctioned off memorabilia for $5.2 million. An ID plate from the lunar module fetched $460,000. This was presented to Armstrong as a souvenir, so of course his heirs had every right to sell it. Or to donate it to a museum. But it does appear that they, unlike their father, cashed in on the vicarious fame of a taxpayer funded endeavor in which they played no part. I rather hope that if I die due to negligence on the part of a hospital, my family will sue the hospital with one over-riding aim: that the publicity of the lawsuit would cause the hospital to change its procedures. Any monetary gain would be secondary. And no: my heirs will not have $5.2 mill to fall back on.
112
Here, here! They should be ashamed and if their father is watching from the heavens I think he’s very disappointed.
5
Many legal settlements are kept quiet so people who might not otherwise sue don't get any ideas.
8
A national tragedy.
6
One of the things I most admired about Neil Armstrong was his refusal to capitalize on his fame. I think he realized that the Moon program was paid for and owned by all Americans, and that he was fortunate to be the face of its achievements. Seems like that anti-show-me-the-money humility was not something that could be passed on through genes.
63
As a physician myself I have one piece of advice and one complaint.
The advice is that if you need any major surgery, go to a university hospital rather than a community hospital. In all likelihood it won't make a difference but if for any reason there is a problem at a university hospital you can be assured of there being an expert on just about any problem in the hospital 24 hours a day.
As to the complaint, secret agreements like those made by the Armstrongs might be beneficial financially for them but it indicates that they didn't care about anybody in the future who might experience the same problems as their father did.
Their father was portrayed as someone selfless who was willing to risk his life for his country. His sons didn't seem to have the same level of caring about others.
And for anyone who thinks no one wouldn't pursue a financial settlement, I had a medical student whose mother died over improper care in a hospital. The family could have sought a financial settlement that would have been kept confidential but instead settled for the hospital admitting the error and instituting changes that would prevent it being repeated.
157
@Steve
Too much depends on the actual doctor/surgeon. After my husband was operated in a university hospital (colon removal), his physician and surgeon had to travel abroad. The young residents and doctors did not recognize subsequent huge abscess on my husband's liver despite triple additional hospitalizations. Luckily my husband was still alive when his surgeon returned, recognized the problem and saved his life.
1
@Steve. I would disagree. As a cardiologist I referred hundreds of patients to "University Hospitals" as well as "non University Hospitals" with national reputations. My experience has been that at University Hospitals it's common the patient won't have an identifiable advocate as responsibility for care is shared from attendings, to fellows, to residents, to medical students. When I send a patient to a non University Hospital the receiving physician is the patient's advocate and takes responsibility for all aspects of care. One of the most critical aspects of care is not only expertise but someone who is the patient's advocate and carefully watching and orchestrating every aspect of care. An institution cannot do this by committee as the ball gets dropped too often from poor communication and lack of a single provider being in control at all times.
3
Wow, way to protect the incompetent medical personnel for personal gain. I wonder how many others died unnecessarily. This is so sad.
12
Why publicize this? What does NYT expect the public to gain with this information about the (yes, complicated and layered, but very private) happening in the life of a public person? There's a cost of opportunity in terms of what to put in the front page of a NYT — and an even greater cost of opportunity in terms of what readers have to bear in their minds. Frankly, as a reader, I don't feel I have been served. I wish my brain had a "unread" feature.
4
"the business enterprise"
What a strange way to refer to a hospital.
7
@James Cameron
Welcome to America, my friend. We’re a proud but backwards country with strange beliefs.
16
@John Cameron
Hospitals in the U.S. are often for profit. State hospitals are usually not. We don't have a national health care system, as does Canada. One of the real downsides to this system is the recent loss of a rural hospital/clinic due to lack of funds; the community it served now has no local hospital. Another problem is the closing of ER facilities in some locations, because they were used for the routine care unaffordable to many without medical coverage. It varies from State to State. Reagan closed community health service clinics because they did not make money; when President he shut down a national health care system for the same reason; it cost taxpayers money and did not create revenue. So, it is not strange in the U.S. to refer to a hospital as a business enterprise. When my daughter worked in Belgium for a large American corp., she went to a local clinic for treatment, and offered her insurance card. The clinic rejected the card; she was treated with follow up care at a cost so low she paid it herself.
1
I am not commenting on the idea of the settlement or the details behind it. I am surprised it is only 6 million dollars, with that kind of conditions attached to it. These for-profit hospitals pay a lot more to their executives.
I do feel for the medical professionals who themselves probably went through quite the trauma of making mistakes that cost the life of one of the most important, beloved and truly unique figures of mankind. I feel sorry for them.
6
Wow, This article is shocking.
It really speaks to the quality of the medical establishment, and protection of itself at all cost.
It shouldn't matter if the care is in a small institution, or at a prestigious medical school, for what by the account should have been a relatively routine treatment plan turned into a series of fatal errors, and an avoidable and pre-mature death. Regardless of the stature of the individual, this shouldn't happen.
I know not all practitioners (I'm being very general as to occupations) have good diagnostic and decision making skills, but in my industry, and at my workplace, which has it's fair share of less-than-capable individuals, peoples lives are not put in jeopardy.
As much as this health care facility should be exposed, and as evidently should have been immediately forthcoming, the cost of this error is beyond monetary. It has and will further erode trust, it will further threaten small community care, and obviously exposes the hidden cost of substandard healthcare.
9
It seems that Neil Armstrong's hero gene skipped a generation,his son's actions would indicate as much.To profit from the death of their father tells me as much as I would ever care to know about these fine young men.When one compares the risk that all of these men with "The Right Stuff" had to endure and overcome to succeed in their various accomplishments with NASA,it may be a bit ironic that heart disease felled one of the greatest.However,it's life,as capricious as it ever was.We demand perfection and a life as it should unfold on OUR terms,fools are we that follow that path.
14
Not sure I understand the point of the article. While Mr. Armstrong was in the public sphere for his work, he lived the rest of his life modestly, by all accounts. So he had surgery that might or not have been necessary, it was botched and the hospital caved to the daughter-in-law's blackmail vs. fighting in court. Happens many times in many hospitals in this country. Why is this any more egregious?
2
@barbara: THIS -- this kind of lawsuit and huge settlement -- is PRECISELY WHY WE DO NOT HAVE UNIVERSAL HEALTH CARE in the USA.
A few people profit nightly, but as a result…the rest of us face unaffordable care, and hospital pricing that is based "on worst case lawsuit scenarios".
Such sad irony. A man who survived numerous flights in experimental vehicles, flew to, landed on, and returned from a trip to the moon while descending like a burning comet through the atmosphere becomes “unsalvagable” while getting wheeled around on a gurney from room to catheter lab to OR.
But the business enterprise must carry on!
12
The most irrelevant element of what happened to Mr. Armstrong is his age. He had years left. Mistakes were made that are violations of accepted procedure. If a hospital performs this surgery, regardless of being a local hospital, they have to know these things. What to do when a hole is torn in someone's heart by something that is known to do that. I feel for the nurse who started the chain that led to death, because he/she didn't know it's too delicate for a nurse to do as a rule. As a rule there are conventions in place. To be accredited for the surgery makes you responsible to follow appropriate methods of treating complications.
82 is not decrepit and all these commenters writing him off will not think so if they live to 81. This is an if/but for scenario. But it doesn't speak well to the sons to extort a confidential settlement lest the public be told with a deadline coming up. They could have gotten a settlement on the merits and put it all in trust for the grandchildren. The distribution was pitiful.
6
How do you know he had years left? Biological age is not the same as chronological.
1
There's so much unknown about the treatment in this case that it's pointless to comment on it. Even so, anticoagulant (mis)management is a more probable cause of bleeding difficulties than removal of pacemaker wires.
3
An 82-year-old with a cardiac condition getting a $6 million wrongful death settlement? This is an example of what’s wrong with the tort system.
And he was taken to cardiac cath probably because that’s where the echocardiogram machine was.
8
If society wishes to bring the costs of medical care in the United States under control, a good place to start would be tort reform.
The $6M verdict mentioned here was probably not appropriate. The multiple billion dollar verdicts against drug manufacturers such as Johnson & Johnson and Bayer, verdicts that seem to be based largely on junk science, threaten the companies with bankruptcy and dramatically raise the costs of their products.
There is a place for tort law and legitimate lawsuits, with proportionate judgements. But the system we have in this country is horribly out of control, does not serve justice, and raises costs for all.
To repeat: we badly need tort reform.
9
@Alex
"verdicts that seem to be based largely on junk science,"
Such as...? Can you name one?
2
@martha goff
You mean blackmail and extortion getting swept under the rug, yes?
