RE: In the Matter of Person and R-T estate - Petition [ URGENT]

Joel Snavely
  
To: Uta v. Eckartsberg
1 hours ago Show Details 

Ms. Von Eckartsberg,

The petition is attached. Please open the zip file with the password I will send you in a separate e-mail.

Joel M. Snavely
Quinn Law Firm
2222 West Grandview Boulevard
Erie, PA 16506
(814) 450-5396 (cell)
(814) 833-2222 (main telephone)
(814) 314-1073 (direct)
(814) 833-6753 (facsimile)
jsnavely@quinnfirm.com
- - - - - - - - - - -(mailto:jsnavely@quinnfirm.com)
---- -------

The information that is contained in this email and any attached documents is privileged and/or confidential and is intended only for the
use of the addressee(s) named above. Note that any unauthorized disclosure, copying or distribution of this transmission is prohibited. If
you have received this communication in error, please notify the Quinn Law Firm immediately by email or telephone (collect) and delete
all copies of the email and any attachments immediately.
P Please consider the environment before printing this email.

From: Uta von Eckartsberg <uvoneck@outlook.com>

Sent: Monday, April 29, 2024 3:05 PM
To: Snavely, Joel <JSnavely@quinnfirm.com>
Cc: Rolf-tonio Von eckartsberg <rolf_tonio@yahoo.com>
Subject: In the Matter of Person and R-T estate - Petition [ URGENT]

Mr. Snavely: I found an approximate 200 page opus in my brother’s mailbox. Given the critical illness of my brother, I am sure you will understand that I have not yet managed to get through it. Also the version in my brother’s mailbox is not

Mr. Snavely:

I found an approximate 200 page opus in my brother’s mailbox. Given the critical illness of my brother, I am sure
you will understand that I have not yet managed to get through it. Also the version in my brother’s mailbox is not
sequentially numbered so much of what I have seen appears to be out of order, in duplicate or incomplete.
Neither I nor my brother are represented by counsel at this time.

I ask that you forward to me as a pdf attachment the entire, date stamped petition as filed at your very earliest
convenience. I note you describe yourself as counsel for St Vincent. Is that accurate? I understand that St
Vincent was acquired by AHN in approximately 2012…? Thank you in advance for your prompt attention to this
urgent matter.

https://inbox.proofpoint.com/securemail/Main.html?state=ewogICJ0aWQiIDogImFjZDhjY y00ZDRlLWFhYTAtMzJlNTQxMzM1ODJmIiwKICAicHBBcHAiIDogIlNlY3VyZSBNYWlsIgp9 4/29/24, 5 54 PM

Page 1 of 1
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 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

PETITION FOR THE APPOINTMENT OF AN EMERGENCY

AND PLENARY GUARDIAN OF THE PERSON AND THE ESTATE IN
ACCORDANCE WITH 20 PA. CONS. STAT. ANN.§ 5511 AND§ 5513 AND TO
REMOVE HEALTHCARE AGENT PURSUANT TO 20 PA. CONS. STAT. ANN.§
5454

AND NOW, comes the Petitioner, Saint Vincent Health Center, d/b/a Saint

Vincent Hospital, by and through its agent, Debra Chapman, BSN, RN, and its

attorneys, Quinn, Buseck, Leemhuis, Toohey & Kroto, Inc., and files this Petition for the

Appointment of an Emergency and Plenary Guardian of the Person and the Estate of

Rolf Tonio Von Eckartsberg, pursuant to 20 Pa. C.S.A. § 5511 and § 5513 and Petition

to Remove Healthcare Agent pursuant to Pa. C.S.A. § 5454, and in support thereof

states the following:

1. Rolf Tonio Von Eckartsberg (hereinafter "Alleged Incapacitated Person") is

an adult individual who was residing in a home at 311 Kelso Drive, Erie, Pennsylvania

16505. The Alleged Incapacitated Person currently is admitted to Saint Vincent Health

Center, d/b/a Saint Vincent Hospital.

2. Saint Vincent Health Center, d/b/a Saint Vincent Hospital (hereinafter

sometimes referred to as "Petitioner" or "Saint Vincent Hospital") has been providing

medical services for the Alleged Incapacitated Person and has a principal place of

business located at 232 West 25th Street, Erie, Pennsylvania 16544.

1
 3. The Petitioner requests that The Proposed Guardian is Karen M. Karle,

BSW, NHA, and CGCM be appointed as the Emergency and Plenary Guardian of the

Person and the Estate of the Alleged Incapacitated Person. Karen Karle is a licensed

nursing home administrator who has her Bachelor of Social Work and also is a certified

geriatric care manager. Ms. Karle currently is the personal care home administrator of

Spring Hill-Asbury. Ms. Karle has extensive experience in healthcare, has experience

in serving as a guardian, is qualified to become a certified guardian, and will take her

certification test before the June deadline. Ms. Karle understands the legal

responsibilities of an emergency and plenary guardianship and is capable of handling

the same.

4. The Alleged Incapacitated Person had lived at home although he has

undergone other recent treatment and has had other recent hospitalizations because of

his medical condition.

The Alleged Incapacitated Person's Medical Condition and Treatments

5. The Alleged Incapacitated Person's medical conditions are caused by

uncontrolled HIV/AIDS, which are the result of non-compliance with medications.

6. The Alleged Incapacitated Person was admitted to Saint Vincent Hospital

on February 26, 2024 as a transfer from Millcreek Community Hospital.

7. The Alleged Incapacitated Person had been admitted to Millcreek

Community Hospital on February 5, 2024 for respiratory distress. The Alleged

Incapacitated Person was treated for presumed pneumocystis pneumonia. The patient

then became unresponsive and had seizure-like activity on February 25, which resulted

2
in him having been intubated and then transferred to Saint Vincent Hospital on February

26.

8. At Saint Vincent, hospitalist Avais Raja, M.D. performed the February 26,

2024 history and physical, which is attached hereto as Exhibit A.

9. Doctor Raja noted in part that he had had a conversation with the Alleged

Incapacitated Person's sister, who is Uta Von Eckartsberg. Doctor Raja noted that Ms.

Von Eckartsberg had instructed Doctor Raja to call to give updates and that she will not

initially pick up so please call multiple times.

10. Doctor Raja further noted in the history and physical that his assessment

included acute metabolic encephalopathy and leukoencephalopathy (disease of the

white matter of the brain caused by a virus) and/or meningitis and/or uremia and/or an

anoxic brain injury. Doctor Raja noted that the Alleged Incapacitated Person had been

HIV positive since 2001, had been noncompliant with medications since 2021, had a

history of pneumocystitis pneumonia (an infection often associated with a patient who

has a weakened immune system), and has progressive multifocal leukoencephalopathy

("PML"). PML is a disease of the white matter of the brain caused by a viral infection.

11. Doctor Raja noted other conditions and ordered a number of studies and

consulted the infectious disease seNice and the critical care physicians service.

12. The Alleged Incapacitated Person was on a ventilator and was

nonresponsive.

13. During the course of the Saint Vincent admission, the Alleged

Incapacitated Person has had numerous radiology tests, laboratory tests, other tests

and consultations by specialist physicians.

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 14. A significant clinical finding for the Alleged Incapacitated Person is a

positive cryptococcal antigen test, which suggests that the agent of disease is

Cryptococcus Neoformans, which suggests that the patient rs in an

immunocompromised state.

15. The initial consultation by an infectious disease specialist took place on

February 27, 2024, when the Alleged Incapacitated Person was seen by Holly Bean,

D.O. A copy of Doctor Bean's initial consultation note dated February 27, 2024 is

attached hereto as Exhibit B.

16. Doctor Bean noted among other things that an MRI of the brain without

contrast was performed on February 27 and that it had revealed brain volume loss with

ischemic changes in the white matter and a chronic infarction in the right occipital lobe.

Doctor Bean's assessment included uncontrolled HIV/AIDS, suspected infectious

pneumonia, pancytopenia (abnormally low red and· white blood cells and platelets),

possible seizure and acute kidney injury.

17. Doctor Bean's plan included numerous laboratory studies and to consider

a lumbar puncture in order to obtain spinal fluid samples.

18. The initial. neurology consultation was performed by neurologist Harshit

Shaw, M.D. on February 27, 2024. A copy of Doctor Shaw's consultation note dated

February 27, 2024 is attached hereto as Exhibit C.

19. Nephrologist Darren Dreyfus, D.O. performed a consultation, and Doctor

Dreyfus did not find a cause for the Alleged Incapacitated Person's condition other than

uncontrolled HIV/aides.

20. Consultations and recommendations were made by the dieticians.

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 21. The Alleged Incapacitated Person also has been followed by the

intensivists/critical care physicians.

22. The Alleged Incapacitated Person continues to be regularly followed by

the hospitalists, and he also has been regularly followed by some of the specialist

physicians.

23. The infectious disease physicians have been one of the specialists who

have been regularly following the Alleged Incapacitated Person. One assessment by

Doctor Bean took place on April 3, 2024. A copy of Doctor Bean's note dated April 3,

2024 is attached hereto as Exhibit D.

24. Doctor Bean's April 3 progress note contains a record of some of the

numerous radiology studies and laboratory tests that has been performed on the

Alleged Incapacitated Person since his admission to Saint Vincent. These tests include

additional MRls of the brain, and they were performed on March 2, March 9, and March

23. The findings on these MRls have not been significantly different than the findings

revealed by the February 27 MRI.

25. Doctor Bean's note contains the fact that an EEG was performed on

February 27 and that it revealed generalized slowing suggestive of diffuse cerebral

encephalopathy.

26. Doctor Bean's progress note contains a record of a lumbar puncture that

was performed on February 28 in order to assess the spinal fluid for infectious and viral

pathology.

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 27. Doctor Bean's April 3 note also contains the fact that a tick-borne illness

panel was performed on March 6 and that a bone marrow evaluation was performed on

March 8.

28. Numerous laboratory tests were and are performed on a regular basis.

29. Doctor Bean noted that the Alleged Incapacitated Person remained

unresponsive.

30. An transesophageal echocardiogram ("TEE") was performed, and it did

not reveal a critical cause for the symptoms.

31. The Saint Vincent medical records establish that the Alleged Incapacitated

Person has had an extensive work up in order to look for abnormalities to explain his

condition and overall decline. The testing however did not reveal anything to explain his

serious condition other than non-compliance with his HIV medication and the

consequent progression of the disease.

