The mayor of Middleton, Nova Scotia, is calling for changes to the province’s health-care system after a patient admitted to the local hospital died during a cardiac arrest, and volunteer firefighters were called in to help because there was no doctor available on site.
The mayor noted that fire services are a municipal responsibility, while heath care is the province’s concern. The town of Middleton is situated around 150 kilometres northwest of Halifax, on the north bank of the Annapolis River.
Inpatient Emergency
The mayor wrote that on June 15, at approximately 9 p.m. local time, the Middleton Fire Department and Emergency Health Services were called regarding a cardiac arrest at Soldiers Memorial Hospital (SMH).“Since the ER was closed at this time, our Fire Department assumed that someone arrived at the hospital with chest pain and Emergency Services were called,” Atkinson wrote.
When volunteer firefighters arrived on the scene they were taken upstairs to a medical floor with a patient in cardiac arrest—an admitted inpatient at the hospital, said Atkinson.
“Our Fire Department was informed that there was no doctor on site, nor was there one on-call,” according to the mayor. They were told a doctor was coming from Kentville, more than 30 minutes away. Firefighters assisted emergency responders with chest compressions and life-saving measures until the doctor arrived, said the mayor. The patient did not survive.
Atkinson said the Middleton Fire Department, which is a volunteer municipal service, “should not be called to a hospital to provide medical aid to an admitted inpatient. A hospital is where people go to receive medical treatment from health care professionals that work there – not volunteer firefighters.”
His letter said that firefighters are on call to provide emergency aid to the public, which should not extend to a hospital where inpatients should already have access to a doctor.
According to Atkinson, he had previously contacted the premier on April 6 to discuss what the mayor described as “issues stemming from the consistent ER closures at SMH in Middleton.”
“Regrettably we did not receive a response back,” said the mayor. Instead, he said, Nova Scotia Health official Tanya Nixon met with six municipal regions within the Annapolis Valley. While Atkinson said the discussion was “healthy,” he said there are concerns that the province and Nova Scotia Health do not “have a site-specific strategic plan” for restoring the hospital ER to a 24-hour, seven-day-a-week service.
According to the mayor, Nova Scotia Health told municipal leaders it would require five to seven physicians to re-open the emergency room to run 24 hours a day.
Shortage of Doctors, Nurses
Nova Scotia health spokesman Brendan Elliott told The Epoch Times on June 21, that like many jurisdictions in Canada, Nova Scotia has “challenges with attracting physicians to rural parts of our province.”At press time, Soldier’s Memorial Hospital emergency room was scheduled to be open Tuesday through Friday from 7:30 a.m. to 1:30 p.m., then closed the remainder of each day, as well as closed Saturday, Sunday, and Monday. The hospital was also scheduled to be closed on June 22.
According to Elliott, even if one hospital is closed, each zone has large regional hospitals that never close their emergency departments. “Our pressure points are along the Eastern Shore of Nova Scotia, as well as the South Shore,” he said.
Elliot said the patient death had nothing to do with an emergency department closure, saying there is “always a doctor on call for inpatient care at Soldiers Memorial Hospital.” That doctor can be on-site or nearby, can be called on to provide advice or consultation, and can provide services remotely or in person, according to Elliot, contradicting the mayor’s assertion that there was no doctor on call.
“Should an inpatient require immediate care beyond what in-hospital staff can provide, as was the case in this situation, there are specific protocols staff will follow. When additional immediate assistance is required and a physician is in transit, protocols include calling 911. In the meantime, staff will do everything possible, including commencing CPR, if necessary,” said Elliott.
He said that senior administrative staff in the Western Zone of Nova Scotia Health have “conducted a thorough review of the details surrounding the situation,” and that the process followed by the hospital is consistent with how other N.S. Health sites handle the situation “without after-hours, hospital-based physicians.”
“There is no doubt the outcome was not what anyone wanted. However, staff performed admirably given the circumstances and protocols,” he said, adding that the health department “extends its deepest condolences to the patient’s family and friends.”