1
People with heart disease are at increased risk of dying. 82 is old. I wouldn't call the death due to complications of heart surgery of an 82 year old a "tragedy." Critics looking back at a case after it's played out can always say such and such a thing should or should not have been done by doctors who were acting with urgency and had much less information at the time.
8
@semaj II: Wait until you are 81. Then 81, and indeed 82, won’t sound “old” to you! It’s all a matter of perspective ...
@A Bird In The Hand. Yes, it's good to be alive. I don't expect immortality. I understand that medical procedures have risks. I'll have to die of something. Don't want to linger with dementia. Don't want to suffer with cancer pain. Also, I don't see how the appropriate remedy for the death of an 82 year old is $6M. Lost wages?
1
No doubt six million can easily be recouped by hospitals such as this by engaging in a weeks worth of over billing of out of network patients.
11
Straight to the OR and open up the chest when you have a patient bleeding after pacing wires removed after he had a cardiac bypass surgery. That’s plain and simple . If he was not bleeding badly and was stable then the Cath lab approach would have been defendable.
The hospital would not have paid to cover it up if nothing had happened - but instead they paid up 6 million dollars. That’s a significant amount.
Using the ‘deceased individual’s ‘ famous name to get the most money .... now that is greed that Neil would have disapproved if I am sure.
12
It makes no sense why Mr. Armstrong wasn't brought back to the OR after the leaking happened; a poor medical decision occurred when he was sent to the catheterization lab instead and two boys lost their dad, and the U.S. lost a great American due to negligence. Physicians are fallible but this seems a ludicrous error.
6
I can't help wondering if Neil Armstrong's hospital choice — like that of many of us — was determined by his insurance coverage. Perhaps this was simply the hospital that was in network for him?
7
What is not stated is whether the family called 911 when he began developing cardiac symptoms. Various persons committed that he should have gone to U. Cincinnati Medical Center instead, rather than a local community medical facility. By protocol, the responding EMT’s to a 911 call for a cardiac emergency are usually required by local guidelines to transport to the nearest local medical facility equipped to handle emergency cardiac issues, and the EMT’s know which ones to go to. If, for example, the family requests transport to a more distant medical center, then a non-911 EMT ambulance will transport the patient, only if they are medically stable for the transfer, per discussion by the EMT’s with the nearest hospital emergency department physicians. By current ACLS guidelines, a patient with acute coronary symptoms must be transported to a medical facility that can provide emergent intervention within 90 minutes after onset of symptoms.
1
Wendy saw an opportunity to retire if she played her cards right, and she did, capitalizing on Neil’s walk more than ever before.
7
See Gil Scott Heron. Tell me about the trickle down effects of the space program.
4
This is a news story because it happened to a famous person. Deaths in hospitals as result of misdiagnosis, error and incompetence happen to "ordinary" people a lot more often then is recorded by hospital official accounts. The difference here was that the family had the resources and prestige to hold the hospital accountable and get restitution.
23
Seems to be a lot of people with strong opinions about the death of this American hero. But if any one of our family members had died in this needless way, we might draw a different conclusion. In any case, it saddens me deeply that he might have died for a last minute decision that sounds like it went terribly wrong. My heart goes out to the family.
241
@Anitakey
You don’t know at all if his death was “needless”. Undergoing cardiac surgery is a risky proposition, especially at 82 years of age. Complications can arise at any time during or after surgery, and when emergencies arise, doctors sometimes need to make on-the-spot decisions with incomplete information.
If the outcome isn’t good, that doesn’t mean the decision making was flawed. It’s easy to play Monday morning quarterback from a lazy boy chair months later, but the real world is a more complex place. Any of surgeon who’s been around for any length of time knows “errors” (or really, deviations from perfect decision making) happen all the time.
Doctors, too, are only human. Even “top doctors” may have a history of multiple lawsuits and settlements - being in a high risk field will bring plenty of malpractice suits over a 30 year career. It’s unfortunately the cost of practicing medicine in the US.
51
@Mark doctors like lawyers use the term ‘practice’ for their business. One hopes they have done their practicing before they get to me.
Sarcasm aside: most surgeries have high risk, there are no ‘small surgeries’, but cardiac is a big one.
The key to point here is that the hospital quietly settled’ because of a high visibility patient, and aggressive legal agent. Most ‘ordinary’ people cant get such special treatment. My thought would be that ‘malpractice’ incidents should be prosecuted by the state - funds from settlements or ‘convictions’ go in to a state fund from which payments are made to ‘harmed’ patients and-or their survivors/ estates.
22
@Anitakey
I think if the General population knew what really goes on behind closed doors they wouldn’t walk into a mercy facility. Are used to work there and I can assure you there are things that go on there are totally unacceptable. I wish I could go on national TV and talk about the stuff that goes on at Mercy. It is disgusting
Mercy makes mistakes all the time and the attorneys hide it. They are known for their brutal and nasty attorneys that no one can fight. With the exception of a well known individual Such as Neil Armstrong, who has family and power that could actually fight and go up against the Mercy attorneys. The normal individual has no chance at fighting Mercy attorneys if a loved one of ours dies. And that is very disturbing, sad, unfair, discouraging, And disgusting. Shame on you Mercy
4
“the patient became unsalvageable on the way to the O.R.,” case records show.
"unsalvageable" is such a cold and callous expression, as if they're talking about a broken furniture, instead of a human being. The doctors' language sure seems to reflect the level of care they dispense to their patients.
17
Why would anyone in their right mind go to a local hospital for any kind of complicated cardiac issue? Neil Armstrong had the right that anyone on Medicare can do--go to the best hospitals and doctors who accept Medicare, which is most of them.
A lot went wrong here, and it is hard to watch. He could have gone to the Cleveland Clinic, the Mayo Clinic, or so many excellent hospitals.
19
@SG: as a retired military officer....Armstrong almost certainly had Tricare, which is superior to any private insurance OR Medicare.
I had similar CABGx4 surgery in 2018, but mine was emergency/urgent 3 days after heart attack.
Armstrong's seems to have been non-urgent or at least non-emergency. No mention of a heart attack, just a failed stress test.
The world-best Cleveland Clinic was only hours away---or less by aircopter.
10
It wasn’t a failed stress test. Armstrong was quickly bleeding around the heart after the nurse removed the wires of his pacemaker. The situation became urgent. Instead of immediately transporting him to the OR they take him to the Cath lab, which delayed crucial timing in stopping the bleed. Why they didn’t take him to Cleveland Clinic or Mayo? No one knows.
1
@Miya W. The failed stress test was.why he had the bypass in the first place. Why was that an urgent emergency? He had time and other treatments (including drastic dietary ones) to go to Cleveland Clinic only hours away.
1
One aspect of this story stands out--the possible consequences to the hospital.“Any linkage of this health provider to the death of Decedent could irreparably and unfairly forever taint the business enterprise.”
Why is a hospital a business enterprise?
23
@Karen DeVito You hit the nail on the head with your "why is a hospital a business enterprise."
American hospitals and health systems have morphed from institutions providing care and making enough to cover expenses into huge organizations that though not for profit generate large sums above their overhead. This access money goes to unnecessary building projects, administration salaries and lobbying efforts in D.C.
9
what a sad story for everyone involved, nurses, doctors, Mr. Armstrong. Nobody won except the plaintiff's attorney who piece of the pie should be reported on in this fine reporting. The doctor on doctor crime is also noted, fine job guys.
1
Medical malpractice lawsuits in Ohio require a strict affidavit of merit by a qualified physician to even be filed. With the statutory secrecy of hospital peer review, malpractice suits are the only check on negligent doctors.
9
Neil Armstrong was a true American hero. Following his death, his heirs and executors faced a devastating choice. I know personally from administering such an estate. It appears clear that there were preventable errors made. Given the confidentiality clause in the settlement it seems they couldn't do what the executor wanted most--to prevent a recurrence. The probate court and an unknown individual combined forces to take the matter to the Times, which handled it responsibly and with tact. In my case, there was no question about the action my attorneys were asked to take--ensure it didn't happen again, with no money coming to the heirs. My understanding is that the medical schools in the state and for licensing exams ensured the relatively simple but often ignored cause of the patient's death was essentially eliminated through intensive training. The hospital in question is now closed, but as part of a buyout of numerous hospitals in the market and the hospital and a partner institution withdrawing, putting their charitable assets into a combined foundation that funds worthwhile medical research and initiatives.Without knowing the financial strains of fame on the Armstrong heirs or what similar terms may be included in the settlement but will never be known because the hospital insisted on confidentiality we should not try to judge their motives, bur tather they continued the stellar character traits of Neil Armstrong.. An important story, well told
1
Everyone is human, but it's troubling that even the first man on the moon can't get adequate medical care. Anyone deserved better than this.
10
This was a tragedy, but from the information presented here, it’s not at all clear that it was a tragedy due to malpractice.