32. The Alleged Incapacitated Person's diagnosis has been definitively made.

Nothing further can be done as far as working up the Alleged Incapacitated Person in

order to determine his diagnosis and medical needs.

33. Accordingly, an acute care hospital no longer is the appropriate facility in

which to treat the Alleged Incapacitated Person. In fact, the Alleged Incapacitated

Person no longer qualifies for acute hospital care.

34. A nursing home or similar long-term care facility is the appropriate place

for the Alleged Incapacitated Person.

6
 35. Hospitalist and internist Abege Kebede, M.D. saw the Alleged

Incapacitated Person on April 4, 2024. A copy of Doctor Kebede's progress note dated

April 4 is attached hereto as Exhibit E.

36. Doctor Kebede noted that the patient has a blank stare and is not

responsive to his surroundings.

37. Doctor Kebede's recommendation was for the patient to be transferred to

an extended care facility or skilled nursing facility. The plan of care was discussed with

the nurse, and attempts to reach Ms. Von Eckartsberg by telephone were unsuccessful.

38. Infectious disease specialist Martin Vanoort, M.D. saw the Alleged

Incapacitated Person on April 11, 2024. A copy of Doctor VanDort's progress note

dated April 11 is attached hereto as Exhibit F.

39. Doctor Vanoort noted that the Alleged Incapacitated Person was not

responsive.

40. The Alleged Incapacitated Person basically remains nonresponsive and

does not appear to even be aware of what is going on, let alone being able receive and

understand medical information.

The Healthcare Power of Attorney

41. The Alleged Incapacitated Person had executed a Healthcare Power of

Attorney dated August 13, 2004. A copy of the Power of Attorney is attached hereto as

Exhibit G.

42. The Power of Attorney provides that Ms. Von Eckartsberg is the

healthcare agent.

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 43. The telephone number listed in the Power of Attorney for Ms. Von

Eckartsberg is in fact her correct number. Ms. Von Eckartsberg will respond to this

number on occasion.

44. Ms. Von Eckartsberg has told the Saint Vincent providers that she is

staying at the Alleged Incapacitated Person's home address, which is 311 Kelso Drive,

Erie, PA 16505.

45. Vanessa Thompson is listed as the first alternative agent.

46. Ms. Von Eckartsberg has told Saint Vincent employees that Ms.

Thompson is deceased.

47. Saint Vincent was not able to find an obituary for Vanessa Thompson.

48. Debra Chapman, BSN RN, complex case manager, has tried the number

stated in the POA for Ms. Thompson as well as other possible numbers, and these

numbers have been disconnected.

49. Tobias Von Eckartsberg is listed as the second alternative agent.

50. Ms. Von Eckartsberg has represented that there is no other family for the

Alleged Incapacitated Person besides herself.

51. Attached hereto as Exhibit H is an obituary for Ms. Von Eckartsberg's and

the Alleged Incapacitated Person's mother, who was Elsa Von Eckartsberg. This

obituary, which is from the Pittsburgh Post-Gazette, provides that the father is

deceased, and that the couple had three children, who are Ms. Von Eckartsberg, the

Alleged Incapacitated Person, and Tobias Von Eckartsberg.

52. The Power of Attorney lists a Florida address for Tobias Von Eckartsberg.

8
 53. Ms. Von Eckartsberg has told a Saint Vincent representative that Tobias

Eckartsberg has passed away.

54. Upon information and belief, Tobias Von Eckartsberg recently had lived at

an addre_ss of 3509 Richert Road, Erie, Pennsylvania 16509-4343, although it appears

that he no longer lives there.

55. A current address for Tobias Von Eckartsberg cannot be found.

56. Upon information and belief, Tobias Von Eckartsberg has had a serious

stroke and is not in a position or capacity to assist with decisions for his brother's care.

Attached hereto as Exhibit I is a GoFundMe website for Tobias Von Eckartsberg.

57. In any event, Ms. Chapman has tried the number stated in the POA for

Tobias as well as other possible numbers, and these numbers have been disconnected.

The Healthcare Agent's Actions and Inactions

58. Throughout the course of the Alleged Incapacitated Person's admission,

Ms. Von Eckartsberg has been uncooperative, nonresponsive on many occasions, and

obstructive.

59. Ms. Von Eckartsberg will make accusations about the caregivers at Saint

Vincent and about the care being provided to her brother that have no basis in fact or

medicine.

60. In her written and verbal communications to Saint Vincent, Ms. Von

Eckartsberg repeatedly suggests or outright accuses Saint Vincent and some of the

providers of violating various legal requirements regarding the care that is being

provided to her brother, even though she has no basis in fact or in the law to do so.

9
 61. Ms. Von Eckartsberg continues to assert that her brother should not be

transferred to a long-term care facility and that he requires an acute care hospital and

further medical workups in order to diagnose and treat his conditions.

62. Elizabeth Levine, R.N. noted on February 26, 2024 that two attempts were

made to call Ms. Von Eckartsberg in order to have her complete a consent to have a

brain MRI performed and that there was no response to these telephone calls. A copy of

Ms. Levine's note dated February 26, 2024 is attached hereto as Exhibit J.

63. Critical care physician Anna Prishchepova, M.D. noted on February 27,

2024 at 11: 15 pm that she had not been able to reach Ms. Von Eckartsberg since this

morning and that she wanted Ms. Von Eckartsberg's consent for a platelet transfusion.

A copy of Doctor Prishchepova's February 27, 2024 note is attached hereto to as

Exhibit K.

64. Ms. Von Eckartsberg faxed a message to Doctor Prishchepova on March

28, 2024. A copy of this message dated March 28, without the attachments, is attached

hereto as Exhibit L. In this message, Ms. Von Eckartsberg asserts among other things

that Select Specialty Hospital has a critical care setup which had never been offered to

her or to the patient. Ms. Von Eckartsberg also stated that Select has the staffing and

expertise to provide the specialists and continuity of care that the patient requires.

65. Select is a long-term acute care hospital (LTACH).

66. In order to comply with Ms. Von Eckartsberg's request, Saint Vincent

attempted to have the Alleged Incapacitated Person transferred to Select Specialty

Hospital.

10
 67. Select Specialty Hospital however was not approved by the Alleged

Incapacitated Person's health insurer. A copy of the email dated April 4, 2024 from

Jennifer L. Abbott of Select to Debra Chapman, R.N., complex case manager for Saint

Vincent, along with the supporting documents regarding the denial, is attached hereto

as Exhibit M.

68. The stated reason for the denial was that Select Hospital was not part of

the health insurer's network, that the care at Select was not medically necessary, and

that a provider that is part of the network could meet the patient's needs, and this level

of care is not a covered benefit of the Alleged Incapacitated Person's insurance.

69. Saint Vincent then made an appeal of the denial, and the denial was

upheld.

70. Ms. Von Eckartsberg has not been cooperative in agreeing to meet with

representatives of Saint Vincent in order to discuss her brother's care and to plan for

future care. Ms. Chapman has offered to arrange a meeting in person or by Zoom, but

Ms. Von Eckartsberg often does not respond or otherwise is not available. In any event,

Ms. Von Eckartsberg will not agree to a meeting.

71. A case conference had been scheduled for April 3, 2024. Ms. Von

Eckartsberg had been notified well in advance of the case conference.

72. Ms. Chapman noted on April 1, 2024 that she had received several

notifications from the staff that per Ms. Von Eckartsberg the meeting that had been

scheduled for April 3 had been cancelled. Ms. Chapman further noted that she had not

been notified of the cancellation either by Ms. Von Eckartsberg or by any physician

attendees. Ms. Chapman further noted that she had asked in a letter sent to Ms. Von

11
Eckartsberg for Ms. Von Eckartsberg to call Ms. Chapman should there be any issues

or questions and that Ms. Von Eckartsberg had not done so. A copy of Ms. Chapman's

note dated April 1, 2024 is attached hereto as Exhibit N.

73. Ms. Chapman further stated in her April 1 note the fact that she had made

two telephone calls to Ms. Von Eckartsberg and had requested Ms. Von Eckartsberg to

call her. Ms. Chapman noted that she had told Ms. Von Eckartsberg in a text that the

April 3 meeting had not been cancelled, and she also asked Ms. Von Eckartsberg to let

Ms. Chapman know if she required transportation in order to attend the meeting.

74. The case conference in fact did take place on April 3, 2024. The

conference was attended by neurologist Arthur Lima, M.D.; critical care physician

Cynthia Claggett, M.D.; hospitalist Aditya Mehta, M.D.; hospitalist Abege Kebede, M.D.;

infectious disease specialist Holly Bean, D.O.; ICU nurse manag.er Jean Lindenburger,

R.N.; case manager Judy Pardee, R.N.; ICU Nurse Alicia Vega, RN.; patient

experience person Jess Bickel, and Ms. Chapman.

75. A decision was made at the case conference that the Alleged

Incapacitated Person would no longer benefit from care at an acute care hospital such

as Saint Vincent and that the appropriate facility for the patient is a long-term care

facility.

76. Ms. Von Eckartsberg did not show up for the April 3 case conference.

77. Doctor Kebede noted on April 4 that the nurse had attempted to reach Ms.

Von Eckartsberg by telephone but was unsuccessful. Doctor Kebede noted that .. a

consultation with palliative medicine was cancelled by Ms. Von Eckartsberg and that

Ms. Von Eckartsberg has been very difficult to reach through the telephone. Ms. Von

12
Eckartsberg has cancelled multiple meetings. A copy of Doctor Kebede's April 4, 2024

progress note is attached hereto as Exhibit 0.

78. Palliative care is an interdisciplinary medical caregiving approach aimed

at optimizing quality of life and mitigating suffering among people with serious, complex,

and often terminal illnesses.

79. Doctor Kebede further noted on April 4 that Ms. Von Eckartsberg had

requested a meeting with the Saint Vincent ethics committee.

80. As Doctor Kebede noted, there was no role for the ethics committee since

the patient is receiving full treatment. The issue to resolve now is the appropriate facility

in which to transfer the patient. Doctor Kebede further noted that Ms. Von Eckartsberg

was attempted to be reached again at 11 :45 a.m. and did not pick up the phone.

81. Doctor Kebede further noted on April 4 that the care team meeting on April

3 had determined that the Alleged Incapacitated Person no longer required acute

hospital care and is medically ready for discharge.

82. Stephanie Weaver, RN. noted on April 4 that Ms. Von Eckartsberg had

called at 6:10 p.m. and related that there (allegedly) were some incorrect details in her

brother's medical notes, that Ms. Weaver was changing the patient at that time, and that

she would be happy to talk to Ms. Von Eckartsberg in a moment. Before Ms. Weaver

could say anything else, Ms. Von Eckartsberg said okay and goodbye. A copy of Ms.

