Charlotte Observer, The (NC)
2008-02-08
Section: MAIN
Edition: ONE-THREE
Page: 1A


QUESTIONS LINGER ABOUT DISMISSAL OF ALS EXPERT
NEW CENTER DIRECTOR ARRIVES AMID FOUNDING DIRECTOR'S PENDING LAWSUIT
KAREN GARLOCH, KGARLOCH@CHARLOTTEOBSERVER.COM


A new director is about to start work at Carolinas Medical Center's ALS center, even as longtime patients continue to complain about the abrupt firing of the center's founding director.

Dr. Jeffrey Rosenfeld, fired last May, remains in Charlotte, searching for a job. Six months ago, he took the unusual step of suing his former employer, claiming breach of contract and defamation of character. Carolinas Medical Center has denied the allegations. Dr. Benjamin Brooks, a renowned ALS researcher from the University of Wisconsin Hospital and Clinics, will begin work later this month.

The CMC center was the brainchild of Joe Martin, a former Bank of America executive who died of ALS in 2006, and his brother, former N.C. Gov. Jim Martin. They helped raise $3 million to create a place where ALS patients could get "the best care in the world" without having to travel out-of-state, as Joe Martin did when first diagnosed in 1994.

ALS is short for amyotrophic lateral sclerosis, an incurable neuromuscular disorder, also known as Lou Gehrig's disease.

Since Rosenfeld's firing in May, some ALS patients have criticized the hospital for removing the doctor, whose reputation drew patients from around the country to Charlotte.

"We all feel (the hospital) has done us wrong," Kenneth James of Marshville wrote in an e-mail to the Observer.

James, who has been diagnosed with ALS and cannot speak, acknowledged that new director Brooks is well-liked by patients in Wisconsin. "But no matter how good he is, he will never measure up to what we had (with) Dr. Rosenfeld."

Hospital officials say they're excited about the arrival of Brooks, whom they describe as "a world leader in ALS."

But Brooks has had his own problems in Wisconsin. University officials closed his ALS research lab there in 2003. They alleged his lab workers were poorly trained and supervised and that students and others had access to confidential patient files.

Many of Brooks' patients rallied behind him, urging the university to reopen the lab. In a lawsuit that was later dismissed, Brooks claimed the lab was closed because he had spoken out against actions by the neurology department chairman.

Brooks, who had remained on the faculty at Wisconsin, told the Observer the allegations against him were "totally trumped up," the result of "strong personalities wanting to go in different directions."

CMC spokesman Scott White said hospital officials investigated the Wisconsin incident. "We can't find that there was any gross negligence involved at all."

Pending lawsuit

Rosenfeld, 50, was also highly touted when he was hired in 1998 as the first director of the Carolinas Neuromuscular/ALS Center. He had worked at the University of Connecticut, Johns Hopkins University and Emory University. At the Charlotte center, Joe Martin would become one of his patients.

Hospital officials gave no explanation for Rosenfeld's firing, citing privacy laws. But the doctor's lawsuit, filed in August, provides some details.

In the suit, Rosenfeld, who was also CMC's neurology department chairman, accuses the hospital of "bad faith breach" of his contract and "reckless and intentional defamation" of his character.

Rosenfeld's suit says he was called to a meeting by Dr. James McDeavitt, senior vice president for education and research, on May 3 about "misconduct." The suit says McDeavitt claimed Rosenfeld's performance of physical examinations on some medical students, as part of his teaching practice, was "somehow inappropriate."

In the suit, Rosenfeld denies improper conduct and claims the hospital has engaged in a "campaign to destroy (his) reputation in the medical community."

In its October response to the suit, CMC denied that claim and explained that it had received complaints from female students who alleged Rosenfeld "engaged in inappropriate physical contact during their examinations."

Charles Johnson, the hospital's lawyer, said he could not comment on the pending lawsuit.

Teaching technique

The dispute centers on one of Rosenfeld's methods of teaching students how to conduct physical examinations to diagnose medical problems.

Faculty doctors at Carolinas Medical Center provide clinical education for third- and fourth-year students from UNC Chapel Hill medical school. The educational program is under particular scrutiny because CMC and UNC are in talks about creating a branch campus in Charlotte.

Traditionally, students examine each other or examine patients under faculty supervision to learn good techniques. They may also examine healthy volunteers.

Rosenfeld also offered students the option of being examined by him so he could demonstrate the proper method. The doctor-student exams were "only performed at his student's request," the suit said, and always with a third person present, unless the student declined a chaperone. Feedback from students showed the exams were an "incredibly useful teaching tool," the suit said.

Interviews with officials with several medical schools indicate professors sometimes demonstrate exam techniques on students, but usually in group settings.

Dr. Edward Buckley, interim vice dean for medical education at Duke University, said demonstrating proper technique sometimes involves touching a student. "This is done with their permission, in groups, and under the same guidelines as everyday medical practice."

Rosenfeld told the Observer that, by offering to examine students who asked, he hoped to help them "be aware of the total health of the patients." He said he showed them how to integrate a neurological exam with a general physical exam so they wouldn't miss underlying health conditions. For example, he said, he might have listened to heart and lungs or examined for enlarged lymph nodes, but did not perform gynecological exams.

The exams "were comprehensive, but completely standard," he said. "I didn't do anything out of the ordinary."

Expressions of support

Ruth King, who worked with Rosenfeld as a clinical researcher and practice manager at CMC for nine years, said she was aware of his teaching techniques during that time, which included the use of a female chaperone.

And she said she saw students' anonymous evaluations of him, which always rated the experiences as excellent. She said she never saw or heard of a complaint about the doctor's behavior.

"I stand behind him 100 percent," said King, who left CMC in July. "I don't believe there's any way that those allegations could be true."

Rosenfeld's lawyer John Buric said that the nurse who chaperoned Rosenfeld's student exams has been forbidden by the hospital, where she remains employed, from speaking to him or Rosenfeld.

Patients and families, although unaware of the reasons for Rosenfeld's dismissal, say it was mishandled by the hospital.

Jan Suddath of Denver, N.C., said she was surprised to read of Rosenfeld's firing in the newspaper and didn't receive a letter from the hospital until two months later. She praised Rosenfeld for creating a "very family-type, hopeful place."

Suddath's husband, Gary, 45, can't move or talk because he's in the late stages of ALS. She said he "took a horrible turn for the worse" after Rosenfeld left.

"It sucked a lot of hope out of him. Dr. Rosenfeld was all about hope and not giving up."

Karen Garloch: 704-358-5078

Dr. Benjamin Brooks

New role: Director, Carolinas Medical Center's ALS center.

Most recent title: Professor of neurology, University of Wisconsin School of Medicine and Public Health.

Education: Harvard Medical College, 1970; internship and residency at Boston City Hospital, Massachusetts General Hospital, National Institute of Neurological Disorders and Stroke; fellowship at Johns Hopkins Hospital.

1. Rosenfeld 2. Brooks