Caregivers challenge hospital’s handling of patient issues
Complaints center on move of chief of endocrinology.
by Jennifer Katz

Sandy Thomas, of Chestnut Hill, and Phyllis Levitt, of Mt. Airy, have a bond that many women their age can relate to – their lives have made that third quarter shift from caring for children to caring for elderly parents. Both women are the primary caregivers for their 90-something mothers.

Levitt has her mother, Mildred Levitt, home with her full-time, where she and a hired nurse take turns caring for the 95-year-old woman. Thomas’s mother Ethel Dorfman, 94, lives at The Manor of Chestnut Hill.

For Thomas and Levitt, 2009 has been a year of trips to Chestnut Hill Hospital with their mothers. Dorfman was admitted five times in two months earlier this year. Levitt was admitted three times in 2009.

A mutual friend, Cassie Frazier also had her share of visits to the hospital with her mother, Catherine Miller. Miller succumbed to pneumonia and a pre-existing heart condition on Oct. 2. She was 93.

The three women have met regularly throughout the fall. They realized they had very similar experiences with the staff and care at the hospital.

“My experience there showed me that you can’t rely on the hospital staff to take time or care to do due diligence,” Thomas said.

All three women’s mothers were admitted with pneumonia several times. All three were treated and, when their conditions improved, were sent home within days – until the last time.

Dorfman was released in February only to return a month later. Levitt said her mother was administered a dosage of medication five times that of the recommended amount. Frazier said her mother was given a medication she was allergic to, which was switched before she had a heart attack and died days later.

There has not been a single lawsuit filed by any of these women. As Frazier said, “My mom was 93, she had a heart condition.” What seems to bother them most is the care, or lack thereof, their mothers received while in the hospital.

To address her concerns, Levitt met with the hospital’s chief medical officer, Dr. John Scanlon. She said he admitted that the hospital failed her mother.

“He said to me, ‘I failed you. We failed you,’” she said.

Thomas, who witnessed the conversation between Scanlon and Levitt, said she was hopeful they would be able to open a dialogue with the hospital to make changes.

When Mildred Levitt’s condition failed to improve and, in fact, was deteriorating during her March visit to the hospital, Phyllis became distraught.

“My children flew in from all over – we thought she wasn’t going to make it,” she said.

Phyllis was spending everyday at the hospital, waiting and wondering, worried and upset, fearing the worst. She walked down to the office where her mother’s endocrinologist, Dr. Karen Agersborg, practiced at the hospital.

“She took one look at me and said ‘What’s wrong?’” Phyllis remembered.

Agerborg had been treating Mildred Levitt since she came to Chestnut Hill Hospital from Riverside Regional Hospital, just two years out of her fellowship. Agersborg, 47, went to medical school a little later than some. She spent 10 years working in pharmaceutical sales before attending medical school in her late 30s. She has been in practice now for almost seven years.

When she saw Phyllis in the hall that day she was surprised to learn that one of her patients was in the hospital – no one had told her. Agersborg decided to check in on Mildred and discovered that she was being given too much of the medicine, Synthroid, that she was prescribed. At 125 mg, the dosage was five times that of the prescribed amount.

“She was at a grossly elevated level,” Agersborg said.

Once the dosage was corrected, Mildred Levitt’s health improved and she was sent home.

“She saved my mother’s life,” Phyllis said.

The hospital administration did not share Phyllis’ enthusiasm for Agersborg’s intervention, or at least that is how both Levitt and Thomas have perceived what happened next.

By October, Agersborg was feeling the tension with the hospital administration. While she does not accuse the hospital of retaliating against her for finding the error in the Levitt case, she said she received a cease and desist letter that she was no longer to see patients under the Chestnut Hill Endocrinology practice.

She was allowed to retain her title as Chief of Endocrinology and set up as a private practice, but her office was moved, her patient files retained, and a new doctor was hired.

At first, Thomas and Levitt assumed that the hospital would allow Agersborg to keep her patients. Although they were disappointed at the course of events, they were sure their mothers would remain under her care, but it was not that simple.

In the weeks following the change at Chestnut Hill Endocrinology, Thomas and Levitt said, patients were confused, care lapsed and anger rose as the hospital tried to stay one step ahead of the momentum and Agersborg’s supporters were gaining.

Thomas took out an ad in the Local announcing Agersborg’s new practice after she said the hospital failed to acknowledge the change to patients. Thomas said a letter sent announcing the arrival of Dr. Claresa Levetan made no mention of Agersborg. For weeks, patients would call to make appointments with Agersborg only to be given appointments with Levetan. According to patients other patients showed up for previously scheduled appointments to find themselves with a new doctor. And still other patients were stonewalled when asked for Agersborg and missed key appointments and shots.

At the end of September, Thomas showed up at the Main Street Fair handing out fliers she made announcing Agersborg’s new practice.

Although she said the bold move brought her unpleasant attention from hospital administrators — she said they threatened to call the police — she was able to get enough fliers into people’s hands that she began receiving phone calls from other disgruntled patients.

Kenneth Morgan, of Lafayette Hill, was Agersborg’s patient. In a letter to Scanlon, Morgan called the hospital’s handling of Agersborg’s practice “systematic sabotage.” He said he was unable to receive care during the transition and missed several weeks worth of testosterone injections. According to Morgan, the hospital removed all equipment from Agersborg’s office, and her patient files, making it impossible for her to continue care until they returned the files.

Morgan said that during the two-week transition between closing Agersborg’s office and opening Levetan’s office, patients were without care.

It took a series of e-mails between Thomas and Brooks Turkel, the hospitals chief executive officer, to get the hospital to issue a second letter alerting patients to Agersborg’s new office and its whereabouts. Further, Thomas said she had to tell Turkel to have the staff, now Levetan’s staff, provide patients with information about Agersborg.

“When patients would call, they weren’t allowed to say anything about Dr. Agersborg,” Thomas said.

Thomas has received many phone calls from patients and family members complaining about how Agersborg’s “move” was handled as well as patient care issues at the hospital.

Hospital administrators declined to be interviewed but issued a statement in response to submitted questions that said Agersborg’s patients were notified. They were, but only after Thomas twisted Turkel’s arm.

What continues to concern these women is a perceived lack of attention to detail. One basic principle that seems to be ignored, said Thomas and Levitt and reiterated by Agersborg, is bringing in patients’ doctors. Both Thomas and Levitt said they had to inform their mothers’ doctors that they were in the hospital. It’s a practice Agersborg said she hasn’t seen ignored before.

“They don’t consult with specialists,” Agersborg said, “If you don’t know what’s going on, you get help.”

In its statement, the hospital said its practice is to notify the patient’s primary care physician and that a specialist may be called if the attending physician determines it is necessary.

Not good enough, Thomas said.

“When I saw how they treated Karen and started getting the calls about how other patients were treated, I decided there has to be something we can do about it,” Thomas said.

She and Levitt are forming a patient advocacy group, focused on working to ensure patients’ rights are respected. Frazier said she is still upset over her mother’s death, but does not blame anyone. She said she is not ready to become part of an advocacy group.