PO Box
New York, NY
March 23, 2013
John J. Mack
Chairman of the Board of Trustees
New York-Presbyterian Hospital
525 East 68th Street
Box 156
New York, NY 10065
Dear Mr. Mack:
In accordance with the enclosed Patient Rights and Responsibilities at New York-Presbyterian, I
am contacting you as Chairman of the Board of Trustees to grieve the matters addressed herein.
Since 2008 I have been a patient at NYP. For the most part I have had no concerns. Being a
former Administrator at both Mount Sinai and Memorial Sloan-Kettering, I value the perceived logic of
choosing physicians who are affiliated with the same academic institution. Up until 2012, I saw my
doctors typically just for routine matters without issues.
I had a few minor concerns with my primary, Suzanne Wenderoth, who was a bit absentminded.
She had refilled prescriptions electronically that she never initially prescribed. I did not realize she had
done this until I received them in the mail a few weeks later. Although she never really examined me
when I saw her for annual physicals, etc., she did do blood work and I didn’t think too much of it since I
was not complaining of anything and I trusted that, as a doctor, she would look into what may or may
not of been of concern.
During the initial consultation with her in 2008, I provided all of my records, including a CT
report from a few years prior indicating a 2CM x 3CM mass on my liver. From 2008-2012 this was never
further looked into. I had forgotten about it as well. Aside from some relatively minor GI symptoms
that I had resolved to as my “norm” I really did not have obvious symptoms from a lay person’s
perspective. Late August it came up again and it had almost doubled in size. From 2010-2012, I
experienced unexplained weight loss and this was expressed during my exams. I guess unexplained
weight loss in someone overweight is not concerning even though it is one of the symptoms of liver
masses.
Also in 2008 my back “went out” a few days prior to my initial consultation with Dr. Wenderoth.
At the time I was still working in hospital administration and had an MRI prior to my visit and was
already scheduled to begin physical therapy. Coincidentally when I went for my physical a year later, my
back went out again. That time I asked who she recommends and she referred me to Hospital for
Special Surgery. I saw a spine specialist at HSS and adhered to the recommended course of treatment
and was fortunately fine until January 2011.
January 2011 is when it seems everything simply became a mess. A few weeks after my back
went out, I started experiencing excruciating pain in my left hip area. The spine specialist had a 3 month
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wait so in the meantime I went to see Dr. Wenderoth. Also of note is that in July 2010 I saw a NYP
neurologist, Bridget Carey, for migraines. The migraines resolved a few months later. For some reason,
it never dawned on me that a neurologist treats spine issues such as herniated discs, etc., as well. When
I saw Dr. Wenderoth in January 2011 she just gave me a few prescriptions (something she was
disconcertingly generous with) and, at my request, a referral for PT. Knowing now that Dr. Carey is part
of the Spine Center, I do not know why Wenderoth did not consult with her or refer me to her. It is also
disconcerting that a NYP primary care doctor referred me to an outside, even if affiliated, institution
when there are spine specialists at NYP-Cornell.
In March 2011 I saw the spine specialist at HSS that I had seen in September 2009. He
recommended surgery. My experiences with HSS in 2011 were horrifying. Everything they scheduled
me for was always botched in some way, there was chronic miscommunication and other administrative
mishaps.
Unbeknownst to me they also were not including my NYP PCP on anything. When I had
surgery, I asked for my PCP to clear me. This was not permissible by HSS standards and instead an
internist who had only completed her fellowship 3 days prior was suitable to clear me. Sometime in
June 2011 I saw on the spine surgeon’s site that a neurologist is present for surgery. On HSS’s neurology
web site, Dr. Carey was listed as having privileges at HSS. I explicitly requested Dr. Carey be involved
with the surgery, care, etc., and was told by a PA that the web site was out dated and that a neurologist
will not be present. The PA also noted that a technician may be present. Of course, I received a bill
from a HSS neurologist who purportedly rendered services during my surgery.
