Australian Sara Zelenak was stabbed seven times and slashed twice, but she died nearly instantaneously when the first blow to her neck severed her spinal chord in the London Bridge attacks, an inquest has heard.
The 21-year-old and fellow Australian Kirsty Boden, 28 - along with six others - were killed when Khuram Butt, Rachid Redouane and Youssef Zaghba used a van to run down dozens of people on the bridge on the night of June 3, 2017.
They then stabbed dozens more with ceramic kitchen knives in the nearby Borough Market.
Pathologist Dr Ashley Fegan-Earl on Friday told an inquest into the deaths that the Queenslander, who was one of the first people stabbed, tripped and fell while running away from the attackers.
He said Ms Zelenak was stabbed just below her left ear with the knife severing through her C1 vertebra and spinal chord, immediately cutting her control of her heartbeat and breathing.
"That is without doubt the fatal injury," Dr Fegan-Earl told the inquest
The pathologist said after the Australian's brain stem was severed she was stabbed another six times and slashed twice as she lay on the ground.
Ms Zelenak was also stabbed in the neck again with the knife fracturing her jaw and slashed on the back of her neck.
She was also stabbed in the left side of her chest with so much force that the knife cut her left rib in two.
A stab wound to her left side on back went all the way through skin and muscle and scoring her left shoulder blade. Ms Zelenak also had two superficial knife wounds in her waist.
She was also stabbed in her upper left thigh, with the knife passing right through to the other side.
She had a slash wound to her lower left leg, which passed through skin and muscle to score her fibula bone
Dr Fegan-Earl noted that she had no defence wounds commonly seen in stab victims, despite the fact she was a young and fit lady.
He said that indicated she was already dead from the first blow and would not have felt any pain from the other injuries, which were not fatal.
"In my view it would have caused near instantaneous death," Dr Fegan-Earl said.
"The basic functions of life are controlled in that area."
Canadian Christine Archibald, 30, Frenchmen Xavier Thomas, 45, Sebastian Belanger, 36, and Alexandre Pigeard, 26, Briton James McMulln, 32, and 39-year-old Spaniard Ignacio Echeverria were also killed in the attack.
Ms Archibold and Mr Thomas were hit by the van with the others all stabbed to death.
Another 48 people were seriously wounded, while all three attackers were shot dead by police at the scene.
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