A holistic massage therapist who collapsed after swallowing a mouthful of water while swimming died in “absolute agony” after waiting three hours for an ambulance, an inquest heard.

Christina Lindsay, 48, screamed for help and writhed in agony on the floor of Seymour Leisure Centre in Seymour Place, Marylebone, after a violent coughing fit following a mid-afternoon swim.

Westminster Coroner’s Court was told that 13 separate 999 calls were made between 4.15pm and when paramedics were finally dispatched at 6.41pm.

She had been in too much pain to get in a taxi to make the mile-long journey by herself.

When paramedics arrived at 7pm, husband Stephen angrily confronted them.

Mrs Lindsay, of St John’s Wood Terrace, St John’s Wood, then suffered respiratory arrest in the back on the ambulance on the way to hospital.

She died within half-an-hour of arriving at St Mary’s Hospital in Paddington, having suffered 40 per cent blood loss.

Dr Alexander Polson, who carried out the post-mortem examination, said Mrs Lindsay had a rare abnormality in a vein in her spleen, which he believed may have haemorrhaged after she swallowed the water.

She died from massive internal bleeding due to this congenital abnormality.

Dr Fey Probst, a consultant asked to review the case, said Mrs Lindsay may not have been saved if she got to hospital earlier either, but would have been much more comfortable.

“This woman died in absolute agony, and in hospital the pain would have been alleviated,” she said. “It may not alter the outcome but to die in that much pain for so long is horrific.”

But Richard Gibbs, a vascular surgeon at St Mary’s Hospital, was more confident she would have been saved, even outside the critical hour suggested by Dr Probst.

“Had we heard the diagnosis and knew the patient was bleeding at 5.15pm, I felt there was an 80-90 per cent chance we would have saved that patient,” he told the inquest.

“Everything stacks up; the longer the time goes on the worse the outcome is going to be. At 6.15pm, there was a 50-60 per cent chance of saving that patient’s life.

“Once you get past 6.15pm, there is going to be a progressively bleaker outcome.

“There was a chance up to that point of salvaging the situation, and that chance gets better the shorter the time it takes to get the patient to theatre.”

He said at 5.15pm, Mrs Lindsay would have lost around a litre of blood and a CT scan would have shown the build-up in her abdomen which was causing her excruciating pain.

“She was a young woman, there was no reason to suspect she wasn’t physiologically fit,” Dr Gibbs continued.

“She may be sick afterwards and may need time on intensive care, but she could be fine.”

The inquest was adjourned until later this year.