Mr. Armstrong’s condition after surgery suddenly deteriorated, at which point a decision was made to take him to the catheterization lab, rather than the OR. It was in the catheterization lab that the diagnosis was made, bleeding resulting in compression of the heart (the medical term is tamponade). At this time, things happened quickly and decisions had to be made under pressure. it may well have been too late to save the 82 year old astronaut.
We don’t know, we weren’t there. Hindsight is always 20/20. The statements by the experts seem to depend on who was paying their fees.
The email by lawyer Wendy Armstrong, quoted in this article, “’This event at Kennedy Space Center will receive national news coverage …. 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 lambasted…” makes it seems like this was about money, not justice.
The many non-disclosure agreements described also suggest the case was not about shining light on bad medicine. The refusal of Mr. Armstrong’s wife to participate in the suit is also telling.
Sometimes bad things happen to good people. Sometimes there is negligence or malfeasance. But sometimes not. In this sad case, we just don’t know.
23
@Alex
I spent 10+ years as Director of a Cardiac Surgery ICU at one of the largest open heart programs on the West Coast. This type of bleeding is very uncommon but it is a well known complication of removing temporary pacing wires after CABG and if you do 700-1000 open hearts a year it’s going to happen. The wires are sewn into the outer part of the heart, the epicardium. They’re called epicardial pacing wires and are different from normal pacemaker wires. When they are pulled, the sharp tip comes out of the muscle and can lacerate a coronary artery or cause a tear in the heart muscle. You can’t see what’s happening with the tip of the wire when you pull it, so if it tears something, to a large degree, it’s just bad luck. We would always have a physician or PA remove the wires, not a nurse. If someone did develop bleeding, one of the surgeons would break scrub in whatever case they were doing and take the patient to the OR. That is one of the reasons to go to a large teaching hospital. These complications happen and some are random and unavoidable. But you have to have a team that will recognize them quickly and that knows exactly what to do. We would never take this problem to the Cath lab and that was the big mistake.
16
Many of the comments express dismay over the settlement and I don’t wish to pile it on, but can’t understand why the hospital would pay this. For a younger person who had family, young children, perhaps, but to older adult children with no need for this money? What possible good is served? This is so incredibly wasteful. Making people rich over a regrettable hospital outcome is a complete waste of resources.
5
It does not matter if they are adults. They lost a father. A person who raised them due to negligence. Settlements in these amounts create a checks and balance system to ensure the errors do not happen again. If hospitals are not to be held accountable for loss of life due to negligence - I’d feel sorry for all of us who will eventually rely on them.
1
A principled perfectionist with guts, laid low by incompetence when he expected former from medical team..
6
This is America. The family of a famous man gets to sue and win. If Armstrong had not been famous, go back where you came from, in a manner of speaking.
10
More RN's practicing medicine without a license. Typical of American Healthcare. Do you want someone with an Associates Degree playing with your heart? Welcome to American Medicine.
17
RNs routinely remove pacing wires in cardiac intensive care. As a cardiac anaesthesiologist I have better things to do.
9
@PeteH Well here, we have Nurse Anaesthesnotists because the MDs are running for legal cover - and they have virtually no training. I don't know how they do things Down Under, but I'm sure Bumrungrad gets a good share of work from your county too. Let's just say, I pray your nurses do their work under your close supervision. I can always hope.
6
It's very clear he died from a complication. The records suggest it was malpractice because it was preventable and should not have happened if proper care was given.
This had nothing to do with his age as anyone, no matter their age would die from this complication if not treated correctly or more importantly prevented from happening.
The malpractice crisis per se is not the fault of litigious attorneys but the medical profession itself which fails to properly monitor and address quality care issues. Fails to develop close relationships, bedside manner, with patients and families.
I don't particularly like attorneys but more important are the lives of my patients and their families and they deserve honesty, and the best care possible for the situation. They don't file lawsuits if given these things despite complications that occur and sometimes lethal.
5
To Dr: Thank you for your thoughtful comments about patient care. My mother suffered an acute kidney injury from an unnecessary test involving X-ray contrast dye. She never recovered and endured more than two years of dialysis (three exhausting days a week) before she had a difficult and painful death. We are still angry as we believe others in similar circumstances are. We are sympathetic and glad that the Armstrong family was able to get the attention of the hospital. We would have the same thing but lacked the energy and resources, otherwise it is business as usual for the hospitals. So many mistakes and errors even with our constant presence and extreme vigilance.
3
Well I guess its not secret anymore....
2
This is a story about familial greed. Not the shortcomings of our health care system.
40
It is no one's responsibility to ensure that a person in their care will live forever. That said all established protocols should be followed and appropriate and optimal care should be provided. Beyond that there should be no opportunistic and predatory blackmailing of the hospitals and clinics.
Awards of millions of dollars should be made after very deep consideration and possible arbitration. If not hospitals will go at a loss big time. In our city of Louisville, KY the Jewish Hospital which has state of art standard of care is in financial difficulties. It is the finest Hospitals for transplantation procedures. When a person signs off on a procedure they should do so with utmost care and know the risks of dying. Beyond that gracefully accept the outcome if all proper procedures were followed and every attempt was made to ensure the persons survives.
11
@Girish Kotwal: Because you know, Hospitals shouldn't be held responsible for their patient's health. So when they just hack off the wrong leg, it's OK...Wow, you must work for the insurance industry...
2
@jayhavens Washington Common sense and prudent judgment should prevail. Amputation of the wrong limb is NOT OK. It is negligent malpractice and there should be a price to pay. We are not talking here of straight forward cases and the case of Neil Armstrong was complicated and open to several expert opinions of Doctors who were not treating the patients or were no where close to the patients and called in as an after thought to express an opinion that favored the patient's family.
1
Can’t believe the cynicism expressed in the comments.
A national hero, probably in great physical shape, apparently very humble, goes to his local hospital for care, surgery is recommended and he apparently does well post surgery when nurses remove his pacing wires which causes a fatal bleed and the post operative patient is met with bumbling incompetence.
Yes, his family was correct to sue, a few people messed up big time.
No one should die from having pacing wires removed.
Family was right to sue.
Armstrong might have had a very long life post surgery.
501
@JRS - Rare things happen to people. Something rare happened to Neil Armstrong. It's impossible for you to claim that "no one should die from having pacing wires removed". Heart surgery is inherently risky, particularly when performed on octogenarians, whether they're in "great shape" or not.
88
Except you don’t know his medical history, if he smoked, etc. Even a healthy 82 yo is still 82. Don’t know what his symptoms were when he went in that made this an urgent surgical case. And you definitely don’t know why he bled when the wires were removed by cardiac nurses.
52
Complications happen. It’s in the percentages - not necessarily anyone’s fault.
49
These non-disclosure agreements should be made illegal. The general public has an interest that cannot be met while issues arising from these institutions mistakes are kept secret.
Good on whoever revealed this one. Would that they would all be revealed. Too bad JQ Public will never see the justice that Armstrong’s family did
18
I don’t blame the family for trying to cash in. Everyone tries to in this country. It’s easy for people here to demand that Armstrong’s descendants should live modestly and with honor; I think they’re just envious. While celebrities or people with means tend to get better care, it’s obviously not assured. I’m thinking of Prince, Tom Petty and now Armstrong. Money and celebrity can shield people from good advice and care.
6
Joan Rivers.
3
"The legal settlement adds a grim footnote to the inspiring story of Mr. Armstrong"
I disagree, Mr. Armstrong has no negative or grim footnote attached to his story, that Albatross is firmly planted in the hands of his kids and the members of his family who decided to cash in.
24
My experience with non-disclosure agreements is that they are not much worth the paper they are written on. At least that's how they were viewed by courts 25 years ago when I was a potential witness for a discovery proceeding. If the laws have changed, I'd like to know why. Crooks are most likely to depend on such agreements.
1
@osavus
Neil Armstrong is no ordinary patient or victim of negligence. He was the First Man on the Moon
In this 50th anniversary year, he could have generated $5 million easy for his heirs, but for medical malpractice. Hence, the damage award - in addition to the hospital not wanting the adverse publicity of killing perhaps the most celebrated explorer since Christopher Columbus.
8
Glad this was a "secret settlement" agreement .
1
Was a poorly kept secret in the local medical/legal community at the time. Now that it is in the public, it makes me sad and furious all over again that one of the world’s great heroes died needlessly. He could be enjoying the 50th anniversary of his remarkable achievement but for incompetence and negligence. that was covered up.
292
@Golflaw You don't know that he "died needlessly". You only know that his family made that claim to enrich themselves. Medical experts for hire are a dime a dozen and will say anything.
