For the Holthoff family, a trip to the emergency room at the Cumberland Regional Health Care Centre on New Year's Eve turned into a nightmare.
Gunter Holthoff, of Tidnish, N.S., said his wife Allison began feeling sick the morning of Dec. 31, but thought she just had an upset stomach. When it worsened throughout the morning, Holthoff drove his wife to the nearest emergency department in Amherst, N.S., around 11 a.m.
Holthoff said he carried Allison into the hospital on his back.
"She was obviously in pain," he told CBC News in an interview Sunday. "I was rolling her in the wheelchair and she could hardly sit up."
The pair waited more than six hours in the emergency department waiting room and then in a room inside the unit as Allison's pain worsened. Holthoff said it was after 6 p.m. before they saw a doctor and Allison received any treatment.
By then, he said, it was too late.
How tragedy unfolded
After they were triaged, Holthoff recalled, the nurses asked for a urine sample. When he took Allison to the bathroom, he couldn't support her alone and she fell to the floor.
"I couldn't get her up myself so I went outside the door and just asked for help," Holthoff said. Two security guards had to assist her.
When Holthoff took Allison back to the waiting room, he said she was no longer able to sit in the wheelchair the hospital had provided because of the pain she was in, so she ended up lying on the floor.
WATCH | Gunter Holthoff describes his wife's final moments at N.S. hospital:
"I told the nurses and the lady at the desk there a couple of times, 'It is getting worse,' and nothing happened," he said. "So the security guards, in time, they brought a couple blankets out and they brought us a cup of water and I used it to put some ice on her lips."
As more time passed, Allison told her husband she felt like she was dying. He approached the nurses a few more times.
Around 3 p.m., the couple were taken to a room with a bed, but no medical equipment. Holthoff said he had to help Allison use a bedpan and used paper towel from a roll on the wall to clean up.
"At some point there, she was getting worse and she started to scream out in pain," he said.
A nurse came in and checked Allison's blood pressure again, and saw it was alarmingly low. Holthoff said that's when things started to change and the care became more urgent.
When they finally saw a doctor, they still hadn't received any test results. Then, as the nurses prepped Allison for an X-ray, Holthoff said he watched as her condition worsened — she was in so much pain she couldn't breathe. He tried to comfort her, and assured her the doctors would determine what was causing her pain.
"The next thing is [her] eyes rolled back in her head and her chest started rising. Something started beeping," he said. "The next thing you hear is over the PA, 'code blue, code blue in X-ray.'"
Holthoff said the room flooded with people, while he was sent to the hallway. A doctor later told him they resuscitated Allison three times — to no avail.
"Even if she would have survived at that point ... she had too long a time without sufficient blood flow to the brain and vital organs. It would have been not a life worth living," he said.
Since that day, Holthoff said he feels left in the dark. The results of Allison's autopsy haven't been released and he hadn't heard from anyone in government, except his local MLA, for at least a week after her death.
Holthoff said the health-care system failed his wife and he doesn't want her death to be in vain.
"We need change, the system is obviously broken. Or if it's not broken yet, it's not too far off," Holthoff said. "Something needs to improve. I don't want anybody else to go through this."
"I want a spot where if my kids break their legs, we can take them to the hospital if anything happens."
'The most amazing person'
Allison Holthoff, 37, was mother of three school-aged children. She was also the deputy chief and treasurer of the Tidnish Bridge Fire Department. Her obituary said she won a volunteer of the year award for her work organizing community events like pancake breakfasts and the annual children's Christmas party.
"She was the most amazing person I've ever known," Holthoff said. "She was great and everybody could get a helping hand out of her. If they needed help with anything, she was there for you."
A celebration of life was held at the local community centre on Friday, and Holthoff said the turnout was overwhelming.
"I didn't even know she impacted so many people," he said.
"I've never seen that centre so packed, I haven't seen so many people there in the 10-plus years that I've been here."
The question on Holthoff's mind now is whether his wife would still be alive if she had received treatment quickly on New Year's Eve.
Holthoff said he doesn't blame the staff at the hospital for what happened, but he blames the system.
It wasn't Allison's first time dealing with an unreasonably long wait for emergency medical care, he said.
In September, Holthoff called an ambulance after she fell off her horse. They waited more than three hours in the field — until it was cold and dark — and members of the local fire department then took her to hospital in a rescue truck.
"There [are] horror stories all the time about people waiting for an ambulance … it's horrendous, like there's no ambulances here if you need them and if you do get to a hospital, you're lucky if you get seen," Holthoff said.
Allison did recover from the fall, he said, but she still had some residual hip and back pain.
A problem with the system
After his wife's death, Holthoff approached his local MLA, Elizabeth Smith-McCrossin, for help.
On Jan. 6, Smith-McCrossin wrote an open letter to provincial Health Minister Michelle Thompson, asking for an "urgent investigation" into the situation. The letter said a request to meet earlier in the week had been denied.
"The government doesn't seem to pay any attention," Holthoff said. "I don't know what needs to happen ... or how many more people need to die. It's just a shame."
CBC News asked Nova Scotia Health how many deaths had occurred in emergency departments in 2022, but the department declined to say.
Smith-McCrossin, who sits as an Independent, said she is still pushing to meet with the health minister.
"That is why we're requesting an investigation, so that family has those answers," she said. "They've heard nothing from anyone in government and the challenge is because they're not hearing anything, it's getting more and more upsetting."
"I'm hearing from hundreds of people in the community asking, 'Why is nothing being said? Why is nothing being done?'"
Response from the province
On Monday, Thompson announced that an investigation, also known as a "quality review," had started automatically after Allison's death. She said it will determine what happened and what can be done to prevent similar situations from happening again.
"Family members will be invited and included in the investigation because it's very important, if they want to participate, that they have an opportunity to tell the events as they experienced them," Thompson said in an interview.
Results of the investigation will be shared with the family, she said.
Premier Tim Houston offered his condolences to the family on Monday, calling it a tragic loss that "resolves our focus to fix health care."
"Certainly anything we can do to improve health care, support Nova Scotians and support those working in health-care system, we'll do that quickly," he said.
The same day, an emailed statement from the province said Nova Scotia Health has been in contact with the family as of Sunday, "after several attempts to contact the family since last week."
ER conditions 'not ideal'
Smith-McCrossin said health-care workers have also been contacting her about the working conditions at the hospital.
"I hear from people on a regular basis upset about the long wait times and the concern about the conditions in the ER," she said.
"Our ER flooded in May, so there's been a temporary ER set up in ambulatory care, which is very challenging for our health-care workers to work in."
Last week following a cabinet meeting, Thompson told reporters that the flood prompted Nova Scotia Health to relocate the emergency room "really quickly and unexpectedly."
She acknowledged that the temporary emergency room setup is causing challenges.
"We know that those conditions are not ideal," Thompson said. "They're in a bit of a tough spot right now and we're working with them, knowing that we will make improvements there in the future."
She said a redevelopment plan is in the design phase and she could not share a timeline for the project yet.
For his part, Holthoff said he has a clear message for the government.
"The health-care system in Cumberland County, and probably the whole province, needs major, major improvement in any way."
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