An investigation has been launched after a man died shortly after his family was forced to drive him to the Royal Hobart Hospital because no ambulances were available.
The ABC understands the man's family called Triple Zero shortly before 11pm on Saturday after a fall at a property in inner Hobart.
The incident was initially categorised as a non-urgent Priority 4 case.
But about 25 minutes later, the family called again to say the man's condition had deteriorated, and he was not breathing normally.
The second call prompted the incident to be upgraded to an emergency Priority 1 case.
The family arrived at the Royal Hobart Hospital shortly before midnight. (ABC News: Luke Bowden)
Such cases are considered life-threatening situations that require an ambulance to be dispatched immediately using lights and sirens.
However, the ABC understands it took a further 25 minutes after the second Triple Zero call for an ambulance to be assigned due to a lack of availability.
By the time it arrived at the property about 13 minutes later, no one was home.
The family had already driven the man to the Royal Hobart Hospital, arriving shortly before midnight.
The man, believed to be in his late 40s, was in cardiac arrest on arrival.
Medical staff began resuscitation attempts outside the hospital, before he was taken inside for further treatment.
Under current "transfer of care" protocols, patients are supposed to be transferred from ambulances to the emergency department within 60 minutes. (ABC News: Ebony ten Broeke)
The Department of Health has confirmed the man subsequently died.
"Ambulance Tasmania responded to an incident in Southern Tasmania on Saturday 10 October where sadly, a patient passed away shortly after arriving at the RHH," it said.
"The Department of Health extends its heartfelt condolences to the patient's family, friends and loved ones at this very difficult time."
The department did not respond to the ABC's enquiry on the 25-minute delay to dispatch the ambulance after the man's case was escalated to Priority 1 status.
"Patient safety remains our highest priority and a comprehensive investigation is now underway through the Tasmanian Health Service and Ambulance Tasmania, which will investigate the circumstances surrounding the incident and to identify any immediate actions required," it said.
"This investigation is a priority for the department and further information will be provided following its conclusion, including whether the incident should be referred to the coroner."
'Ramped' ambulances unable to be freed up
The Health and Community Services Union (HACSU) said three ambulances were "ramped" at the hospital at the time of the incident, with patients unable to be transferred from the ambulances due to a backlog in the emergency department.
HACSU said a "Tier 1 escalation" was called at about 10pm in an attempt to make some of the ramped ambulances available, but they remained stuck there.
It said this was despite up to four other Priority 1 cases awaiting assistance in the state's south at the same time as the man's family was seeking urgent help.
"At the time of the call when the case was escalated, all ambulances were either ramped or on other cases out in the community, and that is why there wasn't able to be an immediate response to this P1 case that should have had an urgent response," HACSU state secretary Robbie Moore said.
"Obviously, the ambulance service did everything it could and got an ambulance as quickly as it could, but that delay is obviously not what should be happening, and that's why we have to address the ramping.
"If the three ambulances hadn't been ramped, one of those could have attended to that emergency situation and this situation could have turned out a whole lot better."
Robbie Moore says the P1 case should have had an urgent response. (ABC News: David Hudspeth)
The Health Department did not respond to the ABC's enquiry about the union's claim regarding the number of ambulances that were ramped at the time, nor why none of them were freed up.
Under current "transfer of care" protocols, patients are supposed to be transferred from ambulances to the emergency department within 60 minutes.
Data from Saturday shows 71 per cent of patients were transferred into the Royal Hobart Hospital's emergency department within that time frame.
Other data obtained by Labor last month showed ambulances were not available within three minutes of a Triple Zero call almost 17,000 times in 2025–26 — a 30 per cent increase on the previous year.
Health Minister Bridget Archer said at the time that Triple Zero calls were triaged according to clinical need and that the increase was due to high demand.