Justin Monfries was denied a life-saving lung transplant the month before his death because he was a smoker, had Hepatitis C, and history of drug use, an inquest has heard.
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Monfries, 26, died at The Canberra Hospital in December of respiratory failure as a result of an untreatable pneumonia.
At the time, he had been serving a 13-year sentence in the Alexander Maconochie Centre for a horror hit and run that killed hospital worker Linda Cox, 38, and injured Ashlee Bumpus, then 25, in 2012.
An inquest into his death was heard in the ACT Coroners Court on Tuesday afternoon, as deaths in custody are required to be examined by a coroner.
The court heard Monfries, a two-pack-a-day smoker, had reported he had suffered a cough for three years upon his admission to Canberra jail in 2012.
He continued to report a persistent cough and was treated for smokers cough and respiratory infections during his time in custody.
In October 2014, Monfries was admitted to hospital for inhaled antigens, treated and sent back to jail.
But he continued to deteriorate and was readmitted in November.
Doctors diagnosed him with Usual Interstitial Pneumonia, an untreatable disease characterised by progressive scarring of the lungs.
The court heard the disease is most common in people aged 50 and older.
Monfries was sent to Sydney but deemed unsuitable for a lung transplant due to his smoking status, Hepatitis C, history of drug use, and concerns he would not adhere to a medication regime.
He returned to Canberra and entered palliative care on December 9.
The court heard a special drug, not on the Pharmaceutical Benefits Scheme, which could slow the disease, could not be given to him before his death on the afternoon of December 17.
The court heard from an investigating police officer who concluded the prisoner had died of natural causes and received all possible care in custody.
Coroner Robert Cook said he had been satisfied that Monfries had been afforded the best quality care before his death.
Mr Cook made no findings that care, treatment, or supervision contributed towards his death.
The coroner passed on his condolences to the family, who the court heard had been satisfied Monfries had received appropriate treatment and care.
Monfries was on bail and was evading police in a stolen car in 2012 when he crashed into mother-of-two Mrs Cox, 38, and Ms Bumpus.
Mrs Cox, a much-loved cardiac technician, was killed instantly and Ms Bumpus suffered multiple fractures to her legs.
The pair had been crossing Yamba Drive after finishing a shift at the hospital when Monfries ran a red light and ran them down at speed.
He had hot-wired and stolen the car from a car park in Manuka and committed a number of crimes beforehand.
Monfries continued driving after he hit the victims, crashed into another car down the road, and attempted to flee on foot when he was arrested.
Monfries pleaded guilty to culpable driving causing death and culpable driving causing grievous bodily harm, and was sentenced to 12 years and seven months in prison by Justice John Nield last year.
He had an extensive criminal history, which included previous high-speed car chases.
Monfries would have been eligible for release in January 2022.
