The injury occurred when I visited the bathroom in the Walmart. Upon leaving the bathroom, I opened the door, stepped forward, and fell down an unmarked step. My movement propelled me forward. I tried to catch my balance but ended up hitting the opposite wall in the hallway headfirst, resulting in a fracture of my C1 vertebra. The 6 mm gap in my C1 vertebra is quite severe. I was told the gap was too wide for new bone to grow, but that it was just within the limit of what could calcify, meaning that the gap would fill in with calcium. In the image of my C1 vertebra below, the left side is normal; the fracture is on the right side. The two sides of the C1 appear to be different sizes because the vertebra and the image plane are not completely parallel.

I ended up on the floor in the middle of the hallway, dazed and in incredible pain. The initial pain was so excruciating that I almost blacked out, and I was completely unable to move. On a scale of 1 to 10, my initial pain level was a 10. I thought I might die. My pain level stayed between a 9 and a 10 until I was given significant doses of painkillers many hours later.

I believe that the situation which caused the injury was inherently dangerous and that Walmart was negligent in creating that situation. The step was hidden by the closed door, and there was no signage or indication that there was a step down (though there was an empty holder for a sign on the inside of the door). The following day, workers secured the door open and added indications of the presence of the step.

For privacy reasons, I am not going to go into every detail of my injury or of my medical treatment, but the description above describes it pretty well. My C1 vertebra is a different shape than it used to be, my neck is permanently tilted, and I have significant, chronic pain, as well as a number of lasting peripheral issues including a limited range of motion in my neck, poor balance, and numbness. I take five different medications every day to help manage the pain. It appears that I will be in pain for the rest of my life, and that the other issues will be with me forever as well.

• Was Walmart aware of the dangerous situation?
• What previous incidents of people falling were there?
• Had Walmart received complaints about the situation that they had not acted on?

After the injury, Walmart placed me in even greater danger of permanent injury or death through its actions.

Soon after I fell, several Walmart employees arrived, and immediately started directing things. When they arrived, we had no reason to believe that Walmart or its employees would act in bad faith, against my interests. As a result, we were a little slow to realize what was happening. I stated multiple times that I wanted to be fitted with a neck brace and transported in an ambulance to a hospital. My daughter-in-law, who has some medical training, strongly advised that I be transported to a hospital in an ambulance, and that it was a bad idea for me to be moved without a cervical collar. Walmart’s employees told us that it was impossible to get an ambulance and that we would have to drive ourselves to a hospital. They also told us they might be able to call a firetruck but it would take a long time to arrive and that it wouldn’t have a cervical collar.

It’s obvious now that there wasn’t enough time for Walmart staff to inquire about an ambulance and that they wouldn’t have known how long it would take for a firetruck to arrive or what equipment it would have.

We also now know that there was a small hospital (which I think is similar to an urgent care clinic in the US) 1 km away. At that same location, there was an ambulance available. The best course of action would have been to contact that hospital first, and have medical professionals from the hospital and/or the ambulance evaluate my condition and ensure that appropriate actions were taken to prevent exacerbation of my injury. Instead, Walmart staff with no apparent medical training impeded my access to medical care.

Walmart’s actions forced me to forego medical advice at the scene of the injury and take an ill-advised trip in our rental car without neck stabilization. To get to the rental car, I had to stand up, walk down two flights of stairs, and then walk through the store all the way to our rental car. I did this with the help of two strong men, because there’s no way I could have done it by myself.

Walmart gave us the address of a hospital that was 13 km away. Walmart told us it was the closest hospital. It wasn’t. In addition to the small hospital nearby, there is apparently another hospital 8 km away which we drove past on the way to the hospital we went to. We also learned that there were multiple hospitals very close to the hospital that they sent us to.

• Did Walmart staff really not know about the nearby hospital?
• Did Walmart staff really not know about the nearby ambulance?
• Did Walmart staff simply make up their claim that an ambulance wasn’t available?
• Is making such a claim a standard policy when somebody is injured at a Walmart?
• Why did Walmart staff send us to this particular hospital?

The ride from Walmart to La Paz was bumpy and treacherous, and it was also excruciatingly painful for me. We will never know to what extent my injury was exacerbated during this trip without proper stabilizing measures being taken. This risk is one of the reasons why the first step for a neck injury — or any spinal column injury — is stabilization before transport.

