A coroner has found Green MP Fa’anānā Efeso Collins died of cardiac disease shortly after completing a charity event in central Auckland.

Collins, 49, died at Te Komititanga Square on 21 February 2024 after taking part in the WaterRun, a ChildFund fundraising event to raise money and promote safe drinking water for children in the Pacific region.

Coroner J Anderson found Collins died of cardiac disease arising from complications of diabetes, obesity and hypertension.

Collins had collapsed shortly after completing the event, which involved six high profile participants carrying buckets of water around a short, flat course.

The coroner said Collins appeared relaxed and happy before, during and after the event, with no indication he was experiencing physical symptoms or health concerns.

“His death occurred suddenly and unexpectedly. Efforts were made to resuscitate him after he collapsed, but he was not able to be revived.”

The coroner said deaths from natural causes were not usually the subject of a coronial inquiry, but Collins’ wife raised questions and concerns about the circumstances of his death.

The inquiry considered the event planning, medical coverage, the emergency response after Collins collapsed, and wider public health issues around cardiac arrest and access to defibrillators.

The coroner found the steps taken by the event organisers were adequate, given the nature of the event.

There was an experienced surf lifesaver on hand and several automated external defibrillators in the area.

“The AED that was obtained and used for Fa’anānā was not one that was included in the event plan, but it was still retrieved, and used, promptly.”

The coroner said the initial clinical readings obtained by ambulance staff indicated the CPR carried out after Collins collapsed was of good quality.

The finding said Collins collapsed just before 9am.

CPR began about 90 to 100 seconds later, and the first defibrillator shock was delivered about four minutes and 20 seconds after the collapse.

Independent cardiology and resuscitation expert Dr Tony Scott advised the coroner Collins’ chance of survival was likely to have been in the 40 to 45 per cent range in the circumstances.

The coroner said a cardiac arrest could occur anywhere, at any time.

“This reinforces the importance of access to AED devices, knowledge of CPR, and community health messaging around CVD risks and symptoms.”

The inquiry found Collins had a longstanding history of type II diabetes, high cholesterol, gout and hypertension.

He had bariatric surgery in 2015 and lost a significant amount of weight.

His medical records also showed a significant family history of cardiac disease, with his father and brother both dying at a young age, and a sister having major cardiac surgery in her 30s.

The coroner found Collins had been regularly attending his medical centre and his risk factors were being managed appropriately.

His last primary healthcare consultation was on 28 November 2023, when he received repeat prescriptions and treatment for an ear infection.

No cardiovascular symptoms were identified.

The coroner said Collins had told his doctor in March 2023 he was exercising regularly, going to the gym three to four times a week, and had no chest pain, shortness of breath or other cardiac symptoms.

“Fa’anānā’s family history and his known medical conditions placed him at increased risk of cardiac death. He was monitored and treated in accordance with accepted guidelines. He did everything he could to manage the risks associated with his medical conditions.”

The coroner said there was no obvious reason Collins should not have taken part in the WaterRun.

“The footage of the event does not suggest that he was in any distress or suffering any ill health. His collapse, several minutes after completing the event, was wholly unexpected and there appears to have been no prior warning that he was unwell or required medical attention.”

The coroner said it may have been desirable for an ambulance or emergency medical team to be present, but was not critical of organisers for not having one.

“The event involved a small number of people, over a short time period and the physical activity was not of a particularly dangerous or risky nature.”

The coroner said earlier intervention might not have changed the outcome.

It was not possible to conclude Collins would have survived if defibrillation had occurred a minute or two earlier, or if IV medications had been administered slightly sooner.

The finding also dealt with submissions from New Zealand Doctors Speaking Out With Science, which raised concerns Collins’ death might have been linked to the Pfizer Covid vaccine.

The coroner did not find any link.

The coroner’s cardiology expert said the likelihood the vaccine contributed to Collins’ death was “vanishingly small.”

Collins received his last Covid vaccine dose nearly two years before his death.

The coroner made recommendations for public event organisers, including identifying a specific person to obtain an AED in a cardiac emergency, making sure the person knows the exact location of the nearest device, and considering whether a medical questionnaire or health statement is appropriate for participants.

The coroner also encouraged people living with heart disease or cardiovascular risk factors to make sure family, friends and colleagues know where nearby AEDs are located.

The finding said cardiovascular disease was the leading cause of death in New Zealand, with 11,000 deaths in 2021.

The coroner endorsed wider public education on cardiovascular health, recognising cardiac symptoms, CPR training and increasing access to AEDs, particularly in communities with higher rates of cardiac arrest.

The coroner prohibited publication of police photographs of Collins, TVNZ video footage supplied for the inquiry, and made an interim order prohibiting publication of Auckland Transport CCTV footage.

Collins was remembered in the findings as a loved husband, father, Samoan matai and Member of Parliament.

The coroner said Collins had given his maiden speech to Parliament the week before he died, speaking about poverty, social cohesion and climate change.

“Characteristically, on the day that he died, Fa’anānā was helping others.”

The coroner extended condolences to Collins’ family and loved ones.

“The death of Fa’anānā was felt throughout New Zealand. He achieved so much during his life, and it is beyond doubt that he would have continued to work tirelessly to bring about meaningful and positive changes for all New Zealanders.”