Death in Amherst emergency department raises questions about ambulance wait times

A union representative for paramedics across the province says “it’s a valid question” whether Allison Holthoff would have received better medical attention had her husband called 911 for an ambulance to take her to hospital on Dec. 31. 

Holthoff died while waiting almost seven hours to see a doctor in the emergency department of the Cumberland Regional Health Care Centre in Amherst. Her husband, Gunter, and a bystander trained as a continuing care assistant repeatedly asked nurses for help as Holthoff’s condition worsened.  

Holthoff was a mother of three and a valued community leader and deputy volunteer fire chief in Tidnish Bridge.

Kevin MacMullin is the business manager for Local 727 of the International Operating Engineers Union, which represents paramedics. He said paramedics stationed at bases in Amherst and Pugwash knew Holthoff because of her work as a deputy volunteer fire chief and are grieving her loss. 

On the same day Holthoff died, a 92-year-old woman with a broken hip at Amherst Head waited nearly five hours for an ambulance to get to the Cumberland hospital. Gunter Holthoff decided to drive his wife the 15 minutes to the hospital emergency department because of the couple’s experience last September when Allison was thrown from a horse and it took almost three hours for the ambulance to arrive. 

MacMullin represents approximately 943 paramedics in the province — about 220 fewer than he did a year ago, when he spoke at a Public Accounts committee meeting called in February to discuss Emergency Health Services (EHS). At that time, MacMullin told the committee that paramedics were quitting because there were too few of them to handle the volume of calls coming in and they could earn $10 an hour more doing the same job in Ontario. Here’s what MacMullin told the government almost a year ago:

Today the system is nearing the point of failure. We became paramedics to help Nova Scotians. When we see calls in the queue with no units available to respond or we are dispatched from Cape Breton to calls in Truro and Dartmouth, as was reported Dec. 30, 2021, that takes a serious mental toll on our members and puts Nova Scotians at risk. 

At the time, MacMullin estimated about 160 paramedics were off work on short term or long-term disability and the service could use at least 250 recruits. Today, almost a year later, MacMullin said they need at least 300-350 more paramedics to keep up with an increasing volume of calls in the past six months and upcoming retirements. Roughly 20 paramedics are off the road having taken jobs offered by Nova Scotia Health to triage patients in hospital emergency departments to improve the flow there.  

MacMullin said he’s hopeful that ongoing discussions with EHS and the Department of Health, which funds the service, will lead to improvements in working conditions to retain experienced paramedics. The province has ordered new ambulances with state-of-the-art equipment. Paramedics, who start at $25-$26 an hour, are now being paid double for overtime they agree to work.  

Despite those gains, there are still are only 43 students enrolled in the current one-year paramedic training program. MacMullin said that number could be expanded with courses offered in locations such as Amherst but those changes depend on having people at hospitals with the time available to supervise clinical placements for paramedics in their last stage of training. Time and supervisors are both in short supply. 

Paramedics are currently working under a two-year contract that expires at the end of October. According to the union spokesperson, there are about 768 paramedics available for active duty, down about 200 from a year ago. The Halifax Examiner asked MacMullin for his ideas on how to keep experienced people from leaving:  

We need more paramedics. We need to train more paramedics to replace those who are going to retire. We need to have an attractive remuneration package for paramedics, so that someone who may have left for more money can look back and say well, things have improved and they are willing to pay more money in Nova Scotia, so I will come back. We need more help in our workforce and if you can retain your employees, you will also be able to recruit new ones because people spread the word.

Nova Scotia Health investigation has started

On Monday afternoon, Health Minister Michelle Thompson issued a written statement expressing her condolences to the Holthoff family and promising a review of what happened at Cumberland Regional Health Care Centre, where nurse staffing shortages recently forced a temporary closure of the ICU. Here is part of Thompson’s statement: 

Nova Scotia Health has begun an investigation, known as a quality review, into this case to determine what happened, how we can do better and what we can do to prevent it from happening in the future… This investigation began automatically after the patient’s death. The results will be shared with my department and with the family.

Thompson’s statement does not commit to sharing the results of this investigation with the public. The minister’s statement goes on to promise to “fix” health care.  

I want to assure all Nova Scotians we remain committed to and focused on fixing our healthcare system. We will act on what we learn from this investigation, and we will continue to act on what we’re hearing from healthcare workers, communities and Nova Scotians.

In a news release Wednesday, the NDP called for an inquiry into emergency department deaths. The party cited data from a freedom of information request, showing there were 558 emergency department deaths last year, “the highest annual total in the last six years.”

“People want to know what’s going on with health care in Nova Scotia. There is very real concern from families across the province about the state of emergency care,” Susan Leblanc, NDP Health and Wellness spokesperson, said in the release.

“This is a very serious situation. The Houston government needs to be upfront with people and launch an inquiry into the increasing number of ER deaths. Things have to get better for all Nova Scotians, now.”

In the same release, NDP leader Claudia Chender said, “An inquiry into emergency room deaths would help Nova Scotians understand what’s going on in our hospitals and what needs to be done to ensure no other family faces the same tragic situation as the Holthoff’s.”