It was also in June 2011 that I learned via searching providers in my insurance plan, that NYPCornell had spine surgeons and a spine center at that. I also found that NYP-Columbia has spine
surgeons so I schedule second opinions at each. The NYP-Columbia spine surgeon recommended the
same as the HSS surgeon but was not able to schedule it similarly to when it was scheduled at HSS.
Having two consistent opinions, I did not pursue the last appointment with NYP-Cornell.
In July 2011 I had the spine surgery. There were some long lasting symptoms of dizziness and
fainting, etc., which after doing an MRI in August 2011 the spine surgeon said it was not lumbar so it
wasn’t them and to see a neurologist. They were very dismissive and passive. They also seemed to of
forgotten that I had explicitly requested Dr. Carey be involved with my care as they asked if I had a
neurologist.
After going through the standard post-op process of 2 appointments with the surgeon, I was
referred to see a physiatrist at HSS to address the hip pain that was only resolved for about 2 months
post operatively. I could write a book about the scores of “what not to do” experiences I had with this
physiatrist and HSS in general March 2011-February 2012. After 3 months of “care” by this physiatrist
he exposed the fact that he had not reviewed relevant imaging done at HSS (Hip MRI) as he was treating
me for something it explicitly said I did not have. At that point I left HSS and sought care and guidance
from my PCP, Dr. Wenderoth.
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I saw Dr. Wenderoth in April 2012 and was very troubled by the fact that HSS, an affiliated
institution, did not copy her on care I received there despite indicating so on all the forms and releases I
completed at HSS providers. Dr. Wenderoth ordered a hip MRI. She wasn’t really sure what to do.
When the results came in, they were completely different from the one done at HSS. She was unable to
explain the differences, offer guidance, or confer with other doctors or even the radiologist. Her answer
to me was repeatedly “I don’t know”.
Not having answers or understanding, I reached out to the radiologist that signed the report and
after some helpful back and forth he suggested the pain may be nerve related. I scheduled an
appointment with Dr. Carey who had about a 2 month wait. I asked Dr. Wenderoth (left a message with
her office and emailed her via the Connect system) asking if she could possibly reach out to Dr. Carey
and see if something could happen sooner as the hip pain is not only extremely painful whenever I lay
down and limiting with simple everyday tasks, it has significantly interfered with my sleep since January
2011. I never received a response of any kind from Dr. Wenderoth. When I saw Dr. Carey in May 2012,
it was evident that Dr. Wenderoth had not bothered to reach out to her and that HSS did not include her
on my records. At that point it was apparent that it would behoove me to find a new primary care
doctor. At first I tried NYP-Cornell west side but they were not accepting new patients. Since I need a
PCP for insurance purposes, I made the difficult decision and saw a PCP recommended by a friend but
that is not associated with NYP, or any hospital that I would necessarily choose to see doctors at.
During the consultation with Dr. Carey in May 2012, it also was apparent that HSS had not
included her on any of my treatment there as I had requested. In addition to the hip pain I had
developed mid and upper back pain post the spine surgery that became worse from July 2011-May 2012
and I expressed to Dr. Carey that the new back pain is concerning as it had not improved despite 4 ½
months of physical therapy. She recommended some testing which was done in June. Since the testing
in June 2012 did not reveal anything necessarily telling, she recommended seeing a hip orthopedist to
rule out hip pathology before she would do more neuro testing. Apprehensively, as I had seen one at
HSS prior to the spine surgery, I saw not just one ortho in July 2012 but two hip orthos. They both
referred back to neuro/spine. When this was conveyed to Dr. Carey she said there was nothing she
could do, which contradicted what she had told me before referring me to ortho.
As Dr. Carey did not seem to be concerned with my mid and upper back pain and I received
several mixed messages at HSS and NYP-Cornell, I saw a neurologist my new PCP recommended. Again,
it is a doctor at a hospital I cringe at going into. His office was a mess and I’m sure OSHA would’ve
agreed but he did listen to my symptoms and ordered a thoracic spine MRI. The neurologist also
recommended a pain and rehabilitation specialist. I saw him in July 2012 and he did several injections, 7
in total.
