Doctor accused of negligence in Cumberland emergency room death tells his side of the story

The doctor who was working at the Cumberland Regional Health Centre on New Year's Eve when a 37-year-old mother died in the emergency room is denying allegations of negligence.

A lawsuit has been filed against Dr. John Atia and Nova Scotia Health by Allison Holthoff's family, alleging they didn't test and treat her in an adequate and timely manner. Allegations from Holthoff's family have not been tested in court.

But Atia's version of events — outlined in his notice of defence filed March 30 at the Nova Scotia Supreme Court — tell a different story.

Atia says he was the only emergency medical physician on duty from the time Holthoff arrived in the emergency department until 7 p.m., when another emergency medical physician took over. He says he worked overtime to assist in Holthoff's care.

In addition to caring for Holthoff, Atia said he worked with four critical psychiatric emergency cases and four critical cases of pediatric illnesses. This included a case of pediatric stroke, "which required considerable effort to arrange Life Flight service to the IWK Health Centre," says his notice of defence.

Atia says that between 11:45 a.m. to 6 p.m., he wasn't told about Holthoff's condition. He said initial tests for her came back normal.

"At or just about 6 p.m., Dr. Atia was told for the first time of Mrs. Holthoff's deterioration, including that her blood pressure had dropped precipitously," his notice of defence states.

Upon learning this, Atia says he immediately went to assess her. He says he ordered "interventions to promote hemodynamic stability" which refers to blood flow.

"Because of the clinical and diagnostic uncertainty and the relatively broad differential diagnosis, Dr. Atia began arranging CT imaging of the chest, abdomen, and pelvis," the notice of defence said.

"Without on-site radiology service after 4 p.m., Dr. Atia was required to seek approval from diagnostic radiology and arrange for the imaging study to be done by a radiologist in Halifax." 

Atia ordered X-rays for Holthoff, he said. But while she was in the X-ray department and while Atia was briefing the other emergency medical physician who was scheduled to take over, Holthoff went into cardiac arrest.

Atia says he and the other doctor "immediately began resuscitation protocols and worked diligently to arrange for additional physician support and intensive care, including from internal medicine and general surgery."

Doctor wants lawsuit dismissed

"Dr. Atia remained involved in the efforts to stabilize Mrs. Holthoff. She was stabilized temporarily. Soon after, the on-call internal-medicine specialist arrived and then the on-call general surgeon. The internist assumed responsibility for Mrs. Holthoff's intensive care and, with Mrs. Holthoff stabilized, took her for the CT imaging that Dr. Atia had arranged."

Atia says he "was not involved in the events that then preceded Mrs. Holthoff's passing."

When it comes to Holthoff's family's allegations, Atia denies he failed to respond to pleas of nursing staff because "no pleas occurred."

"... Dr. Atia rejects any insinuation that he failed to work diligently and efficiently in dedicating himself to the patients that day," his statement of claim says.

Atia seeks to have the lawsuit against him dismissed with liberty to pursue costs.