42
@Golflaw
How do you know that he would have lived anther 7 years? As 82 progresses to 83 and beyond, many things can change. Car accidents, falls, cancer, dementia, & more. Very convenient that a daughter-in-law was able to step right up as a plaintiff's attorney.
Neil was modest & humble but his siblings & offspring sure aren't.
17
@Shocked No, docs dont care in the majority. Too arrogant, to contemptuous, too self-serving and self-satisfied. No, ...there ARE between 250 and 400k medical error deaths per year. Yes patients are arrogant to but now the problem is obvious.
4
I do not know all the details of what happened. However it is well known in the medical field that VIPs get the worst possible care sometimes. Too many experts or people who have a name "top doctor" get involved and care gets disjointed. It is always important that you have at least a single physician who coordinates your care at all times and advise you the best options. Optimal care is a result of a good team and not based on individual brilliance of a single surgeon. Your surgeon, your perioperative team, nursing staff, after hours coverage, ability to manage a complication all play a part.
Mr Armstrong is a hero to us. I wish it was a better ending. It hurts to read this article.
17
So even as a great American hero, Neil Armstrong at age 82 had already surpassed the average life expectancy of a white man in the U.S. Unfortunately, complications happen after major surgery in octogenarians.
Large malpractice lawsuits drive up the cost of medical care for all of us in this country. We need tort reform.
22
@Maggie Vuturo Most jurisdictions already have limits on what you can sue these characters for, so you got your wish. Now that you have been muzzled by the for-profit insurance and hospital industries, it's just fine with you if they just practice their malpractice every day without recourse? Do you work for the insurance industry?
1
I'm not a medical expert. But in my experience, any time a person over the age of 80 goes into a hospital, there is a chance they won't come out again. What might be survivable for a 20 year old person - or 40, or 60 - may not be survivable at 80. A patient of that advanced age just isn't going to be as strong or resilient as a younger patient. Surgical procedures are much more complicated for patients of advanced age.
I'm not sure the family's story would have been any happier had the medical center refused to perform the procedure, due to the risks of his advanced age, followed by his death.
13
@Steve Acho You should have stopped after, "I'm not a medical expert." The issue was not his age, it was medical treatment that was below the standard of care. Unfortunately, that substandard treatment led to his death. It wasn't happenstance, it was malpractice.
6
@Mark You may be wrong in assuming that the medical treatment was below the standard of care.We probably can agree that the lawyers for the family would have attempted to make that case and that the hospital felt settlement was the easier course.There was no trial,you are accepting one side of an argument without hearing any evidence from the opposing position.
3
It's really interesting that he didn't have the cardiac surgery in Houston---which is world famous for its heart operations. Michael DeBakey left well trained surgeons to follow him.
9
Other than the fact that it happened to a famous person, this seems to be a private affair between a person, his family, and his doctor. I hope Armstrong's family is able to find closure on this.
2
If NASA and the three astronauts of Apollo 11 were as incompetent as it appears the staff at that small hospital was, Neil and Buzz may have crashed on the Moon instead of successfully landing on it.
In the last minutes of the landing it was clear the computer of the Lunar Module was going to land in a large cratered area. If it wasn’t for Neil Armstrong’s piloting skills that first landing attempt may have been a disaster.
NASA astronauts are the best trained people to fly in space. Period.
3
Of course everyone is already jumping down the throats of the Armstrong sons.
Did you read the article correctly? This is malpractice by a small hospital that should have referred the case to a more experienced facility.
If your father was killed unnecessarily, you’d run to a lawyer too. It’s irrelevant that Armstrong was a national hero. You use whatever leverage you have.
It’s incredible how everyone gets on their high horse about morality. What would you have done in this situation? What would your children have done?
This isn’t academic for me — I’ve already had three heart surgeries, and I have another one in two weeks (which I haven’t mentally processed yet). If I’m killed through malpractice, I hope my children sue for whatever they can get.
395
@David G. We had a family member who died in a hospital due to negligence. What her immediately family did was to meet with hospital administration and insist on changes in protocols to ensure nothing like that happened to another patient. What they did not do is pressure the hospital for a cash payout by threatening to go public. Armstrong’s family appears to have inherited little of his humbleness and reluctance to cash in on his name.
167
@David G As a fellow cardiac patient, I wish you the very best for your latest surgery. May it be completely successful and may you recover quickly!
28
@David G
I don't disagree with the family suing, but saying they need a speedy settlement or else they will publicize the incompetence at a national ceremony sounds like blackmail. The sons enriched themselves using their father's fame. Most 82 year olds won't get a $6 million judgment.
121
Physician, cardiologist here. This same thing has happened to a few of my patients. The temporary pacing wires are removed in the wrong way.
1)Temporary pacing wire are sutured to the outside of the heart during surgery and passed through the skin. The wires are sutured with a knot that will open when a certain amount of traction is applied.
2)They are removed after the first few days after surgery.
3)The wire can migrate from the outside of the heart, through the heart muscle and into a major chamber of the heart if it's not placed correctly.
4)The wires should be pulled by the operating surgeon or other physician, not a nurse. If there is resistance then the wire should not be pulled out. If it's migrated it will rip a hole in the heart if pulled out.
4)Many heart surgeons don't place temporary pacing wires anymore as the risk/benefit doesn't support it.
My patients survived this complication because it was recognized immediately and were quickly treated. The margin for error is minutes.
288
@Dr. That rather substantiates the decision to move him to the Cath lab instead of the OR was mistaken, as the consultant has stated. As important is the question of the risk/benefit of using the pacing wires at all. Certainly this case would have been reviewed in the hospital's mortality/morbidity conference. One wonders if practices have changed since.
6
@Dr. I pray I'll never need your help, but if I did, I'd have great confidence in you, sir. Amen.
10
Your explanation partially explains why I was so vehement in my NYT-recommenced comment.
I also have wires attached to my ventricular chamber. I’ve had three ICDs (pacemaker/defibrillator) implants, but the original wire leads remain in place.
The surgeons have explained that removing wires is a very delicate and dangerous procedure, fraught with risk. They avoid it all costs, and will only remove the wires in a facility that is equipped to handle an emergency that may arise.
That’s why I’m still shocked to read that a NURSE pulled the wires in a hospital that was thoroughly unequipped to treat Armstrong immediately.
I don’t think it’s blackmail at all. Armstrong still had great earning power, and the settlement with his heirs should reflect that. (Not quite related, but Julie Andrews received a very large settlement when doctors ruined her voice. She had contracts for millions in concerts, yet couldn’t sing another note. She didn’t die, but her earning power was greatly diminished. I hope her settlement reflected that.)
19
So basically the family extorted $6,000,000 out of the hospital for an error that caused the death of an 82-year old with heart disease. Lovely. And we wonder why medical care costs so much in this country.
Mr. Armstrong May have never cashed in on his fame; the same can’t be said of his sons.
37
@Mike Let's get this straight: The Health Care For Profit Industry is extorting Billions on a daily basis from the American people. Trust me, the rich and shameless have this all built into their payout equations...
2
@jayhavens Yes, hospitals and doctors have malpractice insurance. Mostly because of nonsense like this.
So his kids blackmailed the hospital with the threat of revealing their complaint. That is a crime.
18 U.S. Code § 873. Blackmail
U.S. Code
Whoever, under a threat of informing, or as a consideration for not informing, against any violation of any law of the United States, demands or receives any money or other valuable thing, shall be fined under this title or imprisoned not more than one year, or both.
11
It has never been more important to maintain one’s health in The United States, than it is today! From the moment you walk into a Doctor’s office, which have become more like clinics, and you are asked to fill out, or enter electronically, tons of forms, by a receptionist who is probably just there to make a few extra bucks for the family, to a office nurse, who often seems like they got their credentials out of a Cracker Jack Box, to the maybe five minutes you are given by the physician, it is a horror show! If a hero like Neil Armstrong can’t get high quality care, what would you expect?! Be well!!!
7
why didnt he get a second opinion. Did the family /patient himself understand the risks and benefits of choosing this hosp/surgery/surgeon/etc. money/litigious nature of this story does send a chill down my nurse’s back.
2
And we supposedly have the best health care system in the world! Ha.
6
Hopefully this will not be the first thing one thinks of when hearing the name Neil Armstrong.
7
If you think "healthcare"--really medical care is bad, pray you don't fall into the legal system. I've had experience with both, and the legal system, lawyers, "judges", etc., etc., are far worse. This is a tiny sliver of it. Will the Gray Lady investigate?
BTW-- who owns this hospital? It didn't just sprout out of nowhere. Who are the owners, and what is their financial stake here? There's a lot more to this story-- please follow up!
3
@follow the money It obviously worked here.
1
A $6 million settlement for someone who dies at age 82 seems questionable and points out part of what is wrong with healthcare in the US.
First, the family is partly responsible for staying with a local hospital instead of a larger one more experienced with such procedures.