I shared the significant findings of the thoracic spine MRI with Dr. Carey in July 2012 as I did not
want specialists at different hospitals. She responded saying there isn’t anything that can be done. Dr.
Carey recommended maintaining core strength but did not order physical therapy and she said she
hopes the injections (note: she did not order or recommend) are helpful that I was having done
elsewhere. I specifically asked for additional testing to be done to which she dismissed saying all she
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would do is prescribe pain medication, something I am opposed to taking especially when there is not
clear insight in to the source (s) of the symptoms. Having absolutely no plan, no relief, no nothing, I
scheduled a follow-up for October 2012 with her.
With no relief from 2 epidurals, 1 hip injection, 4 facet joint injections, I reached back out to my
PCP and Dr. Carey. The Pain & Rehabilitation Specialist recommended additional neurological testing
and surgical consult, especially for matters pertaining to my thoracic spine. Dr. Carey differed in opinion
and said she would only see me sooner if I would take pain medicine – that correspondence is on email
from her. As my painful hip appears to have a calcification, fluid collection of some sort, my PCP
reached out to Dr. Carey and they determined that I should have a biopsy of the area. Not surprisingly
the doctor my PCP recommended was no longer board certified and had a list of settlements and legal
actions against him longer than a child’s Christmas list. Dr. Carey had no recommendations.
I spent a week or two calling every general surgeon’s office at Columbia, Cornell, NYU, and Sinai
that participated with my insurance. From sub-specializations, not having an MRI report with findings, I
got nowhere with trying to get a consult. Asked Dr. Carey again and she did not respond. Having had
some experience professionally with interventional radiology, I contacted them and with a note from my
PCP they scheduled me. That was at NYP-Columbia and was a far less than desirable experience that
resulted in me getting off of the table mid procedure and leaving in tears due to the doctor’s patronizing
attitude.
Both the Pain & Rehabilitation Specialist and my PCP suggested surgical consult. In August, Dr.
Carey referred me to Dr. Härtl and I had to ask her several times. It took her over a week to send me
recommendations for surgical consult.
Scheduling with Dr. Hartl was difficult. The fact his office would say they would get back to me
in a few days then be aloof when I called a week later after not receiving a response only made it more
difficult. I saw Dr. Hartl in September 2012. During the initial consultation, he recommended surgery,
actually explained things that made sense relating my spine issues to hip pain (first doctor to do that),
and ordered additional imaging. Again, his office is very difficult in getting that done and it was
apparent there was a breakdown in communication amongst Dr. Hartl, his nurse, and his staff.
Finally had the imaging and I received a call from the nurse with the results. The nurse indicated
that Dr. Hartl reviewed the imaging and suggested acupuncture and physical therapy. I asked what was
different on the findings as Dr. Hartl had mentioned there would be a different surgical approach
(laterally, posteriorly, etc.) based on imaging and the nurse couldn’t explain it. Since she mentioned
acupuncture and physical therapy, I pointed out that I had 4 ½ months physical therapy, several
injections by a doctor who strongly advocates for acupuncture in medicine but who did not recommend
it for me, etc., all records I had given Dr. Carey and Dr. Hartl. I did concede that if that is truly what he
recommends, I would need prescriptions for both, which is customary. The nurse hastily responded
saying he did not issue any and that she will let him know my questions.
Over a week later Dr. Hartl called me back. I conveyed the same things I did with the nurse and
he seemed to not of been aware of them. He was traveling that day, October 7th, and said he will review
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my chart and get back to me. When I saw Dr. Carey on October 9th, she was under the impression that
Dr. Hartl was doing surgery. She even read his consultation note and said she would follow-up with him.
They spoke on October 17th and I saw him the following week where he did recommend his initial
suggestion of surgery.
During the first several weeks of October there was a lot of grueling back and forth with Dr.
