"No priority" was given to a 911 call from a distraught wife whose husband couldn't breathe and was turning blue, the head of emergency services at King Edward VII Memorial Hospital told an inquest yesterday

Edward Schultz told the hearing into Norman Palmer's death that the ambulance crew sent to the patient's Paget home when he got into difficulty on April 12 last year was never told by the dispatcher that it was a "high risk situation".

"No priority was given to this call at any time," said Dr. Schultz. "If you review the tapes, you will see that."

Mr. Palmer, 57, died soon after arriving at KEMH's Emergency Room, despite the efforts of three doctors to save him. His widow Kathleen has described the ambulance's response as a "fiasco".

Jeffrey Elkinson, lawyer for Mr. Palmer's family, asked Dr. Schultz yesterday if what happened suggested a flaw in the dispatch system, based at Bermuda Fire Service, which could be easily remedied.

Dr. Schultz replied: "We have raised concerns on numerous occasions about the dispatch."

He added: "I'm not here to advise this inquest on how to improve the emergency dispatch system but I would go on record saying I think there are problems with emergency medical dispatching.

"We have proposed a number of remedies over the years but I don't think they are matters to be discussed in this inquest. They are confidential matters between the KEMH and Government."

The inquest previously heard it took more than eight minutes from the time Mrs. Palmer dialled 911 to her running outside to meet the ambulance on Leafy Way, which is around the corner from the hospital.

Dr. Schultz defended the ambulance emergency medical technicians (EMTs) and said he'd driven past the lane for 20 years without knowing it was there. He said the response time was "irrelevant" since by the time Mr. Palmer began turning blue at home "it was already too late to save him".

"The window of opportunity for saving Mr. Palmer had passed," he told Coroner Khamisi Tokunbo.

Dr. Schultz told the hearing he commiserated with Mr. Palmer's family and was "deeply sorry" attempts to save his life were unsuccessful but said extra minutes would not have altered the outcome.

"It's very sad that it came to this but I do not believe that the EMTs, who are the lowest level of training, should be blamed for Mr. Palmer's death because that is not appropriate."

He added: "I feel very bad that Mr. Palmer died, but that doesn't justify blaming someone who is not responsible for his death."

Dr. Schultz, KEMH's director of emergency services, said ER doctor Ashfaq Syed gave instructions to Mr. Palmer six days before he died to see an ear, nose and throat (ENT) specialist.

"I don't think, if his instructions had been followed, we would be having this inquest today," said Dr. Schultz.

The inquest has heard that Mr. Palmer, an asthmatic with a 40-year-old gunshot injury to his neck, refused to see the on-call ENT Wesley Miller on April 6 because of a past bad experience, and went home, saying he would see another doctor, Robert Vallis, the next day.

In fact, as earlier testimony by Mrs. Palmer revealed, he wasn't able to get an appointment with Dr. Vallis until April 14 – two days after his death.

Dr. Schultz said the family could have brought the patient back to the Emergency Room at any time to see the on-call ENT specialist.

He said Mr. Palmer would have been saved if he'd had two procedures – an examination of his larynx using a fibre-optic device and elective surgery on his windpipe to open the airway – following his April 6 ER visit.

"By the time it got to that fateful day (April 12), it was too late," he said. He told the hearing he met with the family after Mr. Palmer's death and they were "extremely angry".

"I believe that the Palmer family gave deliberately misleading statements to the press of this Country, to the media of this Country," he said.

"The hospital, and the EMT service in particular, was subject to these either inaccurate or misleading or outright false statements for about nine months' duration. This behaviour of the family has persisted."

KEMH's chief pathologist Kered James also appeared on the witness stand yesterday, telling the inquest that Mr. Palmer died of respiratory failure, with complications including cancer of the larynx.

Her testimony is due to continue on Monday, when the hearing resumes.