Second, mistakes can and do happen - more so in smaller places less experienced with certain procedures BUT would the family of any other 82 year old dying under identical circumstances get the same settlement?
I have to wonder how much money is spent on malpractice insurance and attorneys bringing and defending against malpractice suits (both deserved and not). A huge amount of the money spent within the bounds of 'health care' seems horribly misplaced. Health insurance companies are the largest focus of misspent funds. The cost and care you get depends on the insurance you have - which comes from companies striving to make the most money for their shareholders and executives. Providing the best and cheapest care for the most people would be in the best interests of society.
14
@cynicalskeptic
re "malpractice suits (both deserved and not)", although there is a popular notion that juries are pushovers for medical malpractice claims, nothing could be farther from the truth. Plaintiff's lawyers won't even take malpractice cases unless the faults are egregious, the evidence is open-and-shut, the damages are huge, and there are no credibility contests involving the doctor(s). Juries respect doctors and tend to believe them rather than their patients if their stories conflict, which means a doctor's written report or chart entry is likely to trump whatever the patient tells the lawyer and his/her claim will never find a lawyer to advocate it. On the facts presented, no ordinary patient's claims would find a champion. it seems inescapable that the magic words were "Neil Armstrong".
rip to a legend
6
Wow 6 million? If you make it over 80 you have died of old age.
7
So the boys used their dad's death to make a few million. Even great men can have, shall we say, somewhat less than great sons.
37
There is a lot of fodder in this article to comment upon. However the one thing that jumps out to me is the oddity of his choice to have a heart operation at a probably less than premiere facility. Having had open heart twice I can tell you how important it is that you find the most “Cracker Jack” surgeon and state of the art facility/cardio-thoracic department you can to perform the surgery. Things can still go south but they are less likely to do so amongst top-quality staff and facilities.
435
@ridergk. Absolutely right. The Cleveland Clinic, the premier place for by-pass surgery was not that far away. I went to Stanford and had a triple by-pass with a doc who had done over 400 of them--that was 30 years ago.
24
@ridergk Large teaching hospitals are not immune from mistakes. A friend had a heart transplant at a very famous teaching hospital in the 1980s. After his surgery and recovery, he felt well enough to reach for his medical chart.
Having had much time to inform himself of the details of his condition, he realized that he had been given the wrong medication. He called for the nurse, and his medication was replaced. He saved his own life. Patients and their families must participate in their own health care in this country.
19
@ridergk
The surgery went fine - it is pretty routine, that kind of heart surgery. What went wrong was the actions of a nurse removing wires that wnet wrong, and the subsequent insane decision by his health care provider to cut costs by sending him to a lab instead of a hospital.
16
Generally speaking, people like to think doctors are infallible, however, the best medical outcomes are usually seen with the most experienced doctors and their trained teams. Sorry to say, but that seems evident here, as well.
7
“Any linkage of this health provider to the death of Decedent could irreparably and unfairly forever taint the business enterprise,”
Business enterprise versus the vital interests of the malpractice victim and his family - how fundamentally corrupt are the bottom line priorities of healthcare in the US!
19
Let's knock it off, folks. Bypass operations have become routine, even in "community' hospitals. It is no longer "rocket science", (although there's plenty of evidence that the survival rate among those who do and do not choose such surgery are about the same... look it up.)
The wiring of a pacemaker, however, is a bit different. It's a process that seems to be done at the intern level or by an "on call" doc at perhaps 3:00AM. I have a pacemaker, and can easily feel the exit wires leading to my heart. It's scary stuff, folks! Initially, I thought those bumps were an infection.
So it's not too surprising (to me) that the pacemaker was the start of the cascade that did him in, despite his age (I'm 78, myself). It's also not at all surprising that a lawsuit ensued. I can assure you: run down a couple of Boy Scouts while turning right on red and you WILL be sued for everything you've got.
Revenge? Recompense? It hardly matters in today's litigious world. Especially here in America.
13
So much for taking the money via a confidential settlement.
5
I have all the sympathy for one of the greatest men US or indeed the world has ever given birth to. But my question is, is this becoming a case because he was Neil Armstrong or this is the risk that comes with this kind of procedure.
6
So, is it just possible the Armstrong family used the threat of Hollywood-style publicity to strong arm the hospital into a multi million dollar settlement?
29
@Paul: that is beyond question.
Everyone here has stated as much, very clearly.
No "Joe Schmoe" would have gotten $6 million for some questionable medical decisions made at a small suburban hospital, on an 82 year old man with advanced heart disease.
It sounds like the diagnosis was rushed with no second opinion. Why would Armstrong and his family not insist on going to a well qualified heart hospital like The Cleveland Clinic? This seems like a procedure that was borderline for this facility and they rushed him to do it.
13
He was a hero twice
In his amazing feat in space
And in his modesty and humility, not cashing in on fame.
Sad his children didn’t emulate him on the latter.
45
Obviously there was an anonymous check for $6,000.000.00 received by Fairfield Hospital on the same day the NYT's received the document dump...sarcasm.
How sad that Neil Armstrong, "...who avoided the limelight and never cashed in on his fame" is survived by a family, who, while championing his honor, integrity and stature as an example to us all, exploits his unfortunate death and underhandedly and cowardly breaks the settlement terms.
We truly have become a nation of posers. I see it everyday and shudder.
29
We all die when. where and why we are supposed to.
We all have a use by mortality date. And we can't take any of our stuff with us and use it. No one will ever hear from nor see us again.
Doctors are not demigods nor gods. Nor are lawyers. Both professions make mistakes.
There is nothing here that changes Neil Armstrong's iconic first man on the moon historic status. And living four score and two years is longer than the first man in space Yuri Gagarin lived.
193
@Blackmamba Nonsense. Life and death are random, but people would rather believe that there is some grand plan so they don't feel so insignificant. This is magical thinking that helps no one.
62
@Blackmamba I, and I’m sure many others, totally disagree with your first sentence.
46
@Blackmamba - Comments that seem to be uttered by one whose life has never been touched by tragedy or violence or natural disaster. I would almost call your comment ... callous.
42
If ever major surgery is needed go to a hospital associated with a medical school and get a surgeon who has done many .
34
Thats a contradiction. Training hospitals train young interns, residents, and fellowships. Attendings oversee procedures but may have grown rusty.
Best option is 4th year residents, ideally chief. They have the repetitions and knowledge.
The surgeon who have the most experience in a procedure are typically private practice. They do procedures day in and day out.
6
Armstrong wouldn’t trade on his legacy whilst alive but some members of his family were open to doing so later. Proper use of it would be to openly publicize medical error and take a lower settlement, not use it as threat to obtain more money and keep things hidden.
865
@Dubliner - Almost nothing In our for-profit medical industry is openly publicized, except for how wasteful and broken it is. A lower settlement amount would still have been hushed, the details hidden.
One can’t help but wonder whether the delay in getting him into the operating room was influenced by the cost.
26
@Dubliner American society is currently hyper-materialistic, so why settle for less money when more is a definite possibility? Besides, Neil Armstrong’s family members are not Neil Armstrong.
10
@Dubliner
If they really wanted to make money from it, they would have contacted a "fixer", like David Packer at AMI, Epstein, Trump, Dershowitz, Cohen. This settlement was a bargain.
10
How he lived is what matters most.
We all die, though not all of us live life courageously.
Here’s to Neil Armstrong’s life!
781
@Kevin Greene
The most important thing about life, is whether or not we learn from it. In this case, Mr. Armstrong (a non-violent American hero, if there ever was one) was maltreated to the extent that the family settled for an enormous sum. Obviously, you would not settle for an enormous dum without having committing a crime.
So, what's the moral of the story? None of is guaranteed to be be treated fairly, not even our best and, certainly, our brightest. Maybe, it's just me, but I think that it really tells us something about America. Unfortunately, none of it is good.
"We need to learn how to take care of our own."
10
First mistake, he was taken to a small community hospital. Second mistake, they didn’t transfer him to a hospital that can care for a high profile patient. Maybe an expert cardiologist can explain why you would take a patient to the cath lab with significant bleeding. Someone panicked.
35
@Harry B Perhaps the choice of hospital and the decision for surgery there was Mr. Armstrong's.
1
Physician guessing here - they may have thought he was having a heart attack and did realize he was actually bleeding. Just a guess
2
Mr Armstrong is an inspiration to generations! From what I understand, he did not cash in on his fame. I wonder what he was able to leave behind for his family. If it wasn’t much in the perception of some members of his family, then the litigation and the settlement is perhaps understandable. The fact that NYT received information by anonymous means indicates that the decision to sue was motivated and not agreeable to some within.
The wife not taking any financial benefits also strikes a note and her reasoning may help understand the real story.
