A senior doctor at King Edward VII Memorial Hospital yesterday accused the family of a man who died in the Emergency Room of "mounting a malicious media campaign" to try to deflect blame from themselves about his care.

Edward Schultz, director of emergency services, alleged during an inquest at Magistrates' Court into 57-year-old Norman Palmer's death, that his family treated him at home for "severe respiratory distress" for nearly an hour before calling 911 on April 12 last year.

Dr. Schultz said in a statement he read out to Coroner Khamisi Tokunbo that ER physician Ashfaq Syed correctly diagnosed upper airway obstruction when Mr. Palmer attended the hospital six days before.

He said the patient refused to see the on-call ear, nose and throat specialist that night "for reasons known only to the Palmer family" and went home, after deciding to go to a different doctor for follow-up care.

Dr. Schultz said Mr. Palmer, an asthmatic who still had pellets in his throat from a 40-year-old gunshot injury, continued to smoke "heavily" i.e. two packs of cigarettes a day.

The inquest heard that Mr. Palmer went in the shower on April 12 when he started to feel unwell.

Dr. Schultz said that decision "delayed his care significantly" and he was "in extremis" or at the point of death when the family "finally requested medical assistance by calling 911".

He said the time between the call and the ambulance arriving at Leafy Way, Paget, was six minutes and 16 seconds, and it was met by a family member "after a brief delay".

"Although the Palmer residence is close to the hospital, there was a considerable amount of confusion and discussion over the exact directions to the house," he said. "This delayed the response for probably two minutes at least."

The ambulance crew's decision upon arrival to treat him for asthma was "not unreasonable" considering they were told he was an asthmatic, said Dr. Schultz. He added that the patient, a Brit who ran his own excavating business on the Island, arrived at ER still breathing but could not be saved despite the "best efforts" of Dr. Syed.

Dr. Schultz told the court: "This family has mounted a malicious media campaign – newspaper, radio – attacking the EMT (emergency medical technician) service at KEMH, basically blaming them for Mr. Palmer's death and abrogating blame from themselves for any of the decisions that were made in his care. They have publicly exaggerated the response times."

He said their claims – including that trained paramedics in the UK would have performed an emergency surgical airway – flew in the face of the facts.

Earlier in the day, Dr. Syed took the stand, telling the hearing: "I tried my best to save this man's life."

He gave a detailed explanation of how Mr. Palmer was "super saturated" with oxygen and of how he attempted to pass a tube into his larynx to help him breathe when he was brought into ER on April 12.

When those measures didn't work, he "immediately rushed" to perform a surgical airway but the patient went into cardiac arrest. Another doctor took over CPR, while Dr. Syed used a scalpel to make an incision in the neck.

"It was a difficult dissection because it felt like there was fibrous tissue," he said. "It felt like cutting through hard leather. It felt like, to me, this patient must have had previous operations."

When his attempt to open up the airway – known as a cricothyroidotomy – failed, Dr. Syed said he performed a lower incision not normally carried out in ER, called a tracheostomy. That too was unsuccessful and, according to Dr. Syed, Mr. Palmer was declared dead after 15 minutes of CPR failed to restart his heart.

Dr. Syed, a fellow of the Royal College of Surgeons, said it was very unfortunate that Mr. Palmer went into cardiac arrest and could not be revived. "I would like to say I did, my team did, the best we could to save the life of Mr. Palmer."

Jeffrey Elkinson, lawyer for the family, asked him why it could be that relatives did not see a cut in his neck when they viewed the body and a pathologist did not mention it in her first report after an autopsy. "I did the procedure," replied Dr. Syed, adding that other medics who were there could confirm that.

Dr. Syed said that six days earlier, when the patient visited ER with breathing trouble, he told him his condition could be "life-threatening" but Mr. Palmer refused to see the on-call specialist.

Anaesthetist Richard Hammond, one of the three physicians who tried to save Mr. Palmer, later confirmed that an incision was made by Dr. Syed, during evidence he gave to the hearing.

Dr. Hammond said he felt on first seeing Mr. Palmer that "the moment to save him had passed".

The hearing continues today.