Chinese tourist Yan Wang (42) was killed when the commercial jet-boat she was a passenger in apparently struck a sandbar on the Kawarau River and flipped about 2.45pm on September 25.
Mrs Wang was trapped underneath the boat and only found 90 minutes later.
She was declared dead by St John Ambulance staff - including an advanced paramedic - at the scene after a 45-minute resuscitation attempt failed.
However, it was revealed last week medical staff at Queenstown's Lakes District Hospital made a second attempt to resuscitate her after she was delivered to the hospital - more than 30 minutes after she was declared dead.
Contacted on Thursday night, Otago and Southland health boards' deputy chief executive Lexie O'Shea said the second attempt was a "clinical decision" she could not comment on.
Yesterday, extracts from the report not blacked out showed Mrs Wang's body had been delivered to the hospital by police, rather than St John staff who were "not in a hurry to bring the patient into the hospital".
Police who delivered Mrs Wang wanted her "deceased" status verified, but a doctor at the hospital was "not comfortable" confirming her death because of unanswered questions from the accident scene, the report said.
"What came first - the drowning or the hypothermia? How long had the patient been in the water, how long had the ambulance staff tried to resuscitate the patient? This history was critical in the decision to enable verification of death."
Instead, after consulting staff at Southland Hospital, Queenstown medical staff began the second resuscitation attempt despite being "fully aware that it was unlikely to have a positive outcome", the report said.
The "time consuming and resource intense resuscitating attempt" lasted 90 minutes, using "various methods to slowly warm the patient while CPR was continuously administered", the report said.
However, the report did not confirm whether there was a genuine possibility Mrs Wang was still alive, or if the second attempt was a procedural matter in the absence of information from St John staff at the scene.
It also did not confirm why St John staff did not deliver Mrs Wang's body by ambulance to the hospital.
Instead, the report's blacked out tracts included almost half of a four-page section on the circumstances surrounding the second attempt at resuscitation.
The report, the result of a debriefing session held following the accident, identified 25 issues to be addressed, from a lack of privacy in the hospital's physio area to the need for more thermometers in the emergency cupboard.
Another item entitled "pre-hospital treatment questions" identified only the need to "seek clarification from St John management on these questions".
Contacted yesterday, Ms O'Shea said she could not answer the outstanding questions.
The debriefing process was continuing, including discussions with St John, and circumstances surrounding Mrs Wang's death were still to be considered by the coroner.
"We don't have all the answers at this time. All we have is the views and opinions of some of the staff that were present," she said.
And, in a statement released with the report, she defended the report's omissions as necessary to protect the privacy of staff and encourage "free and frank expression of opinion" during debriefings.
St John Central Otago district operations manager Pete Grayland declined to comment yesterday, while St John Southern Region operations manager Doug Third, of Dunedin, said he was still studying the report.
Last week, Mr Grayland told the Otago Daily Times his staff "did what they could".
"My guys did everything they could in the power of their training to revive her, but she was dead."