One thing for sure, the professionals who advised the family would have highly rated the probability of winning a settlement out of litigation since they stood to gain from it. Once that carrot is hung in front, it is hard for any one to say no.
Mrs Armstrong should be proud for refusing to benefit herself. I feel that she may be living by MR Armstrong’s values.
31
@VP
Or her own, more likely.
1
I have to give Mrs. Armstrong credit for not taking an interest in the money factor.
94
I am not a lawyer, nor am I pretending to be, but wasn’t the Armstrong family lawyer exhibiting the same kind of behavior labeled extortionist when Michael Avenatti allegedly did it of Nike?
61
Neal Armstrong’s heart rate was 155 right before he landed on the moon. It take a lot of effort to get your heart rate up to 155. So he had his whole body system on overload and he kept his cool and landed on the moon.
5
@Coryb
And yet Aldrin's was much lower. I wonder if this fact indicated Armstrong at an early age had a genetic or congenital problem.
2
Armstrong was piloting.
1
Who was piloting during the landing? If it was Armstrong, it's understandable he would be under more pressure and his heart rate would be higher.
1
“Wendy R. Armstrong, a lawyer and the wife of Mr. Armstrong’s son Mark, …suggested that unless the parties reached a quick settlement, the hospital would be publicly lambasted for giving lethally flawed care to one of America’s most famous and revered public figures.”
This is disgusting. Shame on Wendy Armstrong and the other members of the family who supported this blackmail.
348
@Mark
And shame on Fairfield Hospital for opportunistically operating on Neil Armstrong instead of sending him to Cincinnati or Cleveland for the procedure.
65
@Maria
Are you saying Fairfield Hospital should seek a higher standard of care for Armstrong than they could provide because he was a higher caliber of human?
They do these heart procedures regularly, I’d presume.
13
@Mark Attorneys bluff all the time - it's what they do. The other party at the table has to be able to play poker better.
8
This story is shameful.
I respect his wife but certainly not his sons and daughter-in-law.
130
Ridiculous. Complications arise in elderly people with heart disease and recent heart surgery. Amazing accomplishments earlier in life does not render one immune. Nor does it render one immune from having a petty and opportunistic family, apparently.
101
@GBR My mother went into the hospital at 64 with a stroke and through a series of complications and mistakes, one after another she ended up dying 6 months later at 65, after being pushed out of and bounced around from hospital to hospital.
I probably could have found something in the cascade of mistakes and other malfeasance that I could have leveraged for a big payday.
The funny thing is, I wouldn't want that money anyway. I hope some day the two sons have a massive wave of guilt or remorse or regret for this shakedown. Some day they will understand that cashing in on their father's death was a horrific decision to make.
34
@John. I don’t think Neil Armstrong’s sons will ever regret what they have done. I do know I regret that their behavior left a stain, not on the life, but the death of a great American Hero.
16
@GBR. Perfect.
1
Bypass surgery at age 82...anesthesia, heart lung machine, etc...seems riskier than a flight to the moon. My dad had it at age 59 and I was amazed he made it thru. It was like a controlled car accident in its impact on his body
41
@Chris Baker
Plenty of 82 year-olds have bypasses. The hospital where my 83-year-old father had a triple bypass performed the surgery all the time and had little concern about his age. The bypass was 23 years after a mild heart attack (if there is such a thing.) He was out of bed the next morning and was able to walk the length of the hospital floor without help. They sent him home very quickly--no rehab. He eventually needed a pacemaker though. He lived to see his 98th birthday.
Perhaps your father was already in very poor condition and was a risky candidate for a bypass.
4
He made it thru and is still alive at age 80. But it was a serious operation even at that age
4
@Chris BakerMy Dad had the same at about the same age. The recovery was so painful he said he would have chosen against the surgery had he known.
1
So a hospital botched a heart operation on the first man to step on the Moon. Then tried hard to cover it up with $6 million dollars for silence to his surviving family.
Hurray for health care in America!
Didn't this small hospital stop and consider that they might not be the best place to operate on this most famous person of the 20th century...or did they ignore the risks and just go after the money?
331
@Rob Hubris.
10
Not greed, but hubris, my friend. So much bad happens in medicine because of hubris.
Joanne Roberts, MD
55
@Joanne Roberts
It's all about the money,he probably didn't even need the bypass.
12
Look an 80 something year old patient goes to a local ‘community’ hospital. Who were the doctors there? All Ivy trained etc.? And the nurses and staff? Prob not. So they did their best. Next time go to a better hospital. The Harvard doc knows his business because he’s a Harvard doc. But don’t expect the 1/20th experienced doc to make the same call. Cmon man.
18
Harvard does not confer godlike skills. There are plenty better cardiovascular training centers (like the #1 Cleveland Clinic) who’s graduates staff many community hospitals like Fairfield. Not everyone can or will take the journey to the ivory tower medical palaces. Support of family and friends and home nearby with facilities and staff that meets standards can have better outcomes than larger institutions.
6
@Karen Reed: the difference is the coronary SPECIALISTS at Cleveland Clinic (there are other fine coronary centers, but Cleveland Clinic was just hours away from Armstrong in the SAME STATE) do this procedure 10 times a day EACH.
The small hospital doctors do it 1-2 times a week, or less.
The difference is massive experience and know-how.
My dad had a quadruple bypass at the Cleveland Clinic in 2000. He was then 74, and in terrible shape -- long time heart disease, loss of one lung in his 40s from industrial poisoning, angina -- and arteries that his cardiac surgeon described to me as "like sewing together wet Kleenexes".
Had he died during surgery, we would have held his excellent doctors blameless. Yet they performed a miracle on him.
On the day of surgery, I went to a mass meeting with about 50 other families, all having their loved ones surgery that day. It was a MASS assembly line operation -- that's how many bypasses they do there EVERY DAY.
The knowledge a surgeon gets from doing this TEN TIMES A DAY -- the knowledge the NURSES get -- is priceless and cannot be duplicated in a small "hub" hospital where they perhaps do 1-2 such procedures a week -- or month.
Some people cannot access this kind of expertise due to money -- small networks forced on them by BIG INSURANCE -- or just distance. If you live in rural Idaho, this is just too far away.
But Armstrong lived "down the road" and had superb TRICARE as an ex-military and astronaut. He could have easily gone.
1
So, you are the heart surgeon who just operated on Armstrong, the first man on the moon.
You are in a low surgical volume hospital.
And you let a nurse pull the pacemaker leads out?
We need a new word to define arrogance intersecting with laziness.
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@Melnbourne
You imply that his fame justifies a greater level of care - that is disgusting.
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@Melnbourne. We need a new word to define opportunistic sons who take advantage of the celebrity of of their honorable, 82 yr old father’s death to extort money——-$$$$ 6 million dollars.
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@Melnbourne Nurses are trained to do the work of nurses. Cutting the pacemaker wires, then monitoring the patient, is nurse work. You're welcome.
12
This example should be carefully considered when making the claim medical care in the US is the best in the world. Armstrong was a national hero who received poor care in a small local hospital as the reporters tacitly admit when referencing the U of Cincy teaching hospital as a better option.
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@Tibby Elgato:
Most Americans receive adequate but sub-optimal care. The fault lies in our health insurance system, which tends to increase medical risks, limit treatment options to the cheapest procedures (which may require longer-term care & expenses), and drives lifetime costs higher.
Most Americans do not get the best healthcare, due to our antiquated profit-driven health insurance system.
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@IN
Neil Armstrong was not "most Americans."
His family could have taken him to the TOP heart hospital in the country.
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@Tibby Elgato
Total agreement. After 16 years in the health care field, I can say unequivocally that not all hospitals provide the same level of care, and people fail to understand this. Your local community hospital is fine for minor problems. Cancer care, cardio-thoracic care? No way. I gave birth only in a hospital with a Neonatal Intensive Care Unit (NICU). New moms do not realize that if their baby is born in crisis, that infant is transported to a hospital with a NICU, while you, new mom, have to stay at the site of origin.
7
Wow. Are the Armstrong boys doing that poorly in life that they grab an attorney to shame, embarrass, and fleece the hospital that tried keep their 82 yo father alive who was clearly at the end of his life? With all due respect, they could surely cash in on their fathers legacy some other way. This is yet another reason healthcare is out of control. Greedy people and lawyers sucking millions out of a system that is not always perfect, but trying to actually do something in life helping sick people.
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@orange kayak
Fairfield Hospital is not innocent. The only reason the hospital did not refer him to Cincinnati or Cleveland isn’t because it wanted to raise it’s profile.
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@orange kayak "Greedy people and lawyers..." You forgot to add profit-over-people insurance companies and Big Pharma, too.
