A 91-year-old who fell and hit her head waited two hours for an ambulance to take her to hospital, after the first paramedic to arrive immediately fell ill and was unable to treat her.
Eight days later she was dead.
Her story is among dozens the Herald has been told about seriously sick or injured people waiting hours for an ambulance.
St John said an increase in demand had seen 21,653 patients wait more than an hour for an ambulance in the last six months.
Jean Petch, 91, slipped and fell in the bathroom, hitting her head at 3.20am, last November.
An ambulance arrived at her Maungaturoto retirement home in about 10 minutes but the paramedic on board "fell suddenly and violently ill" soon after arriving and was "rendered incapacitated in the back of the ambulance for the duration of the incident" leaving her ambulance officer partner to assess Petch.
When the paramedic fell sick the crew from Bream Bay, 25 minutes away, was assigned. They were soon diverted to a more urgent job leaving the case to St John staff an hour away in Whangarei.
Staff were told she was on blood thinners and a she was assessed as status 3 - injured but stable at that time.
It was 5.20am, two hours after she fell, by the time another paramedic arrived to treat her.
She arrived at Whangarei Hospital about 7am and a scan immediately found a major brain bleed and broken hip.
Doctors tried to stop the bleeding and the effects of the blood thinners but Petch began having seizures which they were not able to control and she died eight days later.
Daughter Kathy Strong was shocked to learn there was only one ambulance crew available in the area at any given time and that others had to be called out from a considerable distance away.
"That to me is life and death - and it was for mum," she said. "Now I have a 94-year-old dad who grieves every day for our mum whom he was married to for 70 years."
She said it was "absolutely crazy" that there was only one crew on each shift and no one who could cover if someone became sick.
"They have to do something. This is supposed to be our first response for emergencies and they can't even get to you because they aren't putting enough money into it."
She also believed an elderly person who knocked their head should be treated more seriously and urgently - especially if they were on blood thinners.
Strong laid a complaint with St John regarding the situation and received an apology but was told staff acted appropriately and gave the best care they could.
"The delay in transport and the subsequent death of your mother is any crew's worst nightmare and they have been deeply affected by this. They want to unreservedly apologise for the delays and wish they could change the events of that morning. We all feel terribly sad for your family and Mrs Petch and can't apologise enough for letting you down that morning," Rodney territory manager Megan Fairley said in her response letter.
She explained there were times when their resources were overwhelmed and staff were sent to what was deemed the most urgent first. She said the Northland region had just received more funding and hoped it would prevent similar situations from occurring.
St John deputy clinical director Dr Craig Ellis told the Weekend Herald the organisation always aimed to respond as soon as possible but life-threatening calls had to be given the highest priority.
Ellis said there had been a marked increase in demand for ambulances with callouts increasing an average of 3 per cent a year for the last five years.
In the financial year from July 2019 to June 2020 St John received more than 540,000 calls to 111 and treated or transported 460,000 patients. That's an average of about 1480 calls and 1260 patients cared for each day.
Ellis said St John provided ambulance services to 90 per cent of New Zealanders in 97 per cent of the country's geographical area.
Government contracts with the Ministry of Health and ACC made up about 78 per cent of the funding for St John's emergency ambulance services with the balance of about $130 million each year made up from ambulance part-charges, third-party contracts, and fundraising.
While the community health programmes run by St John including the health shuttle and first aid courses would always operate through charitable means, the organisation wanted the ambulance service to be "sustainably funded" by the Government, Ellis said.
Its current ambulance contract ends on June 30 and St John had been working with the Government on a "new sustainable commissioning approach" for long term contracts from next year, he said.
In the meantime, the organisation had put in a request for additional funding for the next financial year to help meet the growing demand for the service.
A Ministry of Health spokesman said the National Ambulance Sector Office was in regular discussions with St John regarding funding and was working with St John on a commissioning approach to guide future contracts for road ambulance services.
"The Government is committed to ensuring that New Zealanders have access to emergency ambulances in their time of need. In times of high demand, it is necessary to prioritise patients based on their level of acuity and some patients may experience an increase in wait times," he said.
"In recognition of increased demand and workload, the Government has provided additional financial support for emergency road ambulance providers over the last two years."
Government funding aside, Ellis said the charity was grateful for the "very generous public support of New Zealanders who help us to keep our ambulances on the road and deliver the vital health services we provide to communities throughout the country".
St John's annual appeal started on Monday and he hoped the public would support it so St John Ambulance could buy more ambulances and clinical equipment.