When Neil Armstrong died in 2012, it was officially put down to complications arising from heart surgery. But seven years on, more murky circumstances have come to light.
The New York Times said on July 23 it had received by mail 93 pages of documents revealing a dispute between the family of the most famous astronaut in history and the small Ohio hospital where he was treated and operated on.
The Cincinnati Enquirer also received the documents, which were sent anonymously.
According to the newspapers, the family had threatened to publicly accuse the hospital of medical malpractice.
They ultimately reached a secret settlement that avoided a scandal, with the hospital paying USD 6 million, of which USD 5 million went to Armstrong's two sons, Rick and Mark, in exchange for their silence.
In a July 2014 email, Mark's wife Wendy, a lawyer, threatened to go public during the 45th anniversary of the Apollo 11 mission which saw Armstrong become the first person to set foot on the Moon.
"If this matter becomes public, the resulting damage to your client's reputation would come at a much greater cost than any jury verdict we can imagine," she wrote, according to the Cincinnati Enquirer.
"No institution wants to be remotely associated with the death of one of America's greatest heroes," Bertha Helmick, a lawyer for Armstrong's grandchildren, argued in probate court proceedings, according to the Times.
But Armstrong's widow Carol, his second wife, wanted it known she was not a part of the agreement.
The case concerned the decision by the hospital in Fairfield, Ohio, now a member of the Bon Secours Mercy Health group of hospitals, to not transfer Armstrong immediately to surgery when he began to show rapid internal bleeding, several days after a coronary bypass.
The original decision to perform the bypass surgery has also been questioned.
A hospital spokeswoman told the Enquirer the publication of the details was "very disappointing."
Settlements for medical malpractice suits are commonplace in the United States: only about five percent end up in court, according to Michelle Mello, a law professor at Stanford. Hospitals are insured against the risk.
According to Mello, the biggest settlement by a doctor in 2018 involving the death of a male in his 80s was for USD 1.49 million and the median was USD 145,000.
All such cases are reported to the National Practitioner Data Bank, but settlements by hospitals, which are rare, are not.
According to another expert, William Sage of the University of Texas at Austin, "a $6 million settlement involving the death of a national here does not strike me as unusually large." The case highlights the brand value of the Armstrong name, but also more generally of astronauts from NASA's golden era.