An internal investigation is underway at Middlesex-London EMS headquarters after an ambulance took 23 minutes to respond to a 911 call in Middlesex County.

Details of the call are being kept confidential, but officials say the patient did survive.

The union representing paramedics blames the 'call back' system used in four Middlesex County communities.

The system has paramedics take home a pager in the evening. When paged, they have eight minutes to drive to their station to pick up an ambulance before heading to the emergency.

Scott Simpson of OPSEU Local 147 says, "The problem is, we shouldn't have pagers any more. We shouldn't have paramedics in these small communities out in the county at home, in bed sleeping, waiting to get a call to do a 911 emergency response."

But EMS management disagrees with the union, saying the incident was the result of a technical problem with the paging system, not an issue with the 'call back' method.

John Prno, deputy chief of Middlesex-London EMS, says, "It's technology. Technology breaks. We build backup systems into the system."