THE cause of death for 17-year-old Zara Qairina Mahathir was a traumatic brain injury with complications of hypoxic-ischemic encephalopathy (HIE), a medical witness told the fourth day of her inquest today.
Dr Pavankumar Balachandran, 32, a medical officer from the Neurosurgery Department of Queen Elizabeth Hospital (HQE), read from the official medical report, confirming that Zara was already in a critical state upon arrival and showed no signs of neurological response.
"The patient’s condition deteriorated, and she was pronounced dead on 17 July 2025 at around 1.07pm," said Dr Pavankumar.
"The cause of death was severe traumatic brain injury with hypoxic-ischemic encephalopathy."
The court heard that Zara was found unconscious near a drain at the ground level of her school hostel and was taken to the HQE Emergency and Trauma Department at 4.38am on 16 July by a Pre-Hospital Care (PHC) unit from Kinarut Health Clinic.
A ‘trauma alert’ was activated at 4.42am. Initial assessments showed Zara was already intubated, fully dependent on life support, and exhibited no brainstem activity. Her pupils were dilated with no light reflex, and her Glasgow Coma Scale was the lowest possible.
A physical examination found swelling and a laceration at the back of the head, which had been sutured to control bleeding.
CT scans revealed acute subarachnoid haemorrhage in both hemispheres, subdural bleeding across multiple regions including the interhemispheric fissure and tentorium cerebelli, and early signs of tonsillar herniation at the foramen magnum.
"There was a loss of distinction between the grey and white matter, indicative of severe neurological damage," said Dr Pavankumar.
Besides the head injury, Zara had also sustained fractures to her left wrist, left ankle with an open wound, and trauma to her right ankle.
She was admitted to the neurosurgery ward at 6.40pm on 16 July but showed no improvement and passed away the following afternoon.
Her death was reported to police, and after consultation with her mother, Noraidah Lamat, the body was sent for further investigation to the Forensic Medical Department.
Dr Pavankumar holds a Doctor of Medicine degree from Universitas Padjadjaran, Indonesia (2017), and has served in neurosurgery units at HQE and Hospital Kuala Lumpur.
Meanwhile, the inquest also heard from the fifth witness, Inspector Maidon Bernadus, 52, who led a forensic simulation of Zara’s fall at SMKA Tun Datu Mustapha, Papar, on 3 August.
The simulation began at approximately 3am, using the building’s lights and additional Makita cordless and tower forensic lighting.
"A mannequin weighing 10kg was used. To replicate the victim’s weight, bricks were added to the lower half, bringing the total weight to 53kg. The mannequin was about 180cm tall, 27cm taller than the deceased," said Maidon.
The first simulation involved dropping the mannequin vertically from the third-floor corridor near the toilet, without any forward thrust. It landed 2.14 metres from the building.
In a second simulation with a slight forward push, the dummy landed 3.45 metres away.
"Overall, the first simulation—where the dummy fell without force—most closely matched the victim's position during the initial investigation," Maidon added.
The reconstruction concluded at 6.30am. A full report was submitted via the Royal Malaysia Police’s Forensic Evidence Management System (FEMS) for investigative review. - September 9, 2025
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