A Milwaukee woman whose death at a bus stop on a freezing cold day sparked changes to the city’s 911 response policy died of heart disease.

The Milwaukee County Coroner’s Office released Jolene Waldref’s “final cause of death” report Tuesday. Waldref, 49, died of “hypertensive and atherosclerotic cardiovascular disease,” the report said.

An email from the Medical Examiner’s Office said it had no further comment. In the first report shortly after Waldrev’s death, authorities said they were investigating the possibility that her death was caused by hypothermia.

Waldref died on January 15 after calling 911 from a bus stop. On her phone, she sounded confused and distressed. This call was given to her as a low priority response and a private ambulance was dispatched to assist her.

When I called, the temperature was below freezing and the wind was 20 degrees below zero.

When Curtis Emergency Services crews arrived on scene, the paramedics did not exit the vehicle. Vardrev was lying on the ground, his view blocked by a snow bank. The two drove through the intersection and tried to contact Waldref by phone, but could not reach him and left.

A passerby then found Waldref unconscious and called 911 again. Subsequently arriving Milwaukee Fire Department paramedics were unable to revive her.

The first police report issued by the coroner’s office in January said security video showed Waldref falling and hitting his head. It seems that the report was wrong. Footage from the scene released to the media does not show the fall.

News that first responders left the scene without searching for the woman after she called for help outraged city residents and many local officials. This has led to a policy change that requires emergency workers in the city to get out of their cars and search for patients if there is abnormal weather or poor visibility at the scene.

In February, the Milwaukee City Council approved new contracts with two private ambulance companies serving the city only after both companies agreed to changes. The city’s 911 medical response is split between fire department paramedics, who are dispatched to the most urgent cases, and two civilian services, which typically handle less serious medical emergencies.

Under the new policy, if a patient is “not immediately at the scene,” first responders will ask 911 dispatchers to call the patient back and speak to bystanders who may have knowledge of the patient’s location. However, patients should be asked to use lights and sirens once they arrive on scene. A scene to make yourself more visible.