A British nurse who took her own life following a prank call by two Australian radio DJs was preoccupied at the time with both the hoax and an existing dispute with a hospital colleague.
A London coroner has found Jacintha Saldanha's death in late 2012 was not foreseeable and the 46-year-old was appropriately supported after she was duped into believing 2DayFM host Mel Greig was the Queen.
The night sister transferred Greig and co-host Michael Christian to a ward nurse who gave out confidential information about the Duchess of Cambridge's morning sickness.
"I am satisfied that Jacintha Saldanha took her own life," Dr Fiona Wilcox said at the Royal Courts of Justice on Friday.
"In the days before her death the hoax was clearly pressing on her mind as were the difficulties she'd been experiencing with her colleague."
Earlier it was revealed Ms Saldanha had clashed with a junior nurse she was mentoring at London's King Edward VII Hospital.
The 46-year-old had complained about the junior's performance and she had in turn lodged a grievance against the mother-of-two.
Ms Saldanha was cleared the day before the December 4 prank call and the junior nurse, who'd been provisionally suspended, was told she would be able to return to work in early January on separate shifts so the two wouldn't clash.
Detective Sergeant Will Richards told the court one of three suicide notes left by Ms Saldanha "was to the colleague she'd been having difficulties with".
The content wasn't disclosed.
Another note thanked hospital management for their support and blamed the Australian DJs for her death and asked them to help pay her mortgage.
A third, found in Ms Saldanha's handbag, outlined her "personal wishes".
An examination of the nurse's laptop revealed that in the hours before her death she'd searched the internet for media articles about the royal hoax.
She'd also searched for information about the human body and suicide prevention.
The last thing Indian-born Ms Saldanha viewed was a Bollywood video.
The night sister emailed a colleague in the early hours of December 6 stating: "I don't know how I'll face the bosses tomorrow ... I feel so ashamed of myself."
King Edward VII Hospital chief executive John Lofthouse admitted some senior managers did want Ms Saldanha and the ward nurse to face disciplinary action.
But he and the matron didn't and none was planned, he said on Friday.
"I can categorically state there was not."
The chief executive said if anyone had any inkling Ms Saldanha was fragile "we would have put our arms around her literally and metaphorically".
"(But) we all regarded her as a well-balanced, robust and stable individual," he said.
"No alarm bells rang."
In a highly unusual move Greig, who didn't give evidence during the inquest, was nevertheless granted permission to address the court at its conclusion.
Facing Ms Saldanha's husband and two children the DJ said: "I am so sorry for your loss. I have wanted to say that to you for so long."
Outside court the Saldanha family decried the "despicable and cruel" hoax and also flagged possible legal action against the radio station and the hospital.
"It is an irony that four calls made in 115 seconds, which were the cause of such mirth in Australia, could have deprived Ben of his wife and Lisha and Junal of their beloved mother," spokesman Keith Vaz MP told reporters.
"These despicable and cruel actions, this hoax, has changed their lives forever."
Junal, standing alongside his 16-year-old sister and their father Benedict Barboza, thanked "everyone in Britain and around the world who has comforted and supported us during this difficult time".