Weaver's April 4, 2024 note is attached hereto as Exhibit P.

83. Ms. Chapman noted on April 5 that the Alleged Incapacitated Person is

stable on his trach collar and per his physician is stable for transfer to a nursing home.

A referral list of potential facilities will be given to Ms. Von Eckartsberg. Saint Vincent

13
was waiting for Ms. Von Eckartsberg to return a call to the physicians for a discussion

about care going forward. Calls had been made by multiple physicians with no return

call from Ms. Von Eckartsberg. A copy of Ms. Chapman's April 5, 2024 note is attached

hereto as Exhibit Q.

84. Saint Vincent and Allegheny Health Network provides a "MyChart" option

in order for a patient representative to message a provider. Ms. Von Eckartsberg has

used this MyChart option to make wild accusations that are not supported by the facts

or by the medicine.

85. In a MyChart message sent on April 5, 2024, Ms. Von Eckartsberg told

Doctor Bean that she was fired, that Doctor Bean began a treatment on the patient

without Ms. Von Eckartsberg's consent, that Doctor Bean provided inappropriate

medical care, and that Doctor Kebede also is fired because he is not a hospitalist and in

fact barely finished or did not finish podiatry school. A copy of Ms. Von Eckartsberg's

April 5, 2024 MyChart message is attached hereto as Exhibit R. .

86. In fact, Doctor Kebede is a board certified hospitalist and internal medicine

physician.

87. Ms. Von Eckartsberg stated in another April 5, 2024 MyChart message

that Doctor Kabede is fired, that great harm is being caused to her brother, that her

brother is entitled to rights under federal law and that anyone who cannot provide their

credentials is fired. A copy of the second April 5, 2024 MyChart message is attached

hereto as Exhibit S.

88. Although there was no basis for this request to dismiss Doctor Bean and

Doctor Kabede, Saint Vincent agreed to accommodate this request and arranged for

14
another hospitalist and another infectious disease specialist to be assigned to the

Alleged Incapacitated Person.

89. In view of Ms. Von Eckartsberg's actions and inactions, Virginia DiGello,

DNP, Director of Care management, and Ms. Chapman transmitted to Ms. Von

Eckartsberg a letter dated March 12, 2024. 1

90. The letter was sent Gertified mail on April 12, 2024 to Ms. Von Eckartsberg

at the Kelso Drive, Erie address, and it was hand delivered to Ms. Von Eckartsberg at

Saint Vincent on Sunday, April 14, 2024 .. A copy of the letter is attached hereto as

Exhibit T.

91. In this letter, Ms. Von Eckartsberg was advised about the fact that her

request for a change in physicians was honored, that Saint Vincent would cooperate in

facilitating her request for a second opinion at another facility, that her brother no longer

requires an admission to an acute care hospital, that a list of facilities within a 50 mile

radius was included in this letter, that the request for an admission to Select has been

denied, and that she must not make inappropriate communications through MyChart.

92. Chelsea Barton, LPN noted on April 8, 2024 that Ms. Von Eckartsberg

visited in the evening from about 7:30 p.m. to 9:10 p.m., that she brought a large bag

full of papers and posters and some stuffed animals and that she continued to inquire

about care and whether different consultations were available. A copy of Ms. Barton's

April 8, 2024 note is attached hereto as Exhibit U.

93. Ms. Von Eckartsberg sent a fax to Ms. DiGello on April 12, 2024. A copy

of the fax dated April 12, 2024, without the attachments is attached hereto as Exhibit V.

1 The letter was erroneously dated March 12, 2024 as opposed to April 12, 2024.

15
 94. In this fax, Ms. Von Eckartsberg stated in part the following:

Specifically, he needs to be transferred to a critical care hospital. No one

has provided me any options for such care. Public records indicate that
only Corry Memorial Hospital is a critical care hospital. .. Because there is
only one critical care hospital within 50 miles Ameritus (the patient's health
insurer) will cover ....

As we discussed, Judy Pardee, Diane Chambers are fired for harassment,

discrimination against me, and my brother - your patient as well as for
retaliating against me indirectly by denying my brother the critical care he
needs. Also Dr. Straub is fired because she intentionally limited her
request for an exception for out of network coverage to medical
necessity ...

95. Judy Pardee is a case manager at Saint Vincent. Nobody with the name

of Diane Chambers works at Saint Vincent. Diane Chambers is a character from the

television show Cheers.

96. Ms. Von Eckartsberg sent a fax to Ms. DiGello on April 17, 2024. In this

fax, Ms. Von Eckartsberg stated in part that the Alleged Incapacitated Person is

responsive, that Diane C's notes are materially false, and that Saint Vincent has refused

to provide or has withdrawn all necessary goods and services. A copy of the April 17

fax is attached hereto as Exhibit W.

97. In fact, the Alleged Incapacitated Person is not responsive. Nor has

medical care been withheld or withdrawn.

98. The Alleged Incapacitated Person was assessed by psychiatrist Craig

Rush, D.O. A copy of Doctor Rush's April 23, 2024 consultation report is attached

hereto as Exhibit X.

99. Doctor Rush noted in part that the Alleged Incapacitated Person wakes

easily to verbal stimuli and opens his eyes, that he does not make eye contact, that his

16
eyes do not track or blink in response to stimuli, that he is unresponsive and that he

cannot participate in a standard psychiatric interview.

100. In the recommendations section of his consultation report, Doctor Rush

stated that the Alleged Incapacitated Person does not have sufficient capacity to make

treatment decisions, that he does not demonstrate an understanding of the reason for

his hospitalization, and that he is unable to take in and manipulate information about his

medical care.

101. Doctor Rush also completed an expert report. A copy of Doctor Rush's

expert report is attached hereto as Exhibit Y. In his expert report, Doctor Rush stated

that the Alleged Incapacitated Person is totally impaired with respect to all categories of

mental functioning.

102. The treatment that the Alleged Incapacitated Person is currently

undergoing includes having an endotracheal tube with an oxygen mask, feedings

through a stomach tube, and highly active antiretroviral therapy ("HAART").

HAART therapy is a medication regimen that is used to manage and treat human

immunodeficiency virus type one (HIV-1).

103. To the best of the knowledge and belief of the Petitioner, the

Alleged Incapacitated Person currently is not an active member of the armed

forces, and he is not receiving benefits or medical care from the United States

Veterans Administration.

104. To the best of the knowledge and belief of the Petitioner, there

have been no prior incapacity hearings concerning the Alleged Incapacitated

Person.

17
 THE NECESSITY FOR A NEW DECISION-MAKER FOR BOTH HEALTH CARE AND
FINANCES

105. Ms. Von Eckartsberg has not been acting in the best interest of the

Alleged Incapacitated Person. Based upon Saint Vincent's considerable

experience with Ms. Von Eckartsberg, from the time of his admission on

February 26 through to the present, there is every reason to believe that Ms. Von

Eckartsberg's inappropriate behavior will continue.

106. The Alleged Incapacitated Person's condition and diagnosis for his

condition has been determined.

107. The only reason to continue care at an acute care hospital at this

point would be to subject the patient to additional diagnostic tests and further

workup.

108. There is nothing to be gained from further workup and in fact it

would be inappropriate to force the patient to continue to undergo various tests,

which will not further clarify the clinical picture.

109. Also, the failure to transfer the Alleged Incapacitated Person to a

long-term care facility very well could result in the health insurer denying some or

all of the treatment at Saint Vincent, which will cause a financial burden to both

the Alleged Incapacitated Person and his estate.

110. Saint Vincent emphasizes that if the Alleged Incapacitated Person

would benefit from continued care at the hospital, he would remain there.

111. Since there is no benefit to the patient by remaining at Saint

Vincent, his continued admission will potentially deprive a prospective patient of

a necessary hospital bed.

18
 112. Further, Ms. Von Eckartsberg making herself unavailable for

extended periods of time is certainly not in the Alleged Incapacitated Person's

best interest.

113. In view of this situation, Saint Vincent Hospital respectfully requests

that the healthcare power of attorney be revoked and that a decision-maker be

appointed who will be responsive and act in the Alleged Incapacitated Person's

best interests.

114. Other than Ms. Von Eckartsberg and possibly Tobias Von

Eckhartsberg, the Petitioner is unaware of any other individuals who are entitled

to notice of the filings of Guardianship Reports pursuant to Pennsylvania

Supreme Court Orphans' Court Rule 14.8(b).

115. A current address cannot be found for Tobias Von Eckartsberg.

116. The Alleged Incapacitated Person cannot communicate and lacks

decision making capacity, and he cannot manage his current medical and

financial affairs.

117. The Alleged Incapacitated Person no longer requires acute care

from a hospital, but he does require skilled nursing services in a nursing home or

another appropriate long-term care facility in view of his debilitated state and

mental incapacity.

118. Due to the current medical and mental condition of the Alleged

Incapacitated Person, he lacks the capacity to make or communicate appropriate

medical decisions concerning his person and estate.

19
 119. As the Alleged Incapacitated Person is unable to appropriately

make known or communicate his wishes and properly care for himself and his

estate, there are no less restrictive alternatives available other than the

appointment of a plenary guardian.

120. The Proposed Guardian is Karen M. Karle, BSW, NHA, and CGCM,

who will have direct responsibility for the Alleged Incapacitated Person. The

Proposed Guardian's consent to serve as Plenary Guardian of the Person and

the Estate is attached hereto and incorporated herein as Exhibit Z.

121. The Proposed Guardian has no interest adverse to the Alleged

Incapacitated Person.

122. The Proposed Guardian is available and able to visit and confer

with the Alleged Incapacitated Person.

123. Such other information in support of this Petition as is required by

the provisions of 20 Pa.C.S.A. § 5511(e) is contained in Exhibit AA, which is

attached hereto and is hereby incorporated by reference.

20
 WHEREFORE, the Petitioner respectfully requests that this Honorable Court

revoke the healthcare power of attorney and direct a citation to the Alleged

Incapacitated Person and such other persons as the Court may direct to show cause

why the Alleged Incapacitated Person should not be adjudged an incapacitated person

and an Emergency and Plenary Guardian of the Person and the Estate be appointed.

Respectfully submitted,

QUINN, BUSECK, LEEMHUIS, TOOHEY &

KROTO, INC.

