The family of Allison Holthoff, who died in an emergency department in Amherst on Dec. 31, is suing Nova Scotia Health and an emergency doctor.

The statement of claim filed in Amherst provincial court names Nova Scotia Health and Dr. John Atia, the physician on duty in the emergency department, as being “jointly negligent” in failing to provide proper care to Holthoff. The 37-year-old mother of three died following a seven-hour wait to see a doctor on New Year’s Eve. The statement of claim said Holthoff died “from complications associated with an untreated splenic aneurysm.”

An aneurysm is an abnormal widening of a part of an artery due to weakness in the wall of the blood vessel. The aneurysm Holthoff had was in the area of her spleen, and like many aneurysms can be fatal if there is a rupture. A CT scan is most often used to detect this type of aneurysm, but in this case no x-ray or scan was ordered.

The allegations have not been proven in court, and neither Nova Scotia Health or Atia has filed a defence.

Here’s how the statement of claim describes what happened after Gunter Holthoff carried Allison into the Cumberland Regional Health Care Centre on Dec. 31, 2022:

“Holthoff was suffering from severe pain in the upper left side of her abdomen, difficulty breathing, and nausea. She could not support her own weight.”

The statement of claim says she was triaged by a nurse and a blood sample was taken. When a urine sample was requested, Gunter accompanied his wife to the bathroom to help collect it. Inside the bathroom she collapsed and two security guards arrived to help Gunter lift her back into the wheelchair.

“The Deceased’s condition quickly deteriorated within the first hour of waiting in the hospital’s waiting room,” the court filing reads.

“She was in extreme pain and nauseous. She was vomiting bile. She was unable to sit straight in her wheelchair and remained slumped in the fetal position to one side. She was no longer effectively able to verbalize sentences. The Deceased’s husband, along with witnesses in the waiting room, continued to report the Deceased’s urgent condition to the Defendant’s nursing staff.”

According to the statement, Holthoff was in too much pain to stay seated and spent some time on the floor curled in a fetal position before she was placed in a private cubicle at approximately 3pm.  No monitoring equipment was present and it wasn’t until three hours later, at about 6pm, that a nurse re-assessed Holthoff’s vital signs.  

According to the court document, the patient was found to be “extremely hypotensive and tachycardic,” which means she had very low blood pressure and a rapid heart rate.

At that point, Allison was taken into an observation room where she was examined by Dr. Atia, who ordered an IV and pain relief. The statement of claim said further tests were ordered but before they could occur, “the patient went into cardiac arrest.” She died at about 7pm, eight hours after arriving at the emergency department.

The statement of claim is holding Nova Scotia Health responsible for its employees at the emergency department of Cumberland Regional for failing to:

  • conduct appropriate testing in a timely manner
  • adequately triage the Deceased
  • change the triage score as the patient’s condition deteriorated
  • bring a physician’s attention to the distressed state of the patient
  • adequately monitor changes to the patient’s condition

No dollar amount on special damages being claimed

According to information publicly available, Atia practices family medicine in Amherst. He has been licensed for 10 years in Nova Scotia and graduated from the University of Cairo in 1989.

The statement of claim said the doctor was “credentialed” to practice emergency medicine. He is being sued for failing to:

  • respond to the pleas of nursing staff to see the patient in a timely manner
  • work his shift in the emergency room in the urgent manner expected of emergency room physicians
  • failing to order diagnostic testing in a timely manner

The statement does not put a dollar amount on the special damages it intends to claim on behalf of Allison Holthoff’s husband, Gunter, and her three children — Hayden, Holly, and Heidi.

The Examiner requested comment from Nova Scotia Health, however, spokesperson Krista Keough said the organization does not comment on legal actions.

The Examiner has also requested an update on the status of the quality review undertaken by Nova Scotia Health to determine the circumstances surrounding the patient death. The committee has three months in which to report.

Holthoff died in a makeshift emergency department set up after the original emergency department was closed following a flood last May. The original emergency department was supposed to re-open Feb. 14, but Nova Scotia Health said that has been pushed back as a result of a COVID-19 issue with a contractor. No date for re-opening has been announced.

Jennifer Henderson is a freelance journalist and retired CBC News reporter.

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  1. I doubt the autopsy will be released until June or July. Gov’t employee determines cause of death.

    Ruptured spleen results in pain and internal bleeding too. Cause is usually a fall or a blow. Much more likely to happen if person has mono.

  2. The Holthoff family deserves transparency and accountability from NS Health Authority, the people working the front lines are doing everything they can but still the same people are in charge making the decisions with no accountability what so ever. They continue to receive their significant pay however, they are so shy when it comes to answering questions or providing information. Allison Holthoff, her family deserves significantly better than what they have received to date, and so do all Nova Scotians.
    May the good Lord bless the Holthoff family, now and forever, keeping them safe, helping them thru this terrible event.