Warning: This article contains graphic images of a facial wound.
St John is defending its actions after an elderly man with a gruesome facial wound was refused help from ambulance services.
Seventy-nine-year-old Aupito Pupu Lolesio slipped onto a piece of equipment at a Manukau gym on Tuesday, cutting his left cheek so deep the bone was visible.
But when gym staff called an ambulance, they were told it would be faster to drive him themselves, leaving Mr Lolesio's daughter, Noma Sio-Faiumu, to take him to Middlemore Hospital.
Mr Lolesio, a cancer patient, then had to wait five hours until he was seen by a doctor.
During that time Ms Sio-Faiumu says she had to nurse her father's bleeding wound on her own.
"I can appreciate they're busy. But doctors and nurses were taking selfies in the middle of the ward. No-one was really paying attention."
Seven hours after arriving, his wound was finally treated, but by that stage it had swollen severely, Ms Sio-Faiumu says.
Mr Lolesio was operated on the following day, which went well but his family say this doesn't make up for his ordeal, and have laid a formal complaint against St John and Middlemore Hospital.
In a statement, St John says "the patient was not deemed to have a life-threatening condition and the nurse's advice was given according to best practise.
"The call was managed according to internationally recognised triage processes."
But Ms Sio-Faiumu says the gym repeatedly told the operator it was a severe injury.
"I just felt like it was very much an assessment by numbers. There was no human empathy and when you consider most people consider 111 as the first point of contact to provide help, that's not good enough."
St John says it takes patient welfare seriously and will be reviewing this case with the patient and his family.
Ms Sio-Faiumu says her main concern is looking after her father.
"He's not the kind of person who will tell you if he is injured or be a burden in any way. But we are managing his care as we don't feel safe leaving him here on his own."