BY:
Joel M. navely, Esquire
2222 West Grandview Boulevar
Erie, Pennsylvania 16506-4508
#1660762 Telephone: 814-833-2222
Facsimile: 814-833-6753
Counsel for the Petitioner

21
 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION
SAINT VINCENT HEALTH CENTER
d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

EXHIBIT Z

CONS ENT

Karen M. Karle consents to act as Emergency and Plenary

Guardian of the
Person and the Estate of Rolf Tonio Von Eckartsberg, an Allege
d Incapacitated Person.

ERIE FAMILY CENTER

 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

EXHIBIT AA

PETITION CONTENTS REQUIRED BY 20 PA.C.S.A. § 5511 (E)

1. Name of alleged incapacitated person: Rolf Tonio Von Eckartsberg

2. Date of birth: February 23, 1965

3. Age: 59

4. Current residence: 311 Kelso Drive

Erie, PA 16505

5. Post Office address: 311 Kelso Drive

Erie, PA 16505

6. Names, addresses and phone numbers of:

Spouse: None
Parents: Deceased
Children: None

Siblings: Uta Von Eckartsberg

5600 Munhall Road, Apt. 309
Pittsburgh, PA 15217-2039

311 Kelso Drive

Erie, PA 16505

Tobias Von Eckartsberg

3509 Richert Road
Erie, PA 16509-4343 (Previoius address and
Ms. Von Eckartsberg has represented that
Tobias is deceased)

Nieces: Unknown
Nephews: Unknown

2
 Person or institution providing residential services:

Saint Vincent Health Center d/b/a Saint Vincent Hospital

232 West 25th Street
Erie, Pennsylvania 16544

Other service providers, e.g., doctors, social workers, etc.:

None.known

Person or entity that Petitioner ask to be appointed Guardian:

Karen M. Karle, BSW, NHA and CGCM

1714 Grist Mill Drive
North East, PA 16428-2940

7. The Proposed Guardian has no interest adverse to the alleged

incapacitated person.

8. Guardianship is sought for the following reasons:

The Alleged Incapacitated Person exhibits significant cognitive limitations

associated with his diagnosis. The Alleged Incapacitated Person is unable to
make appropriate decisions regarding his medical needs or personal and
financial affairs.

Uta Von Eckartsberg has a Health Care Power of Attorney. Ms. Von Eckartsberg
however has not acted in her brother's best interest, as set forth in this Petition.

9. The functional limitations and physical and mental condition of the alleged
incapacitated person are as follows:

Due to the Alleged Incapacitated Person's condition, as noted by the attached

physcian's affidavit, his cognitive limitations do not allow him to make appropriate
decisions regarding his medical needs and personal affairs and are unlikely to
improve without appropriate care and treatment.

10. The specific areas of incapacity over which it is requested that the
guardian be assigned powers are as follows: •

The Petitioner specifically requests emergency and plenary guardianship of the

person and the estate of the Alleged Incapacitated Person.

3
11. The qualifications of the Proposed Guardian are as follows:

Karen Karle is a liscensed nursing home adminstrator who has her Bachelor of
Social work and also is a cerified geriatric care manager. Ms. Karle currenlty is
the personal care home administator of Spring Hill-Asbury. Ms. Karle has
extensive experience in healthcare, has experience in serving as a guardian, is
qualifed to become a certified guardian, and will take her certification test by the
June deadline. Ms. Karle understands the legal responsibilities of an emergency
and plenary guardianship and is capable of handling the same.

12. If a limited or plenary guardian of the estate is sought, the gross value of
the estate and net income from all sources to the extent known is as
follows:

Monthly Social Security Income - $Unknown

Gross Estate - $Unknown

4
 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTArE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

VERIFICATION

I, Debra Chapman, BSN, RN, Employee of Allegheny Health Network - Saint

Vincent Hospital, Petitioner in the above matter, depose and say that the facts set forth

in the foregoing Petition for Appointment of Emergency and Plenary Guardian of the

Person and the Estate are true and correct to the best of my knowledg~, information, and

belief. This statement is made subject to the penalties of 18 Pa.C.S.A. §4904 relating to

unsworn falsification to authorities.

SAINT VINCENT HEALTH CENTER, D/B/A

SAINT VINCENT HOSPITAL

By:---'-~--~---'-~--
Date Debra Chapman, BSN, RN
 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

RULE TO SHOW CAUSE

AND NOW, this ___ day of April, 2024, a hearing on the Petition for the
Appointment of an Emergency and Plenary Guardian of the Person and the Estate of
Rolf Tonio Von Eckartsberg and to Remove Healthcare Agent, pursuant to
20 Pa. C.S.A. § 5511, § 5513 and §5454 shall be held on the _ _ day of
_ _ _ _ _ _ _, 2024 at a.m./p.m. before the Honorable Judge
in Court Room of the Erie
. County Court House, 140 West Sixth Street, Erie, Pennsylvania.
The Court directs the issuance of a Citation with notice of the date, time and
place of the hearing. Personal service of the Citation and the present Petition shall be
made on the alleged incapacitated person by the Orphan's Court Investigator.
In addition, notice of the Petition and hearing shall be given to all persons
residing within the Commonwealth who are sui juris and would be entitled to share in
the estate of the alleged incapacitated person if he died intestate and to the institution
providing residential services to the alleged incapacitated person.
BY THE COURT:

AMERICANS WITH DISABILITIES ACT OF 1990 - The Court of Common Pleas of Erie County is
required by law to comply with the Americans with Disabilities Act of 1990. For information about
accessible facilities and reasonable accommodations available to disabled individuals having business
before the Court, please contact the Court's ADA Coordinator at Erie County Court of Common Pleas,
140 West Sixth Street, Room 205, Erie, PA 16501, Phone (814) 451-6308, TDD (814) 451-6237, E-mail
courtadacoordinator@eriecountygov.org. Requests should be made as soon as possible or at least three
business days prior to any hearing or business of the Court.

6
 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

CERTIFICATE OF SERVICE

I hereby certify that on the 26th day of April, 2024 a copy of the foregoing Petition

was served upon the following by personal service, mail, fax, or email as indicated:

Uta Von Eckartsberg Saint Vincent Health Center d/b/a

5600 Munhall Road, Saint Vincent Hospital
Apt. 309 232 West 25th Street
Pittsburgh, PA 15217-2039 Erie, PA 16544

SERVED VIA U.S. MAIL and UPS Attention: Debra Chapman, BSN, RN
OVERNIGHT MAIL High Risk/Complex Case Manager
Debbie.Chapman@ahn.org
Uta Von Eckartsberg SERVED VIA EMAIL
311 Kelso Drive
Erie, PA 16505
SERVED BY HAND DELIVERY

Uta Von Eckartsberg

Package Left at Nurses
Station On Patient's Unit To
Be Delivered to Ms. Von Eckartsberg

(Y\
J M. Snavely
Attorney for Petitioner
 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner
FINAL ORDER

AND NOW, to-wit, this ___ day of _ _ _ _ _ _, 2024, upon

consideration of the foregoing Petition for Guardianship, and to remove Healthcare
agent, and after full hearing and consideration of the testimony and evidence presented,
it is hereby ORDERED, ADJUDGED and DECREED that:

1. Rolf Tonio Von Eckartsberg is hereby adjudged to be an Incapacitated

Person (hereinafter, the "Incapacitated Person").

2. The Healthcare power attorney executed by Rolf Tonio Von Eckartsberg

on August 13, 2004 is revoked and Uta Von Eckartsberg is removed as the Healhcare
agent.

3. _ _ _ _ is appointed as the Plenary Guardian of the Person and the

Estate of the Incapacitated Person.

4. The Plenary Guardian shall serve without bond.

5.. The Guardian shall file an Inventory of the assets of Rolf Tonio Von
Eckartsberg within ninety (90) days of the date of this Order.

6. The Plenary Guardian of the Estate shall file annual Reports as Plenary
Guardian of the Estate of the Incapacitated Estate, pursuant to Pennsylvania Supreme
Court Orphans' Court Rule 14.B(a), with the first Reports being due on
_ _ _ _ _ _ _ _ , 2024, and annually thereafter.

7. The Plenary Guardian of the Person shall file annual Reports as Plenary
Guardian of the Person of the Incapacitated Person, pursuant to Pennsylvania Supreme
Court Orphans' Court Rule 14.B(a), with the first Reports being due on
_ _ _ _ _ _ _ _ , 2024, and annually thereafter.

8. The persons entitled to receive notice of the filing of the Reports of the
Plenary Guardian, pursuant to Pennsylvania Supreme Court Orphans' Court Rule
14.B(a), are any person(s) sui juris who would be entitled to an intestate share in the
estate of Rolf Tonio Von Eckartsberg (if any) and the person or institution providing
residential services to Rolf Tonio Von Eckartsberg.
 9. Within sixty {60) days after the death of the Incapacitated Person or an
adjudication of his capacity, the Plenary Guardian shall file a Final Guardianship Report
of the Person and Estate pursuant to 20 Pa.C.S.A. §5521(c)(2).

10. The Guardian of the Estate shall, within thirty (30) days, present to the
Erie County Register of Wills the Incapacitated Person's most recent original Last Will
and Testament, including codicil(s), together with copies of the same for Erie County
Register of Wills to compare and keep on file, should the same exist. If the
Incapacitated Person does not_bgve a Last Will and Testament, the Guardian shall file
with the Erie County Register of Wills a statement indicating that no Last Will and
Testament of the incapacitated person exists.

11. By this Order, all Durable Powers of Attorney and Healthcare Powers of
Attorney Executed by the Incapacitated Person are revoked.

12. By this Order, the _ _ _ _ , 2024, and _ _ _ _ _, 2024, temporary

emergency guardianship appointment orders are terminated due the appointment of the
plenary guardian herein.

13. The Incapacitated Person is hereby notified of the right to seek

reconsideration of this Order pursuant to Rule 8.2 and the right to appeal this Order
within 30 days from the date of this Order by filing a Notice of Appeal with the Clerk of
the Orphans' Court. The Incapacitated Person may also petition the court at any time to
review, modify, or terminate the guardianship due to a change in circumstances. The
Incapacitated Person has a right to be represented by an attorney to file a motion for
reconsideration, an appeal, or to seek modification or termination of this guardianship. If
the assistance of counsel is needed and the Incapacitated Person cannot afford an
attorney, at attorney will be appointed to represent the Incapacitated Person free of
charge.

14. _____ ___, as Guardian of the Estate, may spend from the
principal of the Incapacitated Person's assets, without prior court approval.

