Saul volunteered her observation after sharply denouncing the ad. In it, a former steelworker, Joe Soptic, suggests that Romney and Bain Capital, the private equity firm he founded, might bear some responsibility for his wife's death from cancer.
"It's just despicable, to be honest," Saul said of the ad, which is aired by Priorities USA Action, a super PAC that supports Obama's reelection.
Independent fact-checkers judged the commercial harshly, sometimes unusually so.
Additionally, the Romney campaign alleged that the president's campaign "lied repeatedly about its knowledge of the content" of the ad. The allegations were denied.
Conservatives were quick to react to Saul's remark about the health-care law that Romney signed as governor.
Talk-show host Rush Limbaugh excoriated Democrats over the TV spot. But he added that the Romney aide's remarks were "a potential gold mine for the Obamaites, because they can say, 'Well, yeah, and Romneycare's the foundation for our plan, Obamacare,' which they are already out there saying."
The back-and-forth largely overshadowed the day's campaign activities.
Romney campaigned in Iowa, where he drew a standing ovation for promising to repeal "Obamacare," the derisive label that Republicans long ago hung on the law the president won from Congress. "That doesn't mean that health care is perfect," he said. "We've got to some reforms in health care. And I have some experiences doing that, as you know."
Obama was in Colorado, where he embraced the Obamacare tag in an appearance before an audience largely made up of women. "I actually like the name," he said, "because I do care. That's why we fought so hard to make it happen."
Obama campaign aides said throughout the day that they had no connection with the TV spot and added that they did not know the specifics of when Soptic's wife became ill. Soptic was featured in an ad the Obama campaign aired in May.
Republicans responded with evidence of a conference call arranged last spring by Stephanie Cutter, a top aide in Obama's campaign, in which reporters were given an opportunity to speak with Soptic.
Under federal law, a campaign may not coordinate its activities with independent groups.
The Obama campaign refused to call on Priorities USA Action to pull the ad. Bill Burton, a former White House aide and cofounder of the group, defended it.
In the ad, Soptic says that the plant where he worked was closed by Romney and Bain in 2001. "I lost my health care, and my family lost their health care. And a short time after that my wife became ill. I don't know how long she was sick and I think maybe she didn't say anything because she knew that we couldn't afford the insurance."
By the time she went to the hospital, he added, she was found to have cancer and died 22 days later.
"I do not think Mitt Romney realizes what he's done to anyone," Soptic says, "and furthermore I do not think Mitt Romney is concerned."
Romney has long said he left Bain Capital in 1999 to take over the management of the 2002 Salt Lake Olympics.