The Rural and Regional Development Minister explained that he only used the analogy to describe the former prime minister's decision to leave Umno.
"I was only answering a question by the press, who asked me whether or not I was surprised by the move.
"I said I wasn't because his actions lately have clearly indicated that he could no longer be with the current leadership. Many expected him to leave the party.
"Hence, the analogy I made, which likened his move to a coma patient. If he dies, people would not be surprised because they have expected it," he said in a statement.
Ismail, who is also an Umno supreme council member, had drawn flak for his controversial remark against Dr Mahathir in an online portal report.
Ismail has, however, said it was unfair for people to attack him, as they were only "reading the misleading headline" without reading the whole article.
Dr Mahathir announced his resignation from Umno on Monday.
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