After we insisted that we wanted an ambulance and that we were uncomfortable driving to a hospital in an unfamiliar location, Walmart sent an employee with us for the stated purpose of making sure that I got to the hospital. We were explicitly told that the employee would provide directions to the hospital. In fact, once we were in the SUV, he told us he did not know where the hospital was. It appears to me that the employee’s true purpose was apparently to monitor us, report back to Walmart, and get me to sign an agreement indemnifying Walmart of responsibility

• Did Walmart lie when they told us the employee would provide directions to the hospital? If so, to what end?
• What was the true reason that Walmart sent the employee with us to the hospital? Why did Walmart not tell us this true reason?
• What were the instructions that Walmart gave to the employee they sent with us to the hospital?
• Is Walmart taking advantage of the imbalance of power between them and their customers to coerce injuried parties into indemnifying then?

The Walmart employee who accompanied us to the hospital listened in on our conversations with the hospital staff and some of our private conversations, without my or our permission. We observed him taking notes. We had to repeatedly send him away. One such time was when the neurosurgeon was showing us some imaging results, and he came over to look at the computer monitor with us. At no time did he ask for permission, nor did I or we grant him permission or say anything to imply that he had permission to observer or listen in on anything related to my care. In fact, we explicitly stated on multiple occasions that the information was private and demanded that he leave. He refused.

The Walmart employee stayed at the emergency room for many hours. Despite our explicit and repeated requests for him to leave, the Walmart employee continued to enter my ER room, speak with doctors and ER staff without my being present, and take notes on my conversations and care. My daughter heard him relay private details of my condition and care in phone calls to employees at the Walmart store.

• Is sending an observer to the hospital standard policy when somebody is injured at a Walmart?
• Is having the observer refuse to leave the hospital when they are asked to standard policy when somebody is injured at a Walmart?
• Does Walmart have a “cozy” relationship with the hospital? Is this why the hospital did not bar the Walmart employee from the emergency room? And is this why Walmart sent us to this hospital?

The Walmart employee gave us two printed forms to fill out and sign. These forms were clearly prepared in advance, as there was no time for them to have been created before we left the Walmart for the hospital — they were not the work of the employees in the store acting on-the-fly. The Walmart employee insisted to my wife and daughter that I had to fill them out. The forms were an incident statement plus an indemnification form that would have absolved Walmart of all responsibility.

I was still in shock and in incredible pain, and there was no way for me, or any of us, to evaluate the legal ramifications of the forms, especially since they were in Spanish which I cannot read. I was concerned about one thing and one thing only — staying alive. What brainpower I could muster was focused on that. In the emergency room, my wife and I had an “if I die” conversation. We were both incredibly scared that I was going to die. That is not a conversation that I wish upon anyone.

This intrusion by Walmart interfered with our need to concentrate on my condition and care, and heightened our anxiety and fear.

I did not fill out or sign either of the forms. (The dates on the incident statement were written by the Walmart employee; he coerced my daughter-in-law into writing my name on the bottom line.)

• Is asking people to sign an indemnification form while they are in the middle of actively dealing with a life-threatening injury a standard policy when somebody is injured at a Walmart?
• Are these forms standard when somebody is injured at a Walmart?
• Where did the forms come from? Who created them?

Walmart’s interference continued through the rest of my hospital stay, delaying tests and care and possibly making my condition worse.

Multiple times, we were told that Walmart needed to approve a test or other medical care before it could be carried out. It appears that Walmart communicated directly with the hospital about my care throughout my stay. Unfortunately, we do not have direct knowledge of what was discussed in those communications, so we do not know the full extent to which Walmart interfered with my care.

The hospital told us that they had to give access to Walmart because they were paying for my care (I don’t know if this is true in Guatemala; it is definitely not true here in the US). This happened despite the fact that the hospital had been told repeatedly and therefore should have known that Walmart wasn’t paying for any of my care. We had signed a written declaration that we were paying, which we affirmed multiple times. Walmart did not pay for any of my care costs at any time.

At one point, Walmart’s interference delayed an MRI at at outside facility for hours. Eventually, we were told that the hospital was waiting on Walmart’s approval. At the same time, two Walmart representatives showed up in my hospital room without any authorization or invitation, and without identifying themselves as Walmart employees. We figured out who they were only after the nurse’s station told us they were not associated with the hospital. At that point, we realized that one was wearing a Walmart employee badge on a lanyard (front and back of badge, partially redacted to protect the employee’s privacy). When we realized who they were, we told them to leave, and they left my room but not the hospital. When my daughter confronted them, they told her that they were waiting to accompany us to the MRI facility. My daughter repeated that Walmart did not have permission to access my health information and told the Walmart employees to leave the hospital. We do not know if they actually left, but we did not see them again. The process of getting the MRI started in the morning and I ended up getting to the facility after 6:30 PM, barely getting there before it closed for the day.