Hartl’s office and I requested Patient Services as I was too taxed to deal with another office like the one
at HSS. No one responded or would give me information. Over a week later while I was on the phone
with his office, I requested it again and after being put on hold for over 5 minutes was given the
number. I reached out to Patient Services and spoke with Lorraine Baker who advised the only thing she
could do was help me schedule an appointment. I asked her for help and never heard back from her
again. Dr. Hartl gave me his cell phone number however, most of the times I did speak with him, he did
not have my records with him and could not answer questions. Based on professional experiences
working with surgeons and having great respect for them, it goes against my intuition to call a surgeon
on his cell phone when he has 3 administrative staff as well as a nurse. As things unfolded with his
office, I now see why he resorts to that.
Also from September through October I had 6 consultations related to my liver – 3 at NYU, 1 at
NYP-Columbia (doctor was fine but CUMC ER visit was horrific), 1 at MSKCC. Due to the experience at
CUMC’s ER, I didn’t even bother seeing another liver specialist there and both surgeons and liver
specialists at NYU and MSKCC recommended surgery.
The liver tumor was concerning as it had grown and after a biopsy in September I developed
longstanding abdominal pain and difficulty breathing. The spine surgery was more important to me as I
had not been able to do the simplest things (i.e., travel to Princeton, take my niece to the park, spend a
day at a museum, school, going out to eat, volunteer work, etc.) and the result of sleeplessness for over
a year were wearing on me. The liver surgery could’ve waited but eventually would’ve needed to be
done. I couldn’t fathom going through 1 major surgery just to know that I would need another one,
especially after the symptoms I experienced since January 2011 and I wanted this season, any needed
surgeries, to be done and behind me.
In the end of October 2012, I spoke about this with Dr. Hartl and he said that it would be
possible to do them a few days apart. Also of note is that my imaging reports were not accessible to
him to answer a few questions I had. I gave him the number to the MSKCC surgeon. A few weeks later
the nurse called me to schedule surgery and I asked what was the outcome of the doctor’s conversation
in regards to scheduling them. The nurse said they spoke but that she was not aware of the outcome.
The nurse also did not know what surgery Dr. Hartl was going to do, etc. I expressed it was important
for me to have them coordinated and I scheduled surgery for December 21, 2012 with Dr. Hartl. The
liver surgery was scheduled for December 19th. I called the following week and asked the nurse if she
had checked and she had not.
I checked with the liver surgeon as the liver surgery was scheduled since October and he could
not do the surgery earlier but he could do it a few weeks later, which was not possible due to the time
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that would entail. I did not want anything with the liver surgery to directly or indirectly affect the spine
surgery (i.e., needing part of a rib removed, delaying recovery treatment such as PT, etc.). I spoke
about these concerns the first week of December and I saw my liver surgeon for a consent appointment
a few days later where he did additional imaging. The imaging indicated that, contrary to initial findings,
the surgery could not be minimally invasive and would need to be open. With this in mind, I contacted
Dr. Hartl to cancel the December 17th surgery and designated a friend to work with his office in
rescheduling it. It was rescheduled to December 31st.
I had the liver surgery on December 19th and was discharged on December 25th. On December
26 I contacted my insurance company to ensure things were in order for the spine surgery and nothing
was on file. I then contacted Dr. Hartl’s office who bounced me around and said Dr. Hartl would be
calling me. He did call me that night and said that he had decided not to do the surgery. Although I
went through the process of undergoing the surgical clearance December 17th (nothing like running
around planning and preparing for 2 surgeries) and it was submitted to the office on December 19th by
my PCP, the office never bothered to notify me, my designee, or my PCP that it was not happening.
th
Completely bamboozled by the experiences with Dr. Hartl’s office, I made a few comments via
Twitter, which were ironically followed up on by Patient Services. I spoke with Loreen Acevedo the
second week of January 2013 and shared all of my concerns with her. It seemed as though NYP
dismissed my concerns as during the second conversation with Loreen she had taken most of the
concerns I had shared and put them in an inaccurate context.
On December 26th, Dr. Hartl recommended seeing a physiatrist he works with, Dr. Radecki,
noting he would manage my spine care. He noted that he would be ideal for determining the source of
the pain and other symptoms. I saw Dr. Radecki on January 15th. Dr. Radecki referred me back to Dr.
