An independent review has been published into claims the NEAS covered up patient failings.
The family of, from Shildon, County Durham, only found out what happened when a family liaison officer visited a few days before her inquest in April 2019.
It found that "however small the probability of recovering was" the teenager "deserved that chance and so did her family". A narrative verdict was recorded by the coroner almost two years after her death., he had called 999 in March 2019 when a power cut meant his home oxygen supply stopped working. The review discovered crews arrived 36 minutes after his call.
Mr Coates' family, who eventually learned what happened via the whistleblower, believe if the crews had reached him sooner "he might still be alive".Another call highlighted in the report was in November 2019 when a 62-year-old man had fallen on to a wooden laundry basket. The review found there was a "trend" for NEAS to provide coroners with "confusing or conflated" information rather than the original material and there was "no independent communications with families" which would have "lessened the trauma".It also found opportunities for learning were missed, with established processes not being followed by NEAS.
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