By Anemona Hartocollis

A large hospital network that had offered to take over the nearly bankrupt St. Vincent’s Hospital Manhattan in Greenwich Village has formally withdrawn its offer, further clouding the hospital’s prospects for survival.

Stan Brezenoff, president of Continuum Health Partners, a consortium of five hospitals in Manhattan and Brooklyn, said in a letter to Henry J. Amoroso, the president and chief executive of St. Vincent’s, that he was withdrawing the offer because of what he said had been a negative reaction to it from both the State Health Department and St. Vincent’s own board. The letter was sent last Friday but not released until Thursday. But Mr. Brezenoff left open the possibility that St. Vincent’s could return to talks with Continuum.

The uncertainty over St. Vincent’s future has led some doctors — especially star doctors — to begin making plans beyond their affiliation with St. Vincent’s. Several St. Vincent’s physicians have approached Continuum about securing admitting privileges at its hospitals, which would give them the right to work in those hospitals, Jim Mandler, a spokesman for the network, confirmed Thursday. Mr. Mandler said Continuum was talking to those doctors, “because we are very much aware of the recruitment efforts of other hospitals for these physicians.”

In its offer submitted to St. Vincent’s on Jan. 22, Continuum proposed to continue running outpatient facilities for the hospital, on 12th Street and Seventh Avenue, while funneling those who need inpatient care to its own hospitals, St. Luke’s Roosevelt on West 58th Street and Beth Israel, across town on the East Side. Most emergency room and inpatient services would have been eliminated.

St. Vincent’s, the last remaining Catholic general hospital in New York City, is $700 million in debt and needed a state loan this week to make its payroll.

The Continuum plan created an immediate uproar at St. Vincent’s and among local politicians, who said the neighborhood could not be without an emergency room or inpatient services and who accused Continuum of being more interested in shutting down competition and improving its own finances than in saving neighborhood health care.

In his letter, Mr. Brezenoff expressed pique that St. Vincent’s was considering looking for other offers, hinting that he believed that this would turn Continuum’s offer into a bargaining chip. He made it clear that his offer had been a take-it-or-leave-it one.

“On reflection,” Mr. Brezenoff said, “I feel constrained to take the formal step of withdrawing the proposal that we sent to you on January 22, 2010.”

Mr. Brezenoff declined to comment Thursday, but his swift withdrawal of the offer seven days after submitting it reflected his reputation as a skilled player of political hardball, skills honed as a former president of the New York City Health and Hospitals Corporation, executive director of the Port Authority of New York and New Jersey and a deputy mayor in the administration of Mayor Edward I. Koch.

His letter indicated that the door was still open to negotiation if St. Vincent’s came back to him on his terms. “Needless to say, I hope, we stand ready to resume discussions and negotiations at any time if it appears that this would be productive,” the letter said.

Sister Jane Iannucelli, the vice chairwoman of St. Vincent’s board, declined on Thursday to comment on Mr. Brezenoff’s letter.

Council Speaker Christine C. Quinn put a positive spin on Mr. Brezenoff’s decision, saying it could be good for the hospital, because it indicated “a growing recognition of all the parties involved in this process that the community is not going to accept a proposal that doesn’t sustain a full-service hospital.”

Continuum was absent from a meeting Wednesday with Gov. David A. Paterson, Mr. Amoroso, local elected officials, union leaders and hospital creditors to discuss a long-term solution for the hospital’s financial problems. The governor said after the meeting that the state had agreed to keep St. Vincent’s afloat for at least a month while it looked for partners.

Mr. Brezenoff suggested in his letter that the state had been critical of Continuum’s plan to eliminate the hospital’s inpatient beds and close its emergency room. Diane Mathis, a spokeswoman for the state Health Department, said the department had taken a neutral position on it. “This process has really just begun,” she said.