The incident prompted a review by Ambulance Victoria. The organisation has confirmed that taxis are used to take patients to hospital for some non-emergency calls. The case follows one in Bacchus Marsh in which a woman complaining of severe pain was forced to take a taxi to hospital in Ballarat, reportedly because of a shortage of ambulances in the area. Danielle said that when she eventually got to hospital she was diagnosed with acute appendicitis, and required an appendix removal. The commercial manager from Sydney said the illness hit her out of the blue in the early hours of Wednesday, April 18, while she was in Melbourne for business without her family.

Danielle said that after almost "crawling" into the lobby of the Crown Promenade she was attended by a medical officer at the hotel, who called an ambulance. She said the phone was handed to her at points during the conversation. An operator asked her to rate her pain out of 10. Danielle said nine. It is understood the call would have been handled by Ambulance Victoria via its specialist referral service, not by triple-zero operators. Ambulance Victoria chief operating officer Mark Rogers said all calls to triple zero were assessed on their severity, and less-urgent callers were questioned by a paramedic or registered nurse to see if they were suitable for alternative care, such as a GP visit. “After a thorough assessment of the individual circumstances by a paramedic or a nurse, and after discussion with the patient about their ability to transport themselves or arrange other transport, we may organise a taxi to take the patient to a medical facility if their medical condition is less urgent," Mr Rogers said.

Later in the call, Danielle said she was told that she clearly needed to go to hospital, but she was not considered serious enough to require an ambulance. Instead she said a taxi was ordered on her behalf by the ambulance service. After waiting five or 10 minutes for it to arrive, she was bundled into the back of an old maxi taxi, and travelled to the hospital alone. Once she arrived at St Vincent’s Hospital, Danielle was asked to sign a receipt so the taxi driver could be reimbursed. "I remember just sitting there and crying in pain, throwing up, and thinking, 'I can’t believe I have to sign a receipt,'" she said. Danielle does not believe it is right that she was taken to hospital in a taxi, without any medical care, pain relief or assistance to get into the emergency department.

“I have two friends in Sydney who have both had appendicitis. Both of them called triple zero and both of them had ambulances,” she said. “My best friend said to me, ‘I don’t know how you managed in the taxi; the only thing that got me through was that I felt I was in really good medical hands from the first moment.'” Cameron Loy, of the Royal Australian College of General Practitioners, said appendicitis was an urgent presentation that mostly required surgery and could cause very severe lower abdominal pain. “This wasn’t a mild presentation,” Dr Loy said. “I’m sure the expert and highly skilled paramedics would have preferred to have attended that woman and given her appropriate pain relief in a short amount of time and got her to hospital.”

However, Ambulance Victoria says it sees no problem with how the case was handled, following a review by clinical specialists. "A taxi was considered the best way for the patient to make their way to hospital and this was arranged with the agreement of the patient at the time," said communications and referral manager Mick Kyprios. In the Bacchus Marsh case, where the patient was eventually diagnosed with a severe bladder and urinary tract infection after a 30-minute taxi ride to hospital, another review concluded that Ambulance Victoria "could have taken the patient's individual needs further into consideration". Changes were made to Ambulance Victoria’s response system in October 2016 after it was discovered ambulances were being sent to cases that didn’t require urgent lights and siren care, such as a rolled ankle, a person who got caught in the rain and someone who became anxious after seeing a scorpion. About 50,000 patients who would have previously received emergency care received a less urgent response in the past financial year, although Ambulance Victoria was not able to say how often taxis had been used.

The service says the changes have resulted in improved responses, including record survival rates from cardiac arrest. The Australian Medical Association in Victoria says it has been told that Ambulance Victoria is re-examining its protocols following Danielle’s case. "Any circumstance where patient care is compromised because a transfer by ambulance has been denied or re-directed is unacceptable," AMA Victoria president Julian Rait said. However, the ambulance union says the system seems to be working better following the 2016 changes. Secretary Steve McGhie said that the patients utilising taxis now were previously using emergency transport when it was not necessary, holding up paramedics.