Hartl noting there was nothing he could do pertaining to the Thoracic spine. He would not even
examine my hip area despite the concerns and details I shared and said that nothing was on the imaging.
Being able to see and feel something doesn’t seem to count if it isn’t on imaging according to him. He
ended the appointment suggesting a L3-L4 nerve block might be helpful for some of the lumbar pain and
that he would speak with Dr. Hartl regarding the thoracic spine as there was nothing he could do.
After this appointment I reached out to Loreen again, completely frustrated that there was no
collaboration between the purported co-directors of the Spine Center as Dr. Radecki clearly said he had
no idea Dr. Hartl suggested he would be helpful with thoracic spine issues. I also clearly expressed
concern to both her and Dr. Hartl that while I would do the block Radecki recommended, it was very
disconcerting that nothing else was being looked into simultaneously.
About a week went by and still no guidance with my concerns. So I scheduled an appointment
with Dr. Radecki for February 4th to seek clarity, see if he and Dr. Hartl spoke, etc. They had not spoken.
Dr. Radecki offered no advice or guidance related to my concerns of how nothing else was being done to
look into my thoracic spine, hip pain, etc. He ordered a hip MRI but still refused to examine it.
Reluctantly I had the L3-L4 nerve block he recommended on February 19th. That procedure
address solely lumbar spine pain and lateral hip pain, not anterolateral hip pain as he said it potentially
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could. Again, Dr. Radecki said there was nothing he could do and deferred to Dr. Hartl. He did
recommend Pain Management to which I said I do not want to take medications as I could never do
what I desire to do dependent on such things. Although, I can’t do anything now so what really is the
difference besides conviction? Dr. Radecki never clarified that Pain Management at Cornell includes
Anesthesiologists, etc., who do the very procedures Dr. Hartl told me Dr. Radecki would do – I found
that out on my own on February 27th by making an appointment with “Pain Management”. Ironically, I
had done so more to prove my point that they are not helpful to those who will choose not to become
dependent on medications.
On February 27th I saw Dr. Ahmed. During this visit I was surprised to learn that he does what
Dr. Hartl told me Dr. Radecki does and which Dr. Radecki never bother to clarify. Dr. Ahmed said Dr.
Hartl was managing my spine care. I did plan to move forward with a thoracic injection with Dr. Ahmed,
but that could not be scheduled for a month later. Frustrated that yet another month would go by
without anything else being looked into and being repeatedly told conflicting things, I emailed all three
doctors. Dr. Radecki deferred to Drs. Ahmed and Hartl. Dr. Ahmed never responded although a fellow
did eventually contact me and deferred me to Dr. Hartl for spine care, looking into my neurological
symptoms, etc. Dr. Hartl or his office have simply responded by not answering my questions, deflecting
them to Pain Management and my PCP who both defer back to Dr. Hartl despite me indicating they both
deferred back to Dr. Hartl.
Since February 14th I have asked for coordination of care amongst doctors who purportedly
work together as part of the Spine Center at NYP-Cornell. No attempts have been made to address
things collaboratively and no attempts to address my symptoms collectively.
As I write this, I am scheduled for the injection with Dr. Ahmed on March 25th. While I am sure it
will most likely address any pain that may be associated with the one thoracic level he is doing, I doubt it
will be any tangible relief in light of the 12 other herniated discs and the hip/side pain, which even Dr.
Radecki feels is related to my thoracic spine. Dr. Ahmed also doesn’t address neurological symptoms
such as decreased sensation, weakness, falling, etc., in his specialty. Realistically the best result of the
upcoming injection (which would last only up to 2 weeks) still will not improve my quality of life or
enable me to sleep as it’s not even remotely addressing the hip pain. Also, with the type of liver tumor I
had, an endocrine-metabolic issue, and the effects of steroid injections are something that should be
limited. This injection will be the 10th one since July 2012, the 8th of which includes steroids.
