Mrs Bernadette Anderton of Fulwood fell on November 15 last year, and later died in hospital after suffering a subdural hematoma (bleed on the brain).
An inquest at Preston Coroner’s Court was told the small bleed had been undetected by hospital staff and that medication given to prevent a heart attack was likely to have contributed to her death.
The inquest was told that Mrs Anderton, a retired doctor's receptionist, had been found on the kitchen floor by her husband at 5pm. Paramedics reached her at 1.27am and she had been on the floor since falling.
Paramedics found a laceration to Mrs Anderton’s scalp but no bleeding and no facial injuries. She was transferred to Royal Preston Hospital at 3.30am.
Coroner Chris Long asked why it had taken so long for an ambulance to attend the scene.
North West Ambulance Service Paramedic Robert James Wood told the inquest that they were understaffed and had 350 incidents waiting for an ambulance at the time.
He said the first call at 5.11pm was listed as a ‘category five’ incident, giving three hours to respond.
He said: "We were extremely busy at the time and were only at level three capacity which invoked extreme pressure on the services.
"At 17.28pm it was accepted for a clinical call back. However, due to the demand and lack of clinical capability we couldn't call back."
After another 999 call at 8.39pm the incident was moved to ‘category three’ because Mrs Anderton had started feeling drowsy.
He said an ambulance response needed to arrive two hours from the time of the call, which failed as there were 377 incidents across the Trust.
Mr Wood added that ambulances were queueing outside A & E’s in a nationwide problem.
At 1.03am the call changed to a category two and an ambulance crew arrived within 18 minutes, spending 100 minutes stabilising Mrs Anderton before she was transferred to hospital.
It was the following day, at around 3pm, that Mrs Anderton started vomiting and became ‘confused’.
She had been given medicines used to decrease blood clotting and to prevent a stroke, which coroner Chris Long said caused the bleed on her brain to increase.
The court heard that no suspected trauma had been found on the initial examination or on a subsequent trauma CAT scan.
Consultant cardiologist Dr Mike Dobson said in a statement: "With the benefit of hindsight there was a very subtle right-sided subdural haematoma that was very easy to miss."
It was later diagnosed, as critical care consultant Dr Catherine Roberts confirmed, adding that Mrs Anderton had suffered an unsurvivable brain hemorrhage. The care switched to palliative and she died at 8.45pm.
Reaching a narrative verdict, coroner Chris Long added that it would be remiss of him to place blame on anyone's doorstep as he could not say the time taken by the ambulance contributed to her death and that problems concerning ambulance waiting times had since improved.
He added that he could not determine an answer on whether a different radiologist would have made any difference in spotting the ‘very subtle’ bleed on her brain and that it would be speculative to do so; but that the different medication caused the bleed to increase and contributed to Mrs Anderton’s death.
He noted the medical cause of death as an acute subdural haematoma.