Australian Sara Zelenak died nearly instantly when she was stabbed through the neck during the London Bridge terror attacks and would not have felt it when she was stabbed another six times and slashed twice, 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 before stabbing dozens more with ceramic kitchen knives in the nearby Borough Market.
Pathologist Dr Ashley Fegan-Earl told an inquest on Friday when the Queenslander slipped and fell, one of the men stabbed her right through the neck as she lay on the ground.
He said that initial blow severed her brain stem, spinal chord, carotid artery, jugular and windpipe.
"I would expect her to have died extremely rapidly given the importance of the structures of the brain stem and the spinal cord at this extremely high level," Dr Fegan-Earl told the court.
He clarified that in his view, it would have caused "near instantaneous death" because of her complete loss of control of her heartbeat and breathing.
Dr Fegan-Earl said that meant she would have felt none of the attackers' subsequent stabs.
Counsel for the coroner Jonathan Hough QC asked if it was unlikely that Ms Zelenak had felt any pain or suffering after the first blow.
"I can say that with confidence," Dr Fegan-Earl replied.
After the Australian's brain stem was severed, she was stabbed another six times and slashed twice as she lay lifeless on the ground.
She was stabbed in the neck a second time, with the knife fracturing her jaw, and slashed across the back of her neck.
Ms Zelenak was also stabbed in the left side of her chest with so much force that one of her ribs was cut in two.
A stab wound to the left side of the Australian's back went all the way through skin and muscle, and scored her left shoulder blade. She had another two superficial knife wounds in her waist.
Ms Zelenak was also stabbed in her upper left thigh, with the knife passing right through to the other side.
A slash wound on her lower left leg passed through skin and muscle to score her fibula bone.
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 Archibald and Mr Thomas were hit by the van while all the others were stabbed to death.
Another 48 people were seriously wounded. All three attackers were shot dead by police at the scene.