15. All financial institutions, including without limitation, banks, savings and
loans, credit unions, and brokerages, shall grant to the Guardian of the Estate of the
Incapacitated Person access to any and all assets, records, and accounts maintained
for the benefit of the Incapacitated Person, and the Guardian of the Incapacitated
Person's Estate shall be entitled to transfer, retitle, withdraw, or otherwise exercise
dominion and control over any and all said assets, records, and accounts. The failure of
any financial institution to honor this Order may lead to contempt proceedings and the
imposition of sanctions.
16. _ _ _ _ shall be compensated the sum of One Thousand Dollars
($1,000.00.) for a one-time enrollment fee if the Incapacitated Person is not on Medicaid
and then at the rate of One Hundred and Fifty Dollars ($150.00) per hour for all
guardianship services related to the responsibilities of handling matters pertaining to the
guardianship of the Incapacitated Person. _ _ _ _ _ may be compensated for all
guardianship services rendered to the Incapacitated Person from the date of the

2
emergency order forward. The Guardian may be compensated from the income and/or
assets of the Incapacitated Person including funds reserved after "spending down" for
Medicare or Medicaid benefits or other public assistance.
17. Once the Incapacitated Person's assets are reduced to the amount
authorized by the Department of Human Services for Medicaid, ____may be
compensated at the rate of $300.00 per month for guardianship services from the
income of the Incapacitated Person as authorized by the Pennsylvania Department of
Human Services as an expense which may be deducted from the monthly income of the
Incapacitated Person to determine the amount he is expected to pay to the cost of care
pursuant to 55 Pa. Code §181.452 or any other regulation for any month during which
he is receiving such care is eligible for Pennsylvania Medical Assistance or other
benefits.

BY THE COURT:

J.

cc: Joel M. Snavely, 2222 West Grandview Blvd., Erie, PA 16506

Debra Chapman, BSN, RN, Saint Vincent Health Center d/b/a Saint Vincent
Hospital, 232 W. 25th St., Erie, PA 16544
Rolf Tonio Von Eckartsberg, c/o AHN-Saint Vincent Hospital, 232 W. 25th St.,
Erie, PA 16544

Uta Von Eckartsberg; 5600 Munhall Road, Apt. 309, Pittsburgh, PA 15217-2039

3
 IN THE MATTER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER

d/b/a SAINT VINCENT HOSPITAL, No.
Petitioner

CERTIFICATE OF COMPLIANCE

I certify that this filing complies with the provisions of the Public Access Policy of

the Unified Judicial System of Pennsylvania: Case Records of the Appellate and Trial

Courts that require filing confidential information and documents differently than non-

confidential information and documents.

Respectfully submitted,

QUINN, BUSECK, LEEMHUIS, TOOHEY &

KROTO, INC.

BY:
IM. Snavey
2222 West Grandview ulevard
Erie, Pennsylvania 16506-4508
Telephone: 814-833-2222
Facsimile: 814-833-6753
 IN THE MATTER OF THE PERSON AND IN THE COURT OF COMMON PLEAS
OF THE ESTATE OF OF ERIE COUNTY, PENNSYLVANIA
ROLF TONIO VON ECKARTSBERG,
An Alleged Incapacitated Person ORPHANS' COURT DIVISION

SAINT VINCENT HEALTH CENTER d/b/a

SAINT VINCENT HOSPITAL, No.
Petitioner
ORDER

AND NOW, to-wit, this __day of _ _ _ _ 2024, upon consideration of the foregoing

Petition, of Saint Vincent Health Center d/b/a Saint Vincent Hospital, the Court finds that Rolf

Tonio Von Eckartsberg currently lacks sufficient mental capacity to make or communicate or

even participate in responsible decisions concerning his person and estate, that Uta Von

Eckartsberg is not an appropriate person to make decisions with respect to Rolf Tonio Von

Eckartsberg's medical care and treatment or any other decisions for that matter, and that failure

to revoke the healthcare power of attorney and to remove Uta Von Eckartsberg as the

healthcare agent and to appoint an emergency guardian will result in irreparable harm to his

person. It is, therefore, ORDERED and DECREED that the healthcare power of attorney is

revoked, that Uta Von Eckartsberg is removed as the healthcare agent, and that Erie Family

Center is appointed as Emergency Guardian of the Person and the Estate of Rolf Tonio Von

Eckartsberg until ______, 2024, at _ _ _ _ _ , at which time an extension hearing will

be held, and waives the requirement that notice be given of this emergency proceeding.

BY THE COURT:

J.
cc: Joel M. Snavely, 2222 West Grandview Blvd., Erie, PA 16506
Debra Chapman, BSN, RN, CCCTM, Saint Vincent Health Center d/b/a Saint Vincent
Hospital, 232 W. 25th St., Erie, PA 16544
Rolf Tonio Von Eckartsberg, c/o AHN-Saint Vincent Hospital, 232 W. 25th St., Erie, PA
16544
Erie Family Center, 606 Raspberry St., Erie, PA 16502
Uta Von Eckartsberg; 5600 Munhall Road, Apt. 309, Pittsburgh, PA 15217-2039
Uta Von Eckartsberg 311 Kelso Drive, Erie, PA 16505
4/17/24, 2:46 PM Voneckartsberg, Rolf Tonio DOB: 02/2311965 Admission Date: 02126/2024
03/13 Transferred to SVH 4S Intensive Care Unit 1649
1649
03/14 GASTROSCOPY, WITH PEG TUBE INSERTION
1402
04/03 Transferred out of SVH 45 Intensive Care Unit 1454
1454

Vonecl<artsberg, RolfTonio (MRN 156011) Pfinled by Debra Chapman, RN [478091at4/17/20242:46 PM

8/8
,: ICU team Paga: 57·otTT 2024.03-26 Z0:39:22 GMT 14122911384 Fram:

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:ICU team !)le:58 of77. ,... 2024-03-26 20:39:22 GMT 14122911384 From:
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 4/16/24, 4:15 flM DR. ELSA VON ECKARTSBERG I Obituary I Pillsburgh Post Gazette
pi1t•llur.111J tJa•t•'6azdle·

DR. ELSA VON ECKARTSBERG

August 23, 2020

EXHIBIT

I H
https://obituarles.post-gazette.com/obituary/dr-elsa-von-eckartsberg-1080003526
1/3
 4/16/24, 4:15tPM DR. ELSA VON ECKARTSBERG I OblttJary I Pittsburgh Post Gazette

After a valfant fight, Dr. Elsa von Eckartsberg, 90, a bright, beautiful, brave, and resilient warrior
died at home on August 23,
2020. Dr. von ~ckartsberg was a Harvard graduate, a brilliant academic, professor,
a top psychedelic poet, and author,
scholar, former nurse, governess, social worker, and most importantly soulmate and muse
for her beloved husband the late
Dr. Rolf von Eckartsberg a renowned social psychologist and Duquesne University Psycholog
y Professor for nearly thirty
years. Indeed, Dr. von Eckartsberg survived the atrocities of WWII as a child who saw her
entire village destroyed but still
managed to stumble upon what she described as "miracles" that ultimately led the poor
daughter of a Bremen pastor to
marriage with Rolf, a member of the German nobility and an ivy league education at Harvard
Universlty. And even age 76,
after suffering multiple tragedies and personal losses including the untimely, tragic death
of her soul mate, Rolf in 1993; she
never lost her joy, hope, thrill to live, thrive; nor did she ever succumb to despair or bitterness
. And she never lost her
-gratitude for the miracles rn her life even titling her autography, A Memoir of Miracles,A
morvlncit omnia. After her beloved,
eldest brother, Dr. Klaus Penzel, a then-Dartmouth teacher, brought her to the US and promptly
introduced her to his favorite
student, Rolfvon Eckartsberg, a tall, handsome; daredevil, former US paratrooper and brilliant
academic who also happened
to be a member of one Germany's oldest noble families; they promptly fell in love with an
instant spiritual, fntell~ctual, and
physic:al connection that was so intense and passionate that it inspired all who were lucky
enough to circle in their orbit.
Ironically, while Elsa always believed that It was a miracle that brought her tall, athletic handsome
, brilliant soulmate gil1en
her view of herself as a poor church mouse; the truth was that, Rolf viewed Elsa as his miracle,
always grateful for the
ungovernable spirit who brought a glimpse of light and joy to all those whom she knew and
loved. Another "miracle
"occurred after Rolf secured a spot in Harvard for his doctoral program In Psychology. Without
means, connections, or even
any understanding the prestige of a Harvard, that after knocking on Radcliffe's door, she
was promptly directed down the
street to Harvard where she was offered an instructor position during a time when wom1m's
equality was barely in its infancy
and Harvard was still largely all-male Indeed, Dr. von Eckartsberg obtained her doctorate
from Harvard in 1962 as a member
of the first class of women to ever receive a doctorate from Harvard. Subsequently, she and
Rolf moved to Pittsburgh after
Rolf accepted his position at Duquesne one of the few institutions in the US with a focus
on existentialism and
phenomenological psychology. They initially settled in a conservative suburb immediat_ely
outside downtown where they
promptly shocked all the neighbors by bringing Harvard's then psychedelic culture with
them. Indeed, together and
separately they were part of the "birth of the psychedelic nation* because while at Harvard,
Rolf was Assistant Professor to
Dr. Tfmothy Leary who is known today as one of the most prominent, cultural figures of the
60's who coined the famous
phrase to, "tune in and drop outM although Rolf and Elsa were too invested in their endless
quest to learn, teach, and grow to
ever give a second thought to Dr. Leary's call. However, they became immersed in the psychede
lic, consciousness expanding
tidal wave of change that swept Harvard and the country and continued the journey in Pittsburgh
creating their own
"Camelot" comprised of students, friends, and academic counterparts that kept their lives
together endlessly inspiring and
exciting. Throughout the years they continued their quest to learn and create both individual
ly and together on multiple
projects such as, Dr von Eckartsberg (and Ronald S. Valle's), Metaphors of Consciousness,
while simultaneously raising their
three children. At all times Elsa, created and wrote vast amounts of amazing poetry and published
several books including
her personal anthem, Christa Astralis- EineAmerica- Odyssee and also lch Trage das Gluck
in meinem Herzen, aptly
described by one critic offering a unique and entertaining view on how both intoxicating
and tragic love played a role ln the
creation of great literary works that are revered even today. Having not accomplished enough,
at a time when most women
of a certain age did not typically pursue academic achievement nor thirst for new intellectua
l pursuits; she obtained a
second graduate degree trom Duquesne and thereafter worked as a counselor for the disabled
and disadvantaged. For the
remainder of her life, she continued to write, dream, and create. Dr. von Eckartsberg also
remained humble, grateful and in
awe of her long and miraculous journey. She never even acknowledged the fact that her
accomplishments and achievements
did not simply happen by "miracle" but rather also by virtue of her hard work, grit, determina
tion, perseverance, combined
with a brilliant mind and a beautiful soul. And up to almost the very last day of her life, she
never gave up nor doubted that
another miracle was around the corner. And indeed, she did get her miracle, as she Is finally
ecstatically reunited mind and
soul with the great love of her life, Rolf and for the rest of eternity they shall never be apart
again. Dr. von Eckartsberg leaves
behind her daughter, Uta von Eckartsberg, two sons, Rolf-Tonio and Tobias von Eckartsbe
rg who will be forever grateful for
the miracle that gave them Elsa as their mother. She is also survived by her beloved brothers,
Klaus and Lothar (Heidi)
Penzel; her much loved nephews, Joachim, Goetz-Ulrich, Marcus, Thomas Penzel and niece,
Piera Paine. In lieu of flowers,
the family requests that a donation be made to a charity of their choice. A memorial service
will be held on a date yet to be
determined. Arrangements by JOHN A. FREYVOGEL SONS, INC.(freyvogelfuneralhome.com
)

