A cabby, who was unaware he had a tumour in his liver, was driving his vehicle along Queensway on March 22 when the tumour suddenly ruptured, causing him to black out.
Mr How Yuen Fah's taxi continued travelling towards Jalan Bukit Merah before hitting at least three pedestrians who were crossing the road at a traffic junction which was then showing the green man signal.
One of them, Madam Tng Yew Huay, 66, was taken to the National University Hospital (NUH) where she died of a head injury at around 9.20pm that day. The other pedestrians survived.
Following an inquiry on Wednesday, State Coroner Kamala Ponnampalam found her death to be "an unfortunate traffic misadventure".
She said Mr How, 72, was also taken to NUH and a scan showed the ruptured tumour.
He underwent surgery and further medical investigations revealed that he had hepatocellular carcinoma, a cancer of the liver.
The state coroner added: "The doctor who treated him clarified that the tumour rupture caused severe bleeding into the involved party's abdomen and a loss of blood flow to his brain. The doctor also clarified that this caused the transient period of loss of consciousness. Based on the evidence uncovered, there is no basis to suspect foul play."
Mr How started driving his taxi at around 6.30pm on March 22. He did not feel tired or sick at the time and was fully rested before he began his shift.
He later picked up three passengers at a Bishan Road taxi stand and was driving past Lornie Road when he felt a sharp pain on the right side of his abdomen that subsequently went away.
While travelling along Commonwealth Avenue West towards Queensway, he felt the pain on the right side of his abdomen again.
He also felt pain in his neck, started breaking out in a cold sweat and his vision became blurred. He then applied medicated oil to his forehead and nose.
He was driving along Queensway before the junction with Jalan Bukit Merah when he came to a stop as the traffic lights had turned red.
State Coroner Kamala said the cabby recalled signalling right before he fell unconscious.
She added: "When he regained consciousness, he heard the front-seat passenger... shouting at him."
The court heard that Mr How felt pain on the right side of his abdomen. He subsequently realised that his taxi's windscreen was cracked and his vehicle was already at the junction with Alexandra Road, but he was unaware that a collision had occurred.
He and Madam Tng were taken to NUH where she died about two hours later.