Xbox Designer Paralyzed After Overlake Hospital Missed Spinal Fracture Four Times: $20 Million Settlement

In May 2013, August de los Reyes fell out of bed at his Bellevue home and injured his back. He had been living for years with ankylosing spondylitis, a rare inflammatory disease that fuses vertebrae and makes the spine brittle, and he told that to hospital staff. What followed was a cascade of communication failures that cost him the use of his legs.

Over the course of four emergency-room visits across two weeks, at least six Overlake Medical Center staff members dismissed his warnings that he had suffered a spinal fracture. The first ER physician who examined him noted a probable lumbar or thoracic fracture in his assessment, but did not enter that note into the medical record for five days. Other providers reviewed the chart, saw nothing flagged, and sent de los Reyes home each time with pain medication. On May 25, 2013, he returned in severe pain. While hospital staff repositioned him for an MRI scan, he felt sudden, unspeakable pain and lost sensation below the chest. The MRI confirmed what had been missed: his spine had fractured. He was 42. He has used a motorized wheelchair ever since.

Luvera Law Firm attorneys Robert Gellatly and Joel Cunningham filed suit in King County Superior Court in October 2014, naming Overlake Hospital, the physicians group, and the imaging center that treated de los Reyes. The case centered on what the firm described as every category of medical communication error occurring in a single patient's chart. Providers who saw conflicting information documented it. Providers who saw nothing alarming discharged him. No single clinician took ownership of his care from visit to visit.

In March 2016, the parties reached a settlement of more than $20 million. De los Reyes had one condition beyond the financial figure: no confidentiality agreement. Luvera Law Firm had a standing policy against gag orders in malpractice settlements, and Gellatly has said such agreements do not serve the public interest. De los Reyes went further, negotiating a term requiring Overlake's top executives to partner with him in identifying what went wrong as a design and systems problem, developing reforms, and implementing changes meant to prevent the same chain of failures from recurring. He joined the hospital's Patient and Family Advisory Council and began recruiting fellow designers to assist Overlake and other health systems with safety-process work.

The $20 million figure and the identity of counsel were confirmed by the Seattle Times and CNBC at the time of settlement.