It is sad that the Armstrong family chose to crudely leverage the hospital on the shabby care Neil Armstrong received which probably resultedin an early death.They should have pressed their case legally without leveraging the nation’s love and admiration for Neil.
18
What a tragedy if Mr. Armstrong life could have been prolonged with proper decision making from the hospital doctors. He truly was. and is, an American Hero!
On another note, if the settlement details are true (and I don't think we have the complete story here) Shame on his children for settling this case in exchange for money! They could have brought the story public right away and let the hospital bear the brunt of the consequence! Instead they chose money and silence. Silence that will allow this type of malpractice and mistreatment of people to continue! How truly selfish, greedy, and evil. Especially Mrs. Wendy Armstrong who to quote the article "suggested that unless the parties reached a quick settlement, the hospital would be publicly lambasted for giving lethally flawed care to one of America’s most famous and revered public figures" Well Mrs. Armstrong. Maybe you should have let that happen instead of trading $6 million for dignity and justice for your father-in -law's spilled blood.
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America: great at putting the first man on the moon! Healthcare? Not so much... Let’s vote for someone who will change that.
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Best comment
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@Keef
Each time I see the government running something, except maybe the armed forces, I am grateful we have so far kept them far from being in the medical business.
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@Keef In cucamonga
@Tibby Elgato
one can argue the merits of the quality of US healthcare vs that around the world, but to use this single, high-profile case as an example is ridiculous. physicians and surgeons are not infallible and complications happen everywhere...
7
Republicans have been lying for years saying that the American people receive the best healthcare in the world. They are still lying and the statistics prove they are lying.
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@DSD The patient chose a local hospital and got local hospital expertise. It’s not a fair measure of the entire system. Cmon man.
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@Honeybee
What are you talking about? Of course good medical care can prologue life and with quality of life! This is true for 20, 40, 60 and 80 year olds. Are you opposing good health care and treatment for those over 80?
14
Stats don’t account for patient population. Take the American population (obese and type 2 diabetic) and put them in the Canadian or Swedish systems and watch the outcomes crash.
1
I find the conduct of the Armstrong family disgusting, irrespective of the quality of the care that Neil Armstrong received. I feel certain that Mr. Armstrong would feel similarly about what amounts to blackmail with his fame as the lever.
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@MHW Yeah a deft piece of reporting. Like kabuki. Or that Japanese film about different perspectives. Seven Samurai?
@Richard - Rashomon.
3
@Richard
Rashomon
Kurasawa
2
His sons definitely used their father’s fame to get a big settlement. But the idea that it was all kept secret bothers me even more. Both parties, the hospital
and the family, agreed to the secrecy so I am critical of both. This is a sad final chapter to Neal’s remarkable life.
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@Jo The letter Mark's lawyer wife sent to the hospital certainly sounds like something a shakedown artist would write. It certainly leveraged all the hot buttons, emotions and threats of public humiliation.
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@John - My guess is that any lawyer would knock that letter out within five minutes and not give it a second thought. For what it's worth, my life experience was that a lawyer at the Department of Justice did exactly the same.
5
@Andy Hain Michael Avenatti did that to Nike. This was nothing more than a shakedown.
Hopefully now that this is public her state's Bar Association will review this and make a determination about her continuing ability to practice law. Being an officer of the court is a serious matter.
6
Sad case where an unfortunate death meets unfortunate opportunism.
184
As Harry Dean Stanton said, "Somethings wrong....Somethings wrong:"
"We skipped the light fandango, turned cartwheels 'cross the floor. I was feeling kinda seasick, but the crowd called out for more. The room was humming harder as the ceiling flew away. When we called out for another drink, the waiter brought a tray. And so it was that later as the miller told his tale. That her face, at first just ghostly turned a whiter shade of pale. She said, 'There is no reason,' and the truth is plain to see. But I wandered through my playing cards, and would not let her be. One of sixteen vestal virgins who were leaving for the coast. And although my eyes were open they might have just as well've been closed. And so it was that later as the miller told his tale. That her face, at first just ghostly turned a whiter shade of pale. And so it was that later."
5
Robin Trower a truly underrated guitarist. They used to play that song before every opening set at Fillmore SF.
7
This is one of the reasons that healthcare is so expensive in the U.S. $6 million for an 82 year old man with heart disease??? come on.
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Underrated comment above.
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@osavus
No, it’s not. Every empirical study conducted of the total costs associated with the medical claims system (including settlements and verdicts, attorney fees and litigation expenses, the latter of which are often bloated by a refusal to quickly pay meritorious claims) is a minuscule contributor to the cost of medical care (less than one percent). Meanwhile, it has also been estimated by the NIH and many others that preventable medical mistakes in the care of hospitalized patients (only) kill an estimated 225,000 people annually - the third leading cause of death in America. Medical negligence is an epidemic. Holding negligent care providers accountable has resulted in enormous improvements in the quality of care by several medical specialties, anesthesiology being a prime example. Please do not utter uninformed opinions. We have plenty of those already.
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@osavus
6 million is not the issue. This hospital should have lost its license to practice for eagerly seeking to buy the silence for its negligence and risking the lives of future victims of its defective and IMMORAL policies.
27
The biggest mistake here was the decision to go to a small community hospital in the first place. A man of Armstrong’s age and condition should have gone to the largest and busiest hospital available where heart procedures are regularly performed.
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@Blue Dog Go to the busiest, exactly. Studies going back decades support your observation. Practice makes perfect.
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@Blue Dog Considering he had taught at the University of Cincinnati, you'd think that would have been the hospital of choice.
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@Blue Dog
Exactly. Neil Armstrong went from Wapakenta, Ohio to the moon, but he did not go from Wapakenta to the Cleveland Clinic.
Nobody deserves to die like Armstrong. But the truth is, in most instances celebrities get better treatment. And this was one unique celebrity.
You can bet that Cleveland Clinic administration and legal staff would have demanded the best to keep the probability of negligence close to zero.
Also, even at world class hospitals having a friend on the staff is of immeasurable value.
41
The history of America is the history of aggressive litigation, going right back to Jefferson, who searched like a squirrel for legal precedent to use against King George III. Thus it is somehow fitting that the first man on the moon, a laconic American, should depart the Earth with legal claims and a settlement trailing behind him like lunar shadows.
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@Michael Steger His kids believed they were entitled to one last pig payday off of their father's back, I guess.
17
Neil Armstrong rode the razor’s edge of science and technology
to the moon and back. To have his life shortened by malpractice at the hands of the american medical machine is disgusting.
And who takes Neil Armstrong for gods sake to some hub hospital?
Mayo clinic no less. The best care anywhere was earned long ago, and more.
r.i.p
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@brian The Mayo clinic spent like 20 years removing spleens for Myelofibrosis (sic) before discovering it didn’t make any difference in outcomes. Little known fact I discovered researching my cure. So much for Mayo clinic. Just saying. (I went to Germany. It’s been 12 years now. Do the math.)
5
@brian It's the pervasive medical malpractice machine that is in fact disgusting.
And, come to think of it, so is the suggestion that someone famous deserves better health care than the rest of us.
Regional medical hubs provide necessary, and generally fine, medical care to most of the country. This suburban Ohio resident was 82 and had heart disease; not a wholly unexpected outcome.
5
@Richard That's very interesting. A friend of mine had what he was told by three major health institutions in the US, including the Mayo Clinic, that his sinus/brain cancer tumor was inoperable and would prove fatal. He went to Germany for surgery and is recovered and well. I made me wonder where "cutting edge" care really is happening.
7
So the 'hero's our space program's family strong arms a hospital or they will damage the reputation of that place.
In everyday care for any patient, mistakes can be made- and the vast majority have no means to do what the Armstrong clan did.
Shame on this family for jumping on his fame- something he and his wife never did.
We see this in our celebrity nation a lot- when Elvis, Michael Jackson and on and on went down- doctors were the target.
They are not gods and this huge payouts don't avoid the last thing we all face- death.
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@Dennis McSorley
So true...I am a victim of a medical error which almost killed me. I do not have the means to do what the Armstrong clan did. When I asked for a mere $36.000 to cover my out of pocket expense (lost work etc from 3 months of 3 hospital stays/ 2 angiograms/3 blood transfusions etc.) I was informed by one of my physicians (who had been told by their risk management team) to tell me if I pursued any legal remedy they would have the right to drop me as a patient...hows that !! I wasn't after blood from the doctor's or the hospital that caused my error, I was after simple compensation for my out of pocket expenses. Medical errors are a way of life...how a medical facility handles those errors defines them. There is an organization out of UW School of Medicine called The Collaborative working to change how medical facilities handle medical errors. I encourge anyone that has had a similar experience to check them out. It is about accountability in an effort to avoid litigation.
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@Dennis McSorley
"Shame on this family for jumping on his fame- something he and his wife never did."
