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Bosses said the Birmingham death had a “knock on effect” for efforts in Solihull to send “non urgent/non life threatening conditions” to Solihull Walk In Centre at Solihull Hospital.
Avoiding costly A&E admissions is seen as vital for borough NHS chiefs to meet savings targets.
The “young adult” was sent to a walk-in centre in Birmingham with what was thought to be normal flu symptoms, an NHS report says.
Another “adverse event” from sending a patient to a Birmingham walk-in centre had been recorded, it said, but gave no further details.
Both were “through no fault of the ambulance crews” it added.
It said: “One case was a young adult presented with flu like symptoms, which ended up being a case of swine flu which was fatal.
“This then resulted in crews being very cautious about using the alternative pathway.”
Yet it said Solihull ambulance station “now has a new manager, who is working closely with the crews to ensure they are now using this pathway”.
The report, by Solihull NHS Primary Care Trust, said: “We must continue to work closely with [West Midlands Ambulance Service] to maintain levels of confidence in use of alternative pathways to avoid reoccurrences of Birmingham incidents that had a knock on effect for Solihull.”
The project to avoid sending Solihull patients to A&E saved £186,238 in the 12 months from April 2010, the report said.
The trust had set out to save £17.3m during that year but only managed £11.1m.
A total of 38 projects were proposed around treatments such as cataracts and skin disorders.
The report admitted the proposed success of some projects was due to “pressure to present more favourable savings assumptions than can in reality typically be delivered”.
Plans had to be “more realistic” it said and managers should “have the courage and discipline to stop projects that are not delivering”.
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