TORONTO -- A paramedic who tried to save a woman with no vital signs after she received liposuction says the doctor at the cosmetic surgery clinic waited too long to call for help.

"The patient (Krista Stryland) had become unresponsive an hour after being put in recovery and they didn't call the EMS until 40 minutes later," advance-care paramedic Jeff Carter told a hearing at the College of Physicians and Surgeons of Ontario, which is investigating Dr. Behnaz Yazdanfar for professional misconduct.

"She was chalky white, had lost a lot of fluid and they just waited too long before calling an ambulance," Carter told the hearing yesterday.

"When we arrived (at the Toronto Cosmetic Clinic), she was ventilated and lying in a bunch of bloody fluid ... so much so that my partner asked for a smock to avoid splashes," he said. "I was surprised to see it."

Carter said he spoke with Yazdanfar, who gave him a report on what had happened.

"She told me the patient had lost two to three units of blood after the surgery," Carter said.

Paramedics performed CPR on the way to the hospital, but Stryland never regained any vital signs.

A day after her death, Carter asked his supervisor for an incident form. "I requested it. I believed this was a call that would be investigated later on by a hearing," he said.

The hearing also heard from Wu Guo, the surgical assistant during Stryland's operation.

He said that while Yazdanfar was operating on another patient, a nurse came into the operating room three times to say that Stryland was in bad shape in the recovery room.

Yazdanfar waited until the third notice to check on Stryland, Guo said.

Dr. Bruce Lieberman, the anesthesiologist for Stryland's surgery, also took the stand, but on the advice of his lawyers refused to answer questions that could incriminate him in any further investigations.

"Dr. Lieberman, who actually caused the death, may be charged (by the College). An independent report says he caused the death," said Yazdanfar's lawyer, Clayton Ruby.

However, the notice of the hearing says that "Dr. Yazdanfar is incompetent and failed to maintain the standard of the practice of the profession in her cosmetic surgery practice in relation to her care of (Stryland)."

The college criticizes Yazdanfar's performance during the liposuction and her post-operative care and treatment of the patient.

The college claims Yazdanfar also "engaged in disgraceful, dishonourable or unprofessional conduct" when she failed to accompany Stryland, or to send someone who was familiar with her case, to hospital.