A Sudanese asylum seeker at Manus Island detention centre suffered a cardiac arrest that led him to collapse and his death was unavoidable, an inquest has been told.
State Coroner Terry Ryan is examining the circumstances surrounding Faysal Ishak Ahmed's death and the standard of his treatment throughout 2016 as his health worsened.
Wrapping up the two-day inquest in Brisbane on Tuesday, Counsel Assisting Sarah Lane said expert evidence had shown the death of the sickle cell trait sufferer could not have been prevented.
Clinical haematologist Steven Stylian on Tuesday differed from other medical experts on Monday, who posited that a seizure led to his instant fall causing a brain injury.
Dr Stylian put forward the view that Mr Ahmed grabbing his chest before collapsing indicated he had cardiac arrhythmia, meaning an irregular heartbeat, leading to a cardiac arrest.
"I've never seen a patient with a seizure clutch their chest first ... that he was standing seemingly normally and then clutched his chest to me suggests a cardiac arrhythmia as the cause of this collapse."
Mr Ahmed was alone when he fell down a short flight of stairs, banging his head on the concrete and suffering a fatal brain injury after 10pm on December 22, 2016.
When pressed on whether his death could have been prevented with quicker medical care or evacuation to a larger, more specialised hospital, Dr Stylian said the death was unavoidable.
"I doubt the outcome would have differed," he said.
"There is nothing that could have prevented the fall. The cardiac arrest complication... can occur spontaneously without warning."
"There's no cure at all."
The 30-year-old presented to International Health Medical Services staff about 60 times during his three-year stint in detention with complaints of jaundice, gastric symptoms, kidney pain, chronic sinusitis, mental health issues and chest pain.
He saw medical staff eight times alone in December 2016 - the month he died.
The inquest was told dozens of Sudanese refugees detained with Mr Ahmed raised the issue of his deteriorating health with the centre's medical staff before his death.
IHMS was the Australian government contracted healthcare provider at the centre until it was closed.
Mr Ahmed, born in the restive Darfur region in Sudan, arrived in Australian waters by boat in 2013 and was detained on the Australian funded and managed offshore detention centre on Manus Island in Papua New Guinea.
It was shuttered in late 2017 after PNG's Supreme Court ordered its closure.
The inquest revealed it took 26 hours for Mr Ahmed to be airlifted from Manus Island to Royal Brisbane and Women's Hospital before he died on Christmas Eve.
IHMS and the Australian government's lawyers stressed that any delays or lags in his transfer were due to the island's remote nature.
The company's medical evacuations flying out from Manus to Port Moresby and then to Brisbane were infrequent.
The airlift cost taxpayers more than $140,000.
The Australian government's lawyers argued the evidence presented showed that procedures were followed.
"There are a number of things that needed to be done logistically medically, legally and diplomatically," they said.
"Resoundingly the process worked and everything that need to happen, happened promptly."
The government's lawyers also paid their condolences to Mr Ahmed's family.
Mr Ryan, who oversaw a 2021 inquest into the death of Iranian asylum-seeker Omid Masoumali on Nauru's offshore detention centre, acknowledged the patience and the distress for Mr Ahmed's family.
Mr Ahmed's lawyers read a heartfelt message from his brother Suliman.
"After his death the family lost hope in all life and they always think about their deceased son... and from there they lost everything and their wishes were destroyed."
The inquest is one of a handful in recent years that delved into the medical care provided to people detained offshore by the Australian government.
Australian Associated Press