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Time
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 Allegheny
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To see your results onllne, visit: .bll~guide.careQorthealtt-i'.com/a!legh!rny/resu!ts/6C-RA
ARGM
--- --- --- --- --- --- --- --~ --- --- --- --- --- --
_ _ _ _ _ _ _ _ _ _ _ _ _ _ am aware that I have choice in post-acute care
providers. The hospital .has a
complete list of post-acute providers in the region available to me (and/or my authorize
d representative listed below). My
choices are listed ·below and my signature hereby authorizes the release of my complete medical
record information to the
provider(s) whom I select. Patient/ Guardian/ Responsible Party Signature: _ _ _ _ _ _
_ _ __.;_ _ _Date:
_ _ _ _ Time: If patient is unable to sign: Witness Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ Date:
_ _ _ _ Time: '------ -

Please review 25 Skilled Nursing Facility provjders

25 Provid ers Near Erie. PA

PROVID ER INFO QUAUT Y POST-ACUTE QUALIT Y MEASURES

RATINGS CARE PROVIDERiSTATI! AVG/NAT AVG
NETWO RK(S) .
'
i ==== ==== ===-= -;...:;; J :
l LECOM Nursing and
j Rehabilitation
***** (2/5)
Helion's Quality Score
AHN Own~d ot j' Rehosp 9.12% 20.8% 10.48% I
; ~ (814) 969,-311 S ~~~c ~tt- Falls 0,0% 3.4% 0.8% j

i® 4114 Schaper Avenue, Erie, PA High PerformancJ Ulcers 0.0% 3.7% 2.4% I
I
' _PA 16508 (3.1 miles)
**** *(2/5 )
CMS Quality Rating
~etwork _J MSPIJ 1.09 0.9 1.02
I
I
Jiighmark I
I
fholeCa re In- l

~-- -_-_- _____

Network Providers
....,
fogether Blue
___ ____,
,.Network
 PROVIDER INFO QUALIT Y POST-ACU.TE QUALIT Y ME~SURES
RATINGS CARE PROVIDER/STATE AVG/NAT AVG
NETWO RK(S) j
I I
! Ball Pavilion at Brevlllier Data Unavailable PA
I High Performance' Rehosp 10.4% 20.8% 10.48% \
'j Wlage
~ (814) 899-8600
Helion's Quality Score ~en-:ork j Fans 0.0% 3.4% 0.8%

II @) 5416 East lake Road, Erie,

**** *(3/5 )
fogether Blue Ulcers
MSPB
0.0% 3.7°/4 2.4%
Network 0.72 0.9 1.02 '
PA 16511 (10.6 miles) CMS Quality Rating
I
I

Il Nightin gale Nursing And

Rehab Center
***** (4/5)
Helion's Quality Score
PA High Performance
I
Network _J
I
Rehosp
Falls
10.68% 20.8% 10.48%
0.8% 3.4% 0.8%
~ (814) 459-0621
I @) 607 East 26th Street, Erie, .**** *(3/5 )
f ogether Blue
-- Ulcers
MSPB
7.8%
1.28
3.7,%
0.9
2.4%
1.02
PA i 6504 (6.0 miles) Network •
CMS Quality Rating

Edinboro 'Manor Data Unavailable FA High .Performanc~ •Rehosp 10.24% 20.8% 10.48%
• ~ (814) 823-3951
® 419 Waterford Street,
Helion's Quality Score Network I Falls 1,7% 3.4% 0.8%
Ulcers 3.6% 3.7% 2.4%
Edinboro, PA 16412 (15.1 ***** (1/5) High
I mark ;]
MSPB 0.86 0.9 1.02
WholeCare In-
: miles) CMS Quality Rating
I ~etwork Providers
!
rogether Blue
Network 7 I

Corry Manor Data Unavailable PA High Performance' Rehosp 9.77% 20.8%

~ (814)664-9606
10.48% .,
Helion's Quality Score ~etwork Falls 1.5% 3.4%
J 0.8%
® 640 Worth Street, Corry, PA
Ulcers
Highmar k 2.7% 3.7% 2.4%
l 16407 (28.9 miles) **** *(3/5 ) l MSPB
YtfholeCare In- 1.12 0.9 1.02
I CMS Quality Rating I
Network Providers

fogether Blue
Network·

I
l
II
 '
PROVIDER INFO QUALITY POST·ACUTE QUALITY MEASURES
RATINGS CARE PROVIDER/STAT!! AVG/NAT AVG
I NETWORK(S)
II
I
: Mancheste r Cqmmons *****( 3/5) PA High PerformancJ Rehosp 18.34%- 20.8% 10A8%
I (Formerly Manchester Helion's Quality Score ~etwork j Falls 0.0% 3.4% 0.8%
, Presbyterian Lodge)
Ulcers 0.0% 3.7% 2.4%
I ~ (814) 314-1622
*****( 5/5)
Highmark
I MSPB 0.71 0.9 1.02
' @) 6351 West Lake Road, Erie, WholeCare In-
CMS Quality Rating
I
PA 1 6505 (3.2 mlles) ~etwork Providers

prth9

f cigethe; -Bfuel
Network

Sarah Reed Senior Living *****( 3/S) PA High Performanc~ Rehosp 9.06% 20.8% 10.48%
I '
I ~ (814) 878-2626 Helion's Quality Score ~etwork j Falls 4.7% 3.4% o.~%
I @) 227 West 22nd Street, Erie, .-... Ulcers 7.8% 3.7% 2.4%
I PA 16502 (4.8 miles)
f:HFi
*****( 2/5) MSPB 0.88 0.9 1.02 i
rogether Blue I
! CMS Quality Rating I
Network
!
II
I
I
;
------·---i
1 Wesbury United Data Unavailable PA High Performance
i Methodist Community Helion's Quality Score ~etwork j
Rehosp 10.31% 20.8% 10.48%
Falls 4.0% 3.4% 0.8%
~ (814) .332·9000 •
Ulcers 3.9% 3.7% 2.4%
@) 31 North Park Ave Ext, *****( S/5) MSPB 1.11 0.9 1.02
Meadville, PA 16335 (31.2 CMS Quality Rating
miles)

·-·---
I St. Paul's *****( 3/5) PAHigh PerformancJ Rehosp 9.95% 20.8% 10.48%
~ (724) 588-7610 x1143
@) 339 East Jamestown Road,
Helion's Quality Score ~etwork J Falls 0.0% 3.4% 0.8%
Ukers 2.1% 3.7% 2.4%
rogetherB :=Jue
-
Greenville, PA 16125 (47.3 *****( 5/5) MSPB . O.!a6
tJetwork 0:9 1.02
miles) CMS Quality Rating

Embassy of Park Avenue Data Unavailable '·

PA High Performancel Reh9.sp 10.87% 20.8% 10.48%
~ (814)337-42 28
@) 14714 Park Ave Extension,
Helion's Quality Score ~etworl<
,
I Falls
Ulcars
0.0% -3A% 0.8%
Highmark 2.2% 3.7% 2.4%
Meadville, PA 16335 {29.2 *****( 2/5) I ·MSPB
WholeCare In- 1.27 0.9 1.02
miles) CMS Quality Rating I
Network Prqviders
 PROVIDER INFO QUALITY POST-ACUTE QUALITY MEASURES
RATINGS CARE PROVIDER/STATE AVG/NAT AVG
NETWORK(S)

,
,=

l
- =
j Twinbrook Healthcare Data Unavailable PA High Performance Rehosp 10.83% 20.8% 10.48%
! And Rehabifftation Center Hellon's Quality Score ~_!Work __j ~lls 4.5% 3.4% 0.8%
1~ (814) 898-5600
@) 3805 Field Street. Erie, PA *****(2/5}
fogether Blue 7
I
Ulcers
MSPB
0.0% 3.7% 2.4%

Network 1.27 0.9 1.02

_j
16511 (8.8 miles) CMS Quality Rating
I
Pleasant Ridge Manor
! ~ (814) 474-5521
Data Unavailable
Helion's Quality Score
I
Network
--·----.
PA High Performance·
I
I
Rehosp
Falls
10.66% 20.8% 10.48%
0.0% 3.4%
!
I
..___ __J 0.8% I
® 8300 West Ridge Road, ,------7
Highmark
Ulcers 3.5% 3.7% 2.4%
I

Girard, PA 16417 (11.1 miles) *****(2/S) MSPB 0.83 0.9 1.02

WholeCare In-
CMS Quality Rating
~twork Providd
r-
fogether Blue
Network

Rolling Fields, Inc Data Unavailable PA High Performance Rehosp 8.9% 20.8% 10.48%
~ (814) 587-2012 Halion's Quality Score f
I @) 9108 State Highway Ste
~etwor~ Falls
Ulcers 11.4%
0.0% 3.4%
3.7%
0.8%
2.4%
i 198, Conneautville, PA 16406 *****(1/S) MSPB 1.14 0.9 1.02
(25.6 miles) CMS Quality Rating