Very well said. These were exactly my thoughts, but I was unable to express them so clearly and succinctly.
I have no religious beliefs, but if I had I would be certain that the great man would be as disgusted at this as I am.
2
@Honeybee You must have meant to say that if no attorney will take it on contingency, then the attorney doesn’t take think they can win at trial or win a large enough award to make it worth their time, NOT that an error wasn’t made and the patient is not deserving of compensation.
1
I’m a Cardiovascular Intensive Care Nurse. Unfortunately there is always risk factors involved in open heart surgery and complications do occur. Bleeding, kidney failure, atrial fibrillation, pulmonary disease, failure to thrive to name a few are complications that can occur. And the older you are or underline disease you have then the greater the risk. We don’t pull wires but cut them. But saying that bleeding can occur because your on thinners to keep the grafts open. Armstrong lived an unbelievable 82 years! Many can’t say they.
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@Leslie And a patient has to assume that when one of these "complications" occurs, the doctors in charge will make the correct decisions and the patient's life will be saved. Obviously from the report -- a number of "wrong" decisions were made beginning with rushing him into surgery initially and then taking him to the catheter lab instead of the OR when he began to bleed.
Those kind of mistakes cost a man his life.
32
@Leslie Using that logic, any death resulting from surgery can be excused. The point is that risks must be minimized, and in this case, by not taking the patient immediately to the OR instead of cath lab, a needless risk was taken, with a devastating result.
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@Leslie
To me it looks like the doctors made some faulty decisions. I'm hoping that the data of this sad situation goes to a state medical board which keeps track of all medical fatalities and acts on them. Hopefully, the public can access this information when choosing a hospital.
I credit your loyalty to your professional colleagues but I don't think that your reasoning "that things can always go wrong" applies in this case because the mistakes that were made led to this unfortunate outcome.
9
This story is distressing. We all emotionally for the family. Unfortunately the number of people who go into a hospital and never walk out is more than myth but fact I am at a lost for words.
Money can never bring a loved one back however it can bring a little bit of accountability to what the hospital did not do. Hopefully the medical staff are doing a better job than they did with Mr. Armstrong.
I hope the family realizes how much Mr. Armstrong was loved ,admired by the entire world. An American superstar forever.
19
@Tony People only go to the hospital when they're very sick. That's why many of them don't walk out.
5
@Tony: do you want universal health care? Medicare For All? Single payer?
Then we CANNOT HAVE THIS.....giant awards for a few individuals, and vast sums for attorneys who game the system.
The typical charge for such a case is 40% plus expenses -- and expenses in a malpractice case would be huge. As much as 55% may well have gone to the LAW FIRM -- not the family, and not to any source that "punishes" the doctors, who are covered by INSURANCE.
LAWYERS and BIG INSURANCE are who makes out here.
Not individuals in our society. Huge lawsuits are the direct cause of very high medical costs!
Let's hope this publicity pushes the controversy in favor of greater public accountability and greater accumulation of knowledge to protect public safety.
36
From Harvey Weinstein to major hospitals, NDA’s allow deep pocketed people and institutions to keep doing what they’re doing, no matter to risks to others they later come across. When will we learn!
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@AG
Sexual assault and medical malpractice are just not the same thing. Nor was the hospital in this case proven to have committed malpractice--thanks to the Armstrong sons.
Any major surgery, especially for an 80 yr old, is risky.
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@trixila. Yes, that is why the proper and professional approach would have been, and is, to take every conceivable precaution. These doctors failed to do that. Bad choices were made. That is why the hospital wanted the story kept quiet.
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@trixila True, but the case has been reviewed by medical peers who are critical of the decisions made by the hospital physicians. I think it goes without saying that they took his age into account.
3
Thank you to the anonymous person who sent these documents to the Times. I'm curious to know why they came forward but the truth in medical malpractice cases should never be concealed. To me this is a sad story about how no one - not even revered heroes who have done incredible feats - can escape our broken and questionable health care system.
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@Tres Leches The "unsigned note included in the envelope said the sender hoped the information would save other lives," the story said. Sounds as if the source might be someone from inside the hospital who thinks this problem is more systemic than singular and that this was the right, newsworthy juncture, at which to raise the issue.
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@Tres Leches Yes, it happens even to famous people and ex-presidents. When Bill Clinton had symptoms of a heart attack about 15 years ago, the local hospital he went to decided he was fine and sent him home. He returned several hours later because he knew something was wrong. The second time, they caught the problem and he ended up having cardiac surgery (at a larger hospital).
Unfortunately, missed diagnoses are not uncommon. It happens even more often for women since their heart attack symptoms are generally more subtle than men's are, and their medical complaints are less likely to be taken seriously.
5
@Nelle Engoron Nelle, just an anecdote: a neighbor of mine, a man who pushed a candy cart for a living before he retired, had successful heart surgery at the larger hospital to which you refer. I can't tell you what a mood lift it gave him to know that he was going to have the procedure with a surgeon who had operated on President Clinton.
4
It's sad to think that Neil Armstrong might have lived longer, perhaps been here today to commemorate his landing on the moon 50 years ago.
It's very much to his credit, though, that he never cashed in on his fame as the first man to walk on the moon.
Meanwhile, his two sons -- and the daughter-in-law -- had no compunction in shaking down the hospital for a fat settlement.
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@John H.
If the medical treatment is inadequate or perhaps, in this instance, bad, the family is not "shaking down" anyone. Medical malpractice is liable to recompose the family because, sadly, they cannot recompense the patient who is beyond their poor medical treatment.
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@Ariel Briesse
Awards in medical malpractice suits can include the following components:
1. Cost of past and future medical treatment costs (economic damages)
2. Reimbursement for lost income/earning potential (economic damages)
3. Pain and suffering (non-economic damages)
4. Punitive damages (usually reserved for cases involving egregious or outrageous conduct)
Items 1, 2 and 3 are intended to compensate the victim and.or his family.
Item 4 is intended as a means of warning medical practitioners, both the actual individuals who made the error, and the medical community in general, that egregious conduct will not be tolerated.
In addition, doctors found to have committed malpractice end up paying a lot more for their malpractice insurance, and in extreme cases, can be sanctioned with loss of their medical license.
11
@Honeybee One of the hospital's experts agreed that there was a departure from the standard of care that caused his death. Under that circumstance, a settlement was proper.
20
Wow. I hope nobody else at the hospital died from the same suspected cause because of two greedy men and an unethical attorney.
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@Casey L. If they died at that hospital from the same cause, it's because the hospital, doctors, and other staff didn't learn from this and continued their improper practices. Nothing associated with that settlement interfered with the hospital undertaking a full investigation and addressing and correcting the root causes.
3
This is thoroughly distressing to read. Who is to be trusted these days?
Twelve years ago i had open heart surgery at U of M Medical Center in Ann Arbor, Michigan. Things did not all go exactly right and i spent five weeks in ICU. Obviously i recovered and am still doing very well.
The luck of the draw?
36
@Nightwood: with all our technology and medical science....the practice of medicine is still an ART and not 100% reliable or predictable.
It was very clear in this article, that had the patient been "Joe Schmoe"....the hospital wouldn't have settled, and no greedy attorney would have made a bundle (they get about 40%, plus expenses!) off the case.
Sad situation where there is doubt about the course of treatment chosen by the doctors. I'm am sure they are well aware of whom they were treating and while all patients deserve treatment to the best of the doctors' and hospital's ability, sometimes a less invasive path is chosen to avoid putting the person through more, but that may be the wrong path, at least in retrospect.
None the less, the quotes from the daughter in law are so typical of a shake down by an aggressive attorney. I assume they were correctly reported, and yet find them abrasive beyond the level needed.
170
I am saddened to read how a hero was shuttled from place to hidden place within the confines of a hospital in whose medical care he was trusted; I am saddened even more to read that his sons auctioned off articles from Mr. Armstrong's personal collections. Couldn't these things have been donated to a museum? Finally, I am saddened most of all by the fact that these horrid errors in medical practice are being dredged up to the surface to air many years later, when the publicity of all of this news will succeed only in further upsetting the family of a hero who fell far too early for his time.
34
@nina Really- is it shameful to auction off one's possessions? Once an object is inherited, it belongs to the heir. If they don't want to keep it, why couldn't they sell it? And how do you know that Neil Armstrong didn't tell his family to sell that stuff off and be happy with the proceeds. Neil Armstrong put his life on the line many times. What is wrong with his family having an easier life? Let's reflect on how difficult it must have been to see your loved one be propelled into space- not knowing that he would return.
21
@nina It is the family -- his two sons -- who filed the lawsuit because they knew he had died due to medical malpractice. They've already lived with the knowledge of the fact that the ineptness of his treatment killed Neil Armstrong.
4