Loreen Acevedo has snarkily said “I can’t make a surgeon do surgery” a few times to which I
have responded indicating I’m not asking for surgery (at this point I couldn’t have another one and still
expect to be employed 3 months down the road and I like my job) but for clarity, a plan, collaboration
with relevant doctors at an institution I have made my primary source of care for several years. Is it
unrealistic to ask for a purported multidisciplinary Spine Center to at least attempt to look at things
collectively? Despite NYP’s values of empathy and teamwork, these requests sent to Dr. Hartl and his
office have been ignored now for 6 weeks.
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In January 2013, I sought out a Cornell PCP in an attempt of thinking that would help in
coordinating things. Additionally, I do not enjoy seeing a doctor who insinuates things are not right,
regarded surgeons did not do a “complete job”, etc., at HSS and NYP. But it does seem that the only
doctors that have looked into my symptoms with an effort of identifying the cause (s) are those type
what I view as subpar doctors, the type of doctors I have believe are in some way or another an
abomination to medicine. A doctor should never insinuate seeking liability from other doctors. There
are also the politics in the medical community in NYC that pose hurdles in these type of situations.
I have no concerns with the other doctors I see at NYP-Cornell. Even the new internist and his
office are normal, as subjective as normal is. I’ve had no issues whatsoever with the endocrinologist,
dermatologist and obg I’ve seen since 2008. I’ve had no issues with the 3 doctors I saw at NYU for the
liver tumor or the liver surgeon I saw at MSKCC. No issues 6 days in the hospital following the liver
surgery. I had no concerns with Dr. Carey when I saw her in 2010. However, the experiences since April
2012 send very, very mixed messages.
Throughout this process I have reached points of utter frustration and anger. Patient Services
has never stepped in and functioned as a medium for nor during visits I’ve had since I reached out to
them, etc. They only reviewed two of the concerns expressed to them.
These experiences at HSS and NYP-Cornell have led me to, at times, doubt myself, which
resulted in recording appointments and conversations. I couldn’t believe what I was experiencing,
doubted what I did or did not express to a doctor as there truly is no other reason why doctors would be
so apathetic, seem almost negligent at times, and non-collaborative with other doctors. Unfortunately
the few things I did record prove that many of the encounters with NYP-Cornell have been just that and
not because I failed to clearly express something.
There are very few doctors with thoracic spine expertise. Fewer yet are in NYC. The one with
the most experience, and the most related research, is Dr. Hartl. Working in higher education, I have
access to all of the medical research resources NYP does and do not form these conclusions via Google.
No other doctor in this city has done a fraction of the research he has done for thoracic disc disease and
his profile indicated he works with specialists, yet I have not experienced that. If my case has been
presented a few monthly spine conferences at Cornell, none of the doctors have ever been on the same
page at the same time as result of it.
It goes against my own judgment writing a letter this long. But I do so out of complete
desperation to hopefully help me understand these experiences and for guidance, ultimately desiring
these matters to be reconciled enabling me to move forward, hopefully at a hospital I have considered
my primary source of care since 2008. At this point there are so many questions based on these
experiences. Questions such as:


Is it mere coincidence that since I reported these concerns to Patient Services, that I
have been ignored by Dr. Hartl’s office?
Is it mere coincidence that since the Privacy office addressed a matter of one of Dr.
Hartl’s staff sending me a different patient’s records on February 20th that the
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

questions I have been asking have went unanswered, that no direction in care has been
rendered? I reported the matter to the Department Administrator in October 2012. On
February 20th, the employee at fault, called me to ask me to destroy it.
Why did it take NYP 4 months to look into and rectify a breach of privacy matter and
disclose to the employee which patient that reported it?
How should such things be interpreted?
Adding to these demoralizing experiences, the response from Patient Services received this
week did not even address half of the concerns expressed. The response is enclosed. Inaccuracies are
highlighted and are accurately mentioned elsewhere in this letter. I’ve also enclosed several other
documents and emails, highlighting things of interest to aforementioned experiences. Also attached
are statements from both the American Board of Neurological Surgery and the American Board of
Physical Medicine and Rehabilitation (Physiatry).
Thank you and the Board for your time and consideration into these matters. Please feel free
to contact me with any questions.
Sincerely,
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