• Why did Walmart tell the hospital that they were paying?
• Did the hospital tell Walmart that we were paying and, if so, why did Walmart continue to insist to the hospital that they were paying?
• Why did Walmart communicate with the hospital about my care? Are such discussions standard policy when somebody is injured at a Walmart?
• What did Walmart discuss with the hospital??
• Why did Walmart cause tests and care to be delayed? Is this standard policy when somebody is injured at a Walmart?
• Did Walmart employees lie to hospital staff in order to gain access to my private care information?
• Did Walmart employees lie to hospital staff in order to gain access to my hospital room? How did they even know what hospital room I was in?
• Why did Walmart employees think they were going to accompany me to my MRI?

We signed a payment form in the emergency room, yet somehow the hospital thought that Walmart was paying. When Walmart delayed the MRI test, we went to the finance office and once again made it clear that we, not Walmart, were paying for all of my care. We also paid Q10,000 (around $1,300) as an initial payment, yet somehow the hospital thought that Walmart was paying.

We did not want Walmart paying because we did not know if there were any legal ramifications of them paying.

When my wife went to pay the final bill before I could leave the hospital in order to return to the US for continued care, the cashier in the finance office told us we didn’t owe anything and we couldn’t pay our bill because “Walmart was taking care of everything.” This final delay happened while an ambulance was waiting to take me to the airport.

Walmart did not pay for any of my care costs at any time.

• Did Walmart want to pay the costs of hospitalization because they thought doing so would create an implicit indemnification, or an actual indemnification under Guatemalan law?
• How was it that, despite repeated assurances that we were paying the entire hospital bill, and the fact that we made an advance payment of Q10,000, hospital staff kept believing that Walmart was paying?
• Why did the hospital listen to any of Walmart’s instructions without my consent?
• Was Walmart interacting with the hospital staff on a regular basis behind our backs and repeatedly contradicting our assurances that we were paying? Is this standard policy when somebody is injured at a Walmart?

My injury was both life-threatening and permanently life-changing. From the moment it happened, I needed professional, knowledgeable care focused on my well-being, condition, and recovery.

Walmart’s interference with my hospital care and treatment was active, ongoing, and intentional. Walmart employees told me things that they either knew were false or that they should have known were false. It looks like they sent somebody with us to the hospital to spy on us, and they lied about the reason they were sending him with us.

Walmart effectively took away my ability to make decisions on my own behalf and the decisions they made were not correct decisions given the severity of my injury. Walmart employees made decisions on my behalf, without telling me they were doing so. Their decisions contradicted my explicitly expressed interests, and certainly seemed to be intended to be for Walmart’s benefit, not mine. Their actions meant my trip to the hospital was much more dangerous and risky than it should have been, and it may have exacerbated my injury. Their actions delayed at least one procedure at the hospital and may have delayed or interfered with other procedures and treatments.

Walmart’s relentless interference with my hospital care and treatment added to our fear, anxiety, and stress at every level. This emotional stress is in addition to the direct negative impacts on my health, treatment, and recovery.

It appears that Walmart is not willing to take responsibility for their decisions and actions.

I don’t want to sue Walmart. I have always considered that a last resort. I had hoped that Walmart would acknowledge what happened and how they mistreated me, and take care of me. But that isn’t going to happen. So, I am preparing to file both a civil suit and a criminal action. (Update: the criminal complaint has now been filed in Guatemala.) We plan to subpoena documents and evidence from Walmart in both Guatemala and the US which we hope will provide the answers to many of the questions asked in this document. Taking these actions in a foreign country with a different legal system is a long and difficult process, while proving jurisdiction in the US would require access to documents that we do not yet have. It’s catch-22 — if we had access to documents proving the policies originated in the US, we could file suit here, but we can’t get access to those documents until after we file suit. And, of course, Walmart isn’t going to turn any documents over willingly. I believe that Walmart is trying to take advantage of their global structure in order to prevent a fair and appropriate resolution. So, for now, we are filing suit in Guatemala.

The overarching questions are:

• Does Walmart have corporate ethics policies that should have prevented this kind of abuse from happening? If so, why were these policies ineffective and what actions were taken as a result of their violation?
• Does Walmart have corporate policies that encourage, require, or mandate the kind of abuse that happened? If so, who created these policies?
• Who is responsible for such policies and decisions?
• What involvement did Walmart corporate have in the creation, management, and application of these policies? Are they the originator of these policies?
• What involvement did the Walmart Global Ethics office have in the creation, management, and application of these policies? Are they the originator of these policies?

and:

• Does Walmart care about customers like me?
• Does Walmart care about ethics?