Crawford Care Center Data Unavailable

,.... ' -----.
PA High Performance Rehosp 9.85% 20.8% 10.48%
'
~ {814) 763-2445
® 208B1 PA-198, Saegertown,
Helion's Quality Score ~etwork __j F.ills - 3.4% 0.8% !
i
Ulcer5 3.7% 2.4% \
Highmark I
PA 16433 (27.1 miles) *****(3/5) I
WholeCare In-
MSPB 0.93 0.9 l.02 I
CMS Quality Rating I
Network Providers I
! Titusville Healthcare And Data Unavailable PA High Performan~ Rehosp .9.67% 20.8% 10.4B%
! Rehabilitation Center Helion's Quality Scor~
I
Network
I
I Falls 3.2% 3.4% 0.8%
~ (814) 827-2727 Ulcers 3.4%
~ighmark 3.7% 2.4%
II @) 81 Dillon.Drive, Titusville, *****(4/5) MSPB 0.99 0.9 1.02
1 WholeCare In~
PA 16354 (40.4 miles) CMS Quality Rating I II
Network Providers
'---

I
I
I
l
I

I
 PROVIDER INFO QUALITY POST-ACUTE QUALITY MEASURES
RAT'INGS CARE PROVIDER/STATE AVG/NAT AVG
NETWORK(S)
I
I
The Grove At c,ireenville Data Unavailable PA High Performance Rehosp 10.39% 20.8% 10.48% '
~ (724) 588-8090 Heliop's Quality Score ~etwork j Faffs 2.4% 3.4% 0.8%
@. 110 Fredonia Road, Ulcers 0.0% ~.7% 2.4%
Highmark
,;;reenville, PA 16125 (49.4 *****(4/5) I MSPB 0.73 0.9 1.02
yvholeCare In~
miles} CMS Quahty Rating
Network. Providers
fogether Blue
Network
'-
7
I Walnut Creek Healthcare
,I And Rehabilitation Center
Data Unavailable
Helion's Quality Score
,------
Highmark
I
WholeCare ln-
Rehosp 9.67% 20.8%
Falb 0.0% 3.4%
10.48% 'I
0.8%•'
I
I

~ (814) 836-3300 -~etwork Providers Ulcers 7.7% 3.7% 2.4%

@ 4850 Zuck Road, Erie, PA *"****(4/5) MSPB 0.89 0.9 1.02
16506 (3.0 miles) CMS Quality Rating

Forestview *****@/5) Rehosp 11.46% 20.8% 10.48%

~ {814) 860-7143 Helion's Quality Score Falls 0.0% 3.4% 0.8%
® 2301 Edinboro Road, Erie, Ulcers 9.8% 3.7% 2.4%
PA 16509 (4A miles) *****(4/5) MSPB 0.9 0.9 1.02
CMS Quality Rating

Greenfield Healthcare And Data Unavailable Highmark Rehosp 10.27% 20.8% 10.48%
Rehabilitation Center I
Helion's Quality Score fholeCare In- Falls 0.0% 3.4% 0.8%
~ (814) 864-0671
['Jetwork Providers Ulcers 5.2% 3.7% 2.4%
(e> 1521 West 54th Street, Erie, *****(2/5) .MSPB 0.87 0.9 1.02
PA 16509 (4.4 miles) CMS Quality Rating

Lec:om At VIiiage Square,

lie
Data Unavailable fogether Blue Rehosp 10.46% 20.8% 10.48%
Helion's Quality Score N!:!twor-k Falls 0.0% 3.4% 0.8%
(6 (814) ~69-3115 Ulcers 4.5% 3.7% 2.4%
. ® 149 West 22nd Street, Erie, *****(3/5) MSPB 0.82 0.9 1.02
PA 16502 (4.9 miles) CMS Quality Rating
 PROVIDER INFO QUALITY POST-ACUTE QUALITY MEASURES
RATINGS CARE PROVIDER/STATE AVG/NAT AVG
NETWORK(S)

,--
UPMC Sugar Creek Station Octa Unavailable Highmark l Rehosp 9.22% 20.8% 10.48%
(6 (814) 437-0100 r
Helion's Quality Score rholeCare In- Falls 0,0% 3.4% 0.8%
® 351 Causeway Drive, Network Providers Ulcers 0.0% 3.7% 2.4%
Franklin, PA 16323 (48.9 miles) *****c s/S) MSPB 0.89 0.9 1.02.
CMS Quality Rating

Providers in this list match criteria provided by your Case Manager/Soda! Worker, including:
Level of Care: Skilled Nursing Facility, Medicare Star Rating: All, Search Location: 50 miles from Erie, PA
_J

WHAT IS A HELION'S QUALITY SCORE?

For fully-insured members of Highmark Blue Cross Blue Shield and/or its affiliated Blue health plans: This val□e represents
Helion's quintile, a-competitive ranking, facilities receive when compared to other facilities/agencies within the state. Five filled
stars indicate the highest quintile. Rankings are performed on a rolling 4-quarter basis. During that time, a provider with at
least 20 episodes, excluding FEP, will be included. If a state is not ranked, the Overall Ranking metrics will not be displayed.

WHAT IS A MEDICARE STAR RATING?

Post acute care providers Vc/ry In the quality of care and services they provide to their patients. Medicare reviews inspection
results, staffing data, and quality measures to assign a star rating in each of these areas. More stars is better.

WHERE DOES QUALITY INFORMAT ION ON THIS LIST COME FROM?

Provider Data: Quality data come from CMS as published on data.medicare'.gov. Sometimes data published on
data.medicare.gov differs slightly from the CMS compare websites.

State Average: CarePort calculates state averages by including all providers in the state. CMS sometimes excludes providers
when cakulatfng these averages. Therefore, CarePort state averages may differ slightly from those calculated by CMS.

National Average: National average data come from CMS as published on data.medicare.gov. Sometimes data published on
data.medicare.gov differs slightly from the CMS compare websites,
 COURT OF COMMON PLEAS OF
ERIE COUNTY fENNSYLVANIA
-------- ---'~-- 0 RPHANS' COURT DIVISION
EX)>ERT REPORT

b_f__,.~.. -=----=--- ---

RE: _ _ _ _ _...:....f2o_1,.,-,-y_Vi_o,.J.....,,-c:-_~e,,~~-A:_rt_T,....,...<S_'
.An Alleged Incapacitated Person .(AJP)
No. _ _ _ _ _ _ __

PART I: l>ROFESSI()NAL BACKGROUND (You may attach your curriculum vitae; ifit provides an-
swers to Questions 1 through 5. Please answer those questions not covered by curriculum vitae.)
Title: 'rSYCJ-\-1A-'i12-JS1 .
2. Professional Address: 7--~;2.. W '2-S,;i:b ~ e:ci\~. pp_ !(p!!>~4

3. Complete education information:

N~e oflnstitution Type of-Pegree.Received Date Completed

Undergraduate 0. 5 . ?-syc,➔oL-06, y 1;;i. I ;,co I
U,1/IV of- -:rt>A:.~6
Graduate
-V\J~ ~ tol,L, o-r,.reo µet J)otRJ~ tjf' l)SR;'OfPr1Wf. f>/Wo,-
Post-Graduate
l-£""lOM/l\\l~ ~ (ON\V'I ,M f':,yC)-t-1 Pif'P/ ties I f>eNt,'f <B/2.01 I

4. Do you have any active professional licenses? [2J"Yes o· No

If yes, indicate in what state or states you are licensed as well as .the-date(s)' jssued.
'PA~ f!/'),,()00:, ~ it1u-N~ c;1nee_.. ~t- ey_R; 10/~1 f,z.q-

List any board certifications: P~yc.i-+1F>fy- A-oB>Nf 2 • AJJ ,chn-1 }11\et\•l;n-e_ -J<tO~Nf

5. An I~ca:pacitated Person is legally defined as:· An adult whose ability to receive and evaluate informatioQ.
effectively and communicate decisions in any way is impaired to such a significant extent that he/she is
partially or totally unable, to manage his/her financial resources or to meet essentiai requirements for his/
her physical health and safety.
Do you have experie_nce·ev&luating whether or iiot an individual is incapacitated? ~Yes No D
Ifyes, indicate the basi.~ of your experience: _ .
• • • , vz c) 1.n{ ~f'I~ . t ~htm.S

evaJ,VM\PJ,.,S

EXHIBIT
Form G.--Qo Effective June 1, 2019
I 7
y p. l of5
9. Indicate the AIP' s ability to p¢'onn the following functions:

Needs Some Not Assessed

Totally
Unimpaired Help or Not Enough
Impaired
(Explain in #l O) Informati9n

Receiving anµ evaluating information

effectively □ .□ .~ □
Communicating de,¢sions □ □ :;12sr □
Ability to give infonned consent □ □ ~ □
ShorMenn memo.ry □ □ ~ □
Long~term memo.ry □ □ N □
Activities of daily living □ □ ~ □
..

Managing :finances (including. paying bills,

making d~posits, withdrawals apd working
□ □ ~ □
with financial institutions) .
Managing health care (inclµdihg following
doctor's orders and managing/taking
medications)
□ □ Qr □
Providing for physical safety □ tJ ~ □
Responding to emergency situations □ □ ff~ □
Ability to resist scams □ □ g □

10. For any response in Question 9 where the AIP "needs some help,'~ please describe the zype and extent of
assistance needed. •
ffi Il 02211!zwtc,e VlcerAed

11. What recommendations have you made or would you make concerning services necessary to meet the
essential requirements for the AIP's physical health and safe~? • j ~
~t)EAAC 'ff~i,«-$ ~I(, 9f,(leJ ~Wirt§ ~ 1 I~ eg.,re.

Fonn G-06 Effective June 1, 2019 p. 3 ofS

12. What recommendations }lave you made or would you make concerning management·ofthe AIP's
finances? .
/t 7Vfll20~k 4-e 111,H deus1¥tyta;e f,".l?f'.lct!> 12 viec.es-;~.

m an
13. As indicated Question 5, Incapacitated Person is legally qefined as: An adult whose.ability to
receive and evaluate information effectively and communicate decisions in any way is impaired to such a
signifi~ant extent that he/she is partially or totally unable to manage his/her financial resources or to meet
essential requirements for his/her physical health and safety.

