Health ministers have launched an investigation into the North East Ambulance Service after it emerged that key documents relating to patient deaths had been altered or suppressed.
Health Minister Maria Caulfield told MPs that she would "not hesitate to take any action necessary" to protect patients.
It comes after whistleblowers raised concerns over the way in which the ambulance service has been dealing with coroner's court cases - including in the case of Shildon teenager Quinn Evie Milburn-Beadle.
In an report produced by the auditors/anti-fraud team AuditOne investigators found that, in spring 2020 - "the coroner is not being made aware of concerns and/or investigations being carried out by the trust in a timely fashion".
NEAS accepted that there were "historical failings" with its processes, but maintains these have been resolved.
Ms Caulfield said following an urgent question on the matter in the House of Commons: "My thoughts are first and foremost for the families affected by the tragic events described, I cannot imagine the distress they're going through.
"It's hard enough to lose a loved one suddenly, but to have fears that mistakes were made that could have made a difference. And more than that, the facts of what happened were not revealed in every case goes further.
"They have my own reserves sympathy and support."
She added: "Given the seriousness of the claims reported over the weekend, we will of course, be investigating more and I will not hesitate to take any action necessary to protect patients."
Former health secretary Jeremy Hunt said the "cover up" by NEAS was "unforgiveable" and pushed the Government to investigate whether there had been gross negligence.
Ms Caulfield repeated that the Government would be investigating the reports, but Sunderland MP Julie Elliott said it was not enough.
"She talks about CQC, they've been involved and they didn't find the errors, and they haven't apologised for the mistakes", she said.
She added: "NEAS has been making mistakes for decades and nothing seems to be done about it. The minister needs to get a grip of this for the people of the population for the North East."
Helen Ray, chief executive of North East Ambulance Service, said in a statement: "We accept that there were historical failings and we have listened and acted upon the concerns raised by staff of the quality and timeliness of documents disclosed to coroners.
"We have reaudited our process, have discussed with coroners and with the CQC and have embedded regular reviews to ensure these issues cannot reoccur. We are confident that the system in place is robust."
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