In a city where conspiracy theories and allegations of cover-ups are as much a part of politics as the fog, the circumstances surrounding the death of high-profile Public Defender Jeff Adachi have insiders running on overdrive.

One repeated question is, why did it take three hours before the police were called in?

After all, police were on the scene within minutes when Mayor Ed Lee suffered a fatal heart attack while shopping at his neighborhood Safeway in December 2017.

In Adachi’s case, three hours elapsed between the time paramedics responded to the 911 call from a woman identifying herself as “Caterina,” who reported a male not breathing, and the time police showed up at the Telegraph Hill apartment where Adachi was stricken.

And that was two hours after Adachi had been declared dead at California Pacific Medial Center in Pacific Heights.

By the time police arrived at the apartment, Caterina was gone — although sources tell us she has since been interviewed by investigators. Police won’t confirm that on the record.

Fire department spokeswoman Mindy Talmadge said there is no official protocol for notifying police “unless there is some reason to contact the police, some sort of criminal activity — for instance a gun or illegal drugs, or if the patient dies on the scene.”

Talmadge said there were no obvious signs of illegal drugs or criminal activity at the apartment at 46 Telegraph Place when paramedics from Station 28 arrived at the scene, hence no need to call the cops.

As for the syringes later listed in police reports: “As far as sharps are concerned, I can’t say with 100 percent certainty there are not cases where one got left behind” by paramedics.

After administering CPR and getting a pulse, paramedics took Adachi to the hospital, where he was pronounced dead.

The police were then called, but then called off while en route by the medical examiner’s operations chief Christopher Wirowek, who according to the police report said that he had no reason to believe that 46 Telegraph Place was “a crime scene.”

Nonetheless, police responded and wrote up a report — complete with photographs — that later wound up in the hands of the media.

It’s no secret that Adachi and parts of the San Francisco Police Department weren’t the best of friends, so getting the report to the media might have been a way of getting back at the deceased public defender.

Whatever the case, the medical examiner has now asked the police department’s homicide unit to assist in its investigation of Adachi’s death.

The medical examiner isn’t talking about why the cops are back on the case and will “not be issuing comment nor releasing information regarding the death of San Francisco Public Defender Jeffrey Adachi until the conclusion of the ongoing investigation,” Chief Medical Examiner Michael Hunter said in an email.

Meantime, the conspiracy theories continue.

San Francisco Chronicle columnist Phillip Matier appears Sundays and Wednesdays. Matier can be seen on the KPIX-TV morning and evening news. He can also be heard on KCBS radio Monday through Friday at 7:50 a.m. and 5:50 p.m. Got a tip? Call 415-777-8815, or email pmatier@sfchronicle.com. Twitter: @philmatier