Gateway restart did not erase the sync backlog: unsynced `buffered_sync_items` count remained at 5 through the container restart because the ward PostgreSQL database is independent of the API process lifecycle. After central API was restarted, sync resumed automatically — all three experiment observations (`gateway-restart-exp6-1782246096-*`) appeared on central and the buffer drained to 0 within 120 seconds. This validates the UPS + ward-server deployment model: brief gateway process restarts (deployments, OOM kills) do not lose clinical events already accepted at the bedside.