It was the middle of the night and her husband Marek was gasping for breath. So Claire Krawczyk did what any Canadian would do -- she rushed him to the emergency room of one of Toronto's biggest hospitals. 

"I was at the point of throwing up and fainting at the same time," said Marek Krawczyk.

When he told the triage nurse that he couldn't breathe and he had suffered from pneumonia before, they assumed he'd be called in to see a doctor right away. They assumed wrong.

Marek passed out in the waiting room, straddled between two chairs. They waited and they waited. After two hours, Claire took him home, in disgust. They then went to a walk-in clinic, where he was treated. If a doctor had seen him in the ER, they likely wouldn't have let him walk out -- because he did have pneumonia.

"He felt so awful," said Claire. "Other people got up and left, too. I think everyone was just sick of waiting."

It is far from being an isolated case.

"The sickest of the sick people, we're not getting to them," said Dr. Andy Brockway, an Ontario emergency room physician who is speaking out because he's tired of being forced to make very ill people wait. "I hate having to say I'm sorry to those patients."

A study of government data on all visits to the ER in Ontario supports Brockway's assertion.

The statistics -- submitted to government by hospitals last year -- show even very ill patients are now waiting longer than they're supposed to; some much longer. The study, the first of its kind, contradicts what many Canadians believe -- that despite the strains on the ERs, if patients are really sick they will still be seen quickly.

"By and large, patients are waiting much longer than the guidelines say they should," said Dr. Michael Schull, who analyzed the data.

"These are typically people who have chest pain, heart attacks, angina, (and) strokes," all of which are possibly fatal in the worst cases, said Schull.

The guidelines Schull refers to are in the Canadian Triage and Acuity Scale (CTAS), recognized by doctors and emergency rooms across Canada as the standard on how long all patients should wait. 

For example, Category 2 patients, those with severe chest pain, trouble breathing, or other serious symptoms, are supposed to be seen by a doctor within 15 minutes. In Ontario last year, those patients waited twice that long, on average. Some very ill people waited as long as two hours.

"This picture is basically the same across the country," said Dr. Schull.

"You're running around trying to put a bucket under a leaky roof," said Dr. Brockway. He tells a story of one patient, a 50-year-old man who was having a full-blown heart attack. The man suffered for an hour and 40 minutes before a doctor could get to him.

"His heart attack ended up being a lot larger than it should have been," said Dr. Brockway. "There was more damage to his heart than there should have been. He was prevented from getting medications at an earlier time that could have helped prevent that damage."

The Canadian Association of Emergency Room Physicians is calling for the governments to take immediate action. It wants the CTAS standards adopted as mandatory, national benchmarks for ER wait times. The doctors also want more funding and resources to meet those standards.

"While I feel the anguish and the pain the doctors feel, I don't have any magic solutions," says federal health minister Ujjal Dosanjh.

Dosanjh supports the idea of ER benchmarks, similar to the wait time benchmarks currently being worked on for surgeries. But, he says, governments can't tackle ER times until they address wait times for surgeries and other treatments first.

"I think we all have to work hard. It's going to take time," says Dosanjh.

The ER doctors say it's time that patients don't have.

"We're saying we're not to accept this anymore," says Dr.  Brockway. "This is not good care. The patients of Ontario and Canada deserve better and we want to give it to them."

Brockway and other ER physicians say some patients have actually died while waiting.  They say others have died after going home untreated.  They've formed a group in Ontario called the "Coalition of Ontario Physicians in Emergency" to push governments for change.

"We've been creeping up to that tipping point and now we're going over," he said, "and things are getting worse rapidly."

How Ontario ERs performed against (CTAS) implementation guidelines:

Level I Resuscitation: conditions that are threats to life or limb.

• Includes cardiac or pulmonary arrest; severe respiratory distress, such as near-death asthma; and major trauma. 
• Recommended time to physician:  immediate.
• Most patients under this category were treated immediately; however, records show that a very small number of patients were left untreated for as long as 30 minutes.

Level II Emergent: conditions that are a potential threats to life or limb.

• Includes head injury; moderate breathing problems; chest pain; and seizures.
• Recommended time to physician: within 15 minutes.
• Patients in Ontario waited twice that long on average. A few patients waited as long as two hours.

Level III Urgent: conditions that could potentially progress to a serious problem requiring emergency intervention.

• Includes head injuries, moderate breathing problems, chest pains and seizures.
• Recommended time to physician: within 30 minutes.
• On average, patients waited almost an hour, with extreme cases waiting as long as three hours.

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