In your expert opinion, within a reasonable degree ofprofessionaJ certainty and based on your knowledge,
skills, experience, and education, is the AIP in~apacitated?
~es, totally impaired O Yes, partially impaired D No
14.).!!_rour opinion, the-most apprqpriate, least restrictive living situation for the AIP is-(check one):
LJ.The AIP can be left alone without supervision --.
0Home (0with part--time home,bealth alde or .O 24/7 assi~tance)
□Independent living facility (room and board provided, emergen~y services readily available)
□Assisted living facility (room and board provided, assistance with some acti~ities of daily
living)
Osecure facility {Alzheimer's/Mental Health for safety and basic needs)
@killed nursing facility
15. If your responses in Questiori 9 indicated thatthe AIP is totally impaired or ''needs some help", do you
~ t h e AIP's abilities in the next 6-months to (Check best estimate):
~.stay the same □Improve Ooecline
Please explain:
fuo~r na-~ fy,,46:Yng ol~~\'loStS &~ MCc;-jW A(~U''5tt.1hvt i)i>~e/ a.,1:-
\fzo&l,it£ , th~ ?<J ~d: Cc,n~; h av! na.s a, ,;,J011p :b wta.,( ff~ Vl~ I~ ~ f:
lW-f ro-teAW.M-[.

PART III: GUARDIANSHIP AND SERVICES

16. Are you a:ware of any circumstances, medical-or otherwise,. that create a need for the appointment of an
emergency guardian for the AIP?
§Yes 0No
If yes, indicate reasons: . 1

C1<.i'f't"'4= fo·A- <?$4•~~ rcz not t0tJf@iht12) M;tfa .&st & 1 ~ \ -

0rt J_,. s Ck-(9 ~ f ~u-~5

Form G-06 Effective June 1, 2019 p. 4 of5

17. The AIP is required to be at the hearing, absent circumstances that CO\,lld cause harm to the AIP. P.utting
aside whether the court proceeding may be moderately upsetting to, confusing to or not understood by the
AIP, do you believe that the .AIP's presence at the hearing would cause hann to the AlP's physical or·
mental condition? •

~es 0No

Indicate reason for response:

Pa b~ t- r2 ~ t, k-- <¥,v, ~_, ve,.i t, f~~ twJ.. c) ~ c1t,vt ce.s .

18.. Please p,-ovide any additional' infonnation that could assist the court in detenninin incapacity.
. . ~- ~ 5~rro A . ckee.1 ~ fd'V1 <VI" • -M, • f ra.c..

YICc>Y'l1S fr;&. l:l,($ ~ t wJ.·,ca.,( [SzVCS; k,s b"--~e,,n.t.

wI f.l 1Jz·{{ ) J1I'. d ~ t j tfq, I~ / «?Ju-, ,re (a, 5 ~,vg c.h o( f CI S I fiV1 - 1t1·ctW',
I

'
I verify that the foregoing information is coxrect to the b~st of my knowledge, infQnnation and belief;- and tliat
this verification is subject to tbe·penalties of 18 fa:C.S. § 4904 relati' to unswom falsification to authorities.

c.cc\f
Date

Name (type or print) . . '

.
~,__ w 2.,-~d. Sr ' SJ-~- V(ne-e.vt {-- 1/c,sp,Ji:..,f
.Address

City, State, Zip

5tf4- Y:Sfl~ Soov

Telephone

Form 0-06 Effective June 1, 2019 p. 5 ofS

IN TI:IE MATIER OF THE PERSON IN THE COURT OF COMMON PLEAS
AND OF THE ESTATE OF
OF ERIE COUNTY, PENNSYLVANIA

An Alleged Incapacitated Person, ORPHAN'S COURT DIVISION

Allegheny Health Network-

Saint Vincent Hospital
Petitioner FILE NO. -2024

AFFIDAVIT TO EXCUSE ALLEGED INCAPACITATED PERSON

FROM COURT BEARING 'PURSUANT TO ERIE COUNTY
ORPHAN'S COURT RULE 14.2.l(d)(l)

1, C!24~ G :( J2'...t.vs,1f ~-, M .s · , am a licensed Physician or Psychiatrist in

the Commonwealth of Pennsylvania. I do hereby swear or ·affirm that within a reasonable degree of
medical certainty that the -above referenced alleged incapacitated person would not. be furthered by
his/her attendance at the court hearing regarding his/her incapacity at the Erie County Courthouse
because he/she is incapable of comprehending the nature of the proceedings or participating in any
meaningful way. In my profe~sional opinion, his/her physical or mental condition would be harmed by
the transportation to the court room and by his/her attendance at the •court hearing.

I have based my opinion on a personal examination of the individu~l and my records pertaining
to his/her condition.

I verify that the statements made in this affidavit are true and com;ct. I l!llderstand that false
statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom
falsific'ation to authorities. •

Dated: rj»/ffel2tf Signature: ~ " ' l ,«'-C~), Cd--f'

PART II: ALLEGED INCAPACITATED PERSON (A.IP)
6. a. Have you treated, assessed, or evaluated the AIP?
lSJyes 0No
b. Indicate the date(s) and location of any treatment, assessment, or evaluation you have provided or made

*ff'°'
over the last t\yo (2) years:
)?7:J/?02'! QJt he:. f~h-~.Y 020M I r1 5[ J'iYI(&\ t lw>6 ~ i •

c. If 6a. is yes, what tests have yo1,1 or others administered, e.g., mini mental status exam (MMSE),
Montreal Cognitive Asses~ent (MOCA),,St. Louis University Ments,l Status Exam..(SLUMS), etc.?
List ates .aJhninistered and the score. (Attach test results, ~ot just the score.) , . ' •
/\l'I . h t,i,\,r ff- Glvt.S \ v1e. ~ t,V1.0..b:, 1C- h

7. What is the ,present condition of the AIP? List all known medical and psychiatric diagnoses anci current
symptoms. (You may attach a li$t fron; your records.)

Diagnosis Symptoms/Manifestati~ns

,.
J,frV / A-I D.$

8. List all known medications, including over-the-counter, that the AIP is taking. For each known 11\edic!ltjon,
. indicate, if known, the p1:escr,ibing ph.ysician and the diagnosis for which the medication was prescribed or
the reason for taking. (You may attach a Iist:from your records.)

Medication Diagnosis/Reason Taken frescribing Ph1:sician

~ V'tl~~

Fonn G-06 Effective June 1, 2019 .P· 2 ofS

Medication List -Rolf Von Eckartsberg DOB: 2/23/2965

Current Scheduled Medications

Start Ordered

04/18/24 1200 enoxaparin {LOVENOX) syringe 40 mg 40 mg, subcutaneous, Every 24 hours scheduled

03/18/24 1100 magnesium oxide (MAG-OX) tablet 400 mg 400 mg, oral, Daily

03/16/24 0900 lansoprazole {PREVACID SOLUTAB) disintegrating tablet 30 mg 30 mg, oral, Daily

03/16/24 0000 atovaquone (MEPRON) 750 mg/5 ml suspension 1,500 mg, g-tube, Daily

03/16/24 0000 dolutegravir (TIVICAY) 50 mg tab tablet 50 mg, g-tube, Daily

03/16/24 0000 emtricitabine (EMTRIVA) 200 mg capsule 200 mg, g-tube, Daily

03/15/24 1100 levothyroxinei (SYNTHROID) tablet SO mcg SO mcg, oral, Every morning before breakfast

03/15/24 0000 nuconazole (DIFLUCAN) 200 mg tablet 800 mg, g-tube, baily

03/15/24 0000 tenofovir disoproxil fumarate (VI READ) 300 mg tablet 300 mg, g-tube, Daily

03/14/24 0900 fluconazole (DIFLUCAN) tablet 800 mg 800 mg, oral, Daily

Pharmacy to·adjust per adult special populations (renal and/or obesity) dosing protocol Yes End date: 5/22/2024

03/10/24 0900 cyanocobalamin (vitamin B-12) tablet 1,000 mcg 1,000 mcg, Per OG Tube, Daily

03/08/24 0900 thiamine (vitamin Bl) tablet 100 mg 100 mg, oral, Daily

03/02/24 0900 atovaquone (ME PRON) 750 mg/5 ml suspension .1,500 mg, oral, Daily

03/02/24 0800 emtrlcitabine (EMTRIVA) capsule 200 mg 200 mg, oral; Daily

03/01/24 1100 tenofovir disoproxil fumarate (VI READ) tablet 300 mg 300 mg, Per OG Tube, Daily

02/27/24 2000 tobramycin (TOBREX) 0.3 % ophthalmic solution 1 drop 1 drop, Left Eye, Every 4. hours scheduled

Current PRN Medication$

04/21/241215 sennosides (SENOKOT) 8.8 mg/5 ml oral syrup 10 ml 10 ml, peg tube, Nightly PRN: constipation

04/21/24 1215 docusate .(COLACE) liquid 100 mg 100 mg, peg tube, Nightly PRN PRN Reasons: constipation
04/08/24 2329 ipratropium-albute rol (DUONEB) nebulizer solution 3 ml 3 ml, nebulization, Every 4 hours PRN

PRN Reasons: wheezing

04/03/24 0802 oxymetazoline 0.05 % nasal spray 2 spray 2 spray, Each Naris, Every 12 hours PRN: congestion

03/13/241700 acetaminophen (TYLENOL) suppository 650 mg 650 mg, rectal, Every 4 hours PRN

PRN Reasons: mild pain, fever w/comm (fever >38)

Medication List Rolf Von Eckartsberg DOB: 2/23/2965 (page ~ of 2)

Current PRN Medications-continued

03/05/241259 acetaminophen (TYLENOL) oral solution 650 mg 650 mg, oral, Every 4 hours PRN

PRN Reasons: fever w/comm, mild pain (fever >38)

03/02/241130 polyethylene glycol (MIRALAX) packet 17 g 17 g, oral, Every 24 hours PRN

PRN Reasons: constipation

02/26/24 2016 glucagon (GlucaGen) injection 1 mg 1 mg, intramuscular, Once as needed

PRN Reasons: if Blood Glucose</= to 70 AND the patient Is unresponsive OR is.unable to take,PO

02/26/24 2016 dextrose 50 % ·(DSOW) injection 25 g 25 g, intravenous, Once as needed

PRN Reasons: if Blood Glucose</;::;. to 70 AND the patient is unresponsive OR.is unable to take PO

02/26/24 2016 DlOW 10 % bolus 250 ml 250 ml, intravenous, 998.7 ml/hr, Once as needed

PRN Reasons: if Blood Glucose</;::;. to 70 AND the patient is 1,mresponsive OR is unable to take PO AND Dextrose 50% is
unavailable

02/2,6/24 1922 ondansetron (ZOFRAN) (PF) Injection 4 mg 4 mg, intravenous, Every 6 hours PRN.

PRN Reasons: nausea, vomiting