The 19-year-old's death in the early hours of November 1, 2022, has led the coroner to make several recommendations over the need for safety glass in older New Zealand homes.
His parents said at the time he was a happy, grounded and beautiful soul. A gifted snowboarder, he won several national age group titles and the Wanaka community treated him like a son. He died two days before his 20th birthday.
The coroner’s report, released on Friday, outlined the circumstances that led to his accidental death and highlighted potential safety improvements to prevent similar tragedies.
Despite being quickly treated by emergency service personnel, Samuel's injuries were unsurvivable.
Coroner Mary-Anne Borrowdale found Samuel's injuries were caused by broken shards of standard pane glass, which were consistent with him striking the window and falling through it.
“Large blood loss would have resulted from the severed pulmonary artery… there was an extremely low likelihood of survival within any feasible timeframe," the report said.
The report did not find the exact cause of Samuel's propulsion through the window.
The report considered various possibilities, including disordered thinking when waking or an accidental fall, but could not determine a definitive cause.
“Regrettably, this inquiry has not yielded any conclusive answers as to what caused Samuel to suddenly awaken and be lethally propelled through his bedroom window,” the coroner said.
The coroner cited the risks posed by the standard pane glass - which shatters into sharp, dangerous shards when broken - found in older homes like Samuel's flat.
“Notwithstanding Sam having come forcefully into contact with his bