Aboriginal and Torres Strait Islander readers are advised that the following article may contain the name of a deceased Aboriginal or Torres Strait Islander person. Readers are also warned there may be words and descriptions that may be culturally distressing

An Aboriginal woman who died in the weeks following an assault died of a "broken heart", her family say.

The woman, who cannot be named, died five weeks after she was assaulted at a licensed venue in northern New South Wales in 2023, an inquest held in Port Macquarie in November heard.

Speaking to the ABC after the NSW Coroners Court handed down its findings, a family member said: "In our statement [to the court] we said she died of a broken heart, referring to the system letting her down because she wasn't protected."

Evidence presented at the inquest before Deputy State Coroner Rebecca Hosking heard the woman may have died from Takotsubo cardiomyopathy — also known as broken heart syndrome — with the hearings examining whether there was a causal link between her seeing the person who had previously assaulted her and the medical events that led to her death.

The Coroner ultimately found the woman died from cardiac arrhythmia, which commenced shortly after she "recorded evidence of a suspected breach of an APVO [Apprehended Personal Violence Order] made for her protection".

Ms Hosking said she could not "rule in or rule out the possibility" that a predisposition to ventricular fibrillation — an often fatal irregular heart rhythm — together with the stress of seeing the person who assaulted her on the street, contributed to her collapse.

The assault

In mid-2023, the inquest heard the woman was assaulted at a nightclub, with CCTV footage showing the assailant punching her and pulling her up by the hair. A female employee told the court the woman said to her, "Help me, I am going to die".

As he was being escorted from the venue, the employee said she thought she heard the assailant yell: "I am not done with you".

The woman suffered facial swelling and bruising, as well as a laceration under her left eye. Neurological observations were considered normal, and, despite complaining of a headache, she was assessed as safe to go home at 2.14 am.

While she was at hospital, her brother's girlfriend reported the assailant — along with others — were outside the woman's home yelling for her to "get out on the fu**ing road". The woman's mother called police, but by the time officers arrived the group had dispersed.

The following day, the woman was made aware of a video circulating that included slurs and death threats. An APVO was subsequently taken out, naming her as the person in need of protection.

The assailant was prohibited from entering her street and was later convicted of assault occasioning actual bodily harm and stalking.

At the time of her death, Ms Hosking found the woman was "suffering from the emotional and psychological consequences of her assault", as well as from the circulation of videos featuring her within her community and the assault of her brother the day before she died.

That assault, carried out by a person known to the original assailant, saw the woman and her mother pressing their weight against the door of their home to prevent a second person from entering.

Five weeks after the initial assault, the woman saw the car of the person subject to the APVO parked on her street as she returned home from shopping with her parents and child.

After asking her mother to drive slowly so she could record evidence of the APVO breach, the woman collapsed in the car. Her phone continued recording as she was driven to hospital.

Ms Hosking noted the footage vividly captured the "parents' distress as they tried to get her to wake up as she was driven immediately to the Hospital".

Trauma

The Coroner found the trauma experienced by the family after the woman's death was compounded by police initially treating the death as suspicious.

"After she died, [the woman's] family's access to her was also limited in that they were not able to touch her body," Ms Hosking said. "I apologised to [the woman's] family for appropriate provisions not being made for them."

In a statement tendered to the court, the woman's Aunty said: "As an Aboriginal person when we grieve and mourn it is important for us to touch our loved ones and say our final goodbyes."

"I was not able to do this and to this day it deeply affects me. This is the first time that a family member has passed where we have not been able to touch and smell them and say our final goodbyes."

Findings

Three doctors who gave evidence to the inquest said the woman's death was caused by a fatal cardiac arrhythmia triggered by severe emotional or mental distress, potentially linked to an underlying predisposition to developing an arrhythmia.

Neurologist Mark Cook raised the possibility of Takotsubo cardiomyopathy, stating the "cardiac event may have been precipitated by extreme emotional stress, superimposed on a background of anxiety and trauma following the assault".

However, emergency specialist Anna Holdgate said Takotsubo cardiomyopathy was less likely, noting it "typically presents with chest pain and failure of the heart pump rather than a primary arrhythmia", and that evidence of the condition would have been visible during post-mortem examinations.

In her findings, Ms Hosking ruled the woman "died from cardiac arrhythmia (first confirmed as ventricular fibrillation) of unascertained cause". She noted Dr Cook ultimately deferred to A/Prof Holdgate and another specialist, concluding the evidence was "ultimately not persuasive in relation to Takotsubo cardiomyopathy".

"While it seems likely that [the woman] suffered an underlying predisposition to developing an arrythmia, the evidence adduced at the inquest does not enable a concluded view including as to the precise nature of the predisposition," she said.