The family of Korjia Jajo are calling for an investigation after it took paramedics 49 minutes to reach their Sydney home, despite living seven minutes from Westmead Hospital.
After spending the evening of May 23 with her children and grandchildren at her home in the Sydney suburb of Merrylands, Korjia Jajo decided to go to bed at around 11pm.
According to her children, the 78-year-old migrant from Iraq had been in good health and didn't mention any symptoms.
At 2am, she awoke with chest pains and called for help. Her children responded and quickly dialled triple zero.
They reported their mother's symptoms and explained that she had a pre-existing heart condition due to her age.
"We told them she was sick and she couldn't breathe and that she has a heart problem. We said, 'please send us an ambulance'," her daughter Ibtisam Koreel said.
Ms Koreel was with her mother that night in the house, which is a seven-minute drive from Westmead Hospital.
SBS Arabic24 has spoken to the family of Ms Jajo who gave their detailed recollection of the events of that difficult night.
Following the first call to triple zero, Ms Koreel's brothers called a further four times from different phones.
More than 30 minutes later, one of Ms Koreel's brothers was instructed over the phone to perform CPR on his mother, despite not having any previous training.
An ambulance finally appeared at 2:51am, 49 minutes after the family made their first triple zero call.
The average ambulance response time in NSW is 11.4 minutes, according to the Productivity Commission report on Government Services 2020.
"Every time we called them, we said 'she's getting worse, please come quickly, our mother is having a heart attack'," Ms Koreel said.
When the first ambulance arrived, my mother was still alive but she'd been fighting a heart attack with no medical care for close to an hour.
The paramedics immediately examined Ms Jajo and informed the family they were not equipped to deal with a heart attack, despite the fact that a heart attack was what the family reported multiple times to the emergency operators.
According to Ms Koreel, the paramedics quickly radioed to request another ambulance that was better equipped to deal with heart attacks.
"Within three to four minutes, four other ambulances appeared out of nowhere," Ms Koreel said.
Paramedics from the newly arrived ambulances rushed to Ms Jajo and applied an oxygen mask, before performing CPR.
Ms Koreel said the paramedics suggested waiting for 20 minutes for her mother's heart rate and vitals to stabilise before transferring her to the hospital.
Ms Jajo was then taken to Westmead Hospital's emergency department.
The ambulance crew refused to let the children on board with their mother, so they instead followed close behind.
Once arrived at the hospital, Ms Jajo was taken inside and the children were asked to wait in an "interview room".
Half an hour later, they were visited by a doctor who informed them that their mother had died.
According to Ms Koreel, the hospital said there was nothing that could be done for her mother, who arrived at the hospital 71 minutes after the initial triple zero call.
Next of kin
"We didn't know what happened. The hospital refused to produce a death certificate or to tell us the cause of death. They made us get a death certificate from a GP. And they still refuse to give us any information today," she said.
According to a letter addressed from Westmead Hospital General Manager Rebecca Tyson to Ms Koreel, which has been seen by SBS Arabic24, the hospital cannot release any information to the family because they are not the "next of kin".
"I have escalated your concerns and I assure you that they have been reviewed. As you are not Mrs Jajo's next of kin, privacy and confidentiality requirements restrict me from sharing details of Mrs Jajo's care and treatment," the letter reads.
However, I assure you that your mother received appropriate care.
According to Australian law, the first degree of kinship is the person's partner. The second degree is parents and the third degree of kinship is the person's children.
"How can we not be my mother's next of kin? If not my brothers and I, then who can know the cause of her death and the details of the care she was provided?"
However, Ms Koreel received a letter from Dr Tyson on June 10, which said they will allow Ms Jajo's children access to their mother's health information.
"After speaking with the privacy and information and compliance officer, I have been advised that there is a provision in the privacy laws that allows information to be released on compassionate grounds," the letter reads.
Ambulance response time
Ms Koreel believes the ambulance response time was one of the main factors leading to her mother's death.
She also believes the lack of preparedness of the first responders to deal with her mother's condition also played a role.
Ms Koreel's family lives 5.3 kilometres from Westmead Hospital where her mother was transported for treatment, a trip that takes around seven minutes during periods of low traffic.
The family also lives 3.6 km from the nearest NSW Ambulance station.
Despite being ready to transport their mother to the hospital themselves, Ms Koreel and her brothers said they were told "help is on the way" every time they spoke with the triple zero operators to get an update on the ambulance's whereabouts.
"They asked my brother to stand outside on the street so the ambulance driver could see him quickly," Ms Koreel said.
"The ambulance arrived after he'd been waiting outside for 30 minutes."
According to cardiologist and lecturer at Monash University, Dr Wally Ahmar, "time is a critical factor" in responding to potential heart attacks.
"The quicker a patient with a heart attack is attended to and receives treatment, the greater their chances of surviving the heart attack and their long term recovery," he said.
"In our field of cardiology, we like to say 'time is muscle'. This means the less time it takes to attend to the attack, the less damage to the heart muscle."
When asked about a 49 minute response time to a potential heart attack, Dr Ahmar described it as "inappropriate".
"If they have notified triple zero that there's chest pain, shortness of breath and a potential heart attack, that response time would be inappropriate.
"You want it to be much shorter than that."
Regarding the case, NSW Ambulance said: "NSW Ambulance has commissioned a Serious Adverse Event Review and informed the family of this process. The patient’s family will be provided the opportunity to participate in it and review the findings."
While this review is underway it would be inappropriate for NSW Ambulance to make further comment.
Ms Koreel and her brothers are now demanding a full investigation into the "devastating" events leading up to their mother's death.
They strongly believe "negligence" was the reason their mother is not alive today, and hope an investigation will answer their many questions about the night she died.