of a critically ill patient.

A visitor who had suffered serious head injuries in a road accident was eventually flown to the US after difficulties over the medical evacuation were ironed out late on Sunday.

The situation arose just as the Airport was due to carry out essential runway resurfacing work.

Last night the 37-year-old woman was in critical condition in intensive care at Massachuetts General Hospital.

The problem arose after doctors at King Edward VII Memorial Hospital decided the patient needed to be flown out for urgent brain surgery, after her condition become unstable.

The medevac company were contacted but permission to land was not granted immediately after a misunderstanding over the severity of the incident.

It is also understood the timing, which was out of normal hours, was an issue.

As soon as it became apparent it was a life or death situation, the aircraft was allowed to fly in.

A hospital source, who did not want to be named, said there should have been a better method of gaining permission for transfers during abnormal hours.

"It was very frustrating for us,'' she said. "The air ambulance were telling us they were ready but couldn't get clearance. The patient was very unstable and needed further surgery in Boston. The company said they were waiting for the Airport to get back to them, because initially they had refused them permission to land.'' The woman said in normal circumstances, when patients are stable, medevacs can wait but in this incident it was essential she was moved.

Lester Nelson, acting general manager of airport operations, said there had been a lack of communication but as soon as the urgent nature of the situation was realised, permission was given.

He said crews who were standing by to resurface part of the runway were called off to allow the aircraft in.

"We had to determine what the nature of the flight was. As soon as the hospital advised us it was critical, approval was given -- all that was done within 15 minutes,'' he said.

Mr. Nelson said a "notice to airmen'' regarding the runway work was sent out some time ago but added in future that should also be sent to the hospital.

He said there were many people on the ground to inform of the impending arrival and officials had to ensure the runway was operational.

Phone calls between KEMH, the medivac company and the Airport may have hindered the approvals process, he said.

"Once we knew that it was definitely a life and death situation there was no refusal. We had to ensure the runway would be in proper condition for the aircraft to land.'' Confusion leads to medevac delay The woman suffered serious head injuries and a broken leg in the accident, which happened at Ferry Road, St. George's on Friday.

She was a pillion passenger on a scooter which was involved in a collision with a car. The car driver and rider were not seriously hurt.

A Boeing 747 was re-routed to Bermuda on Saturday after a female passenger developed heart problems.

The woman was taken to King Edward VII Memorial Hospital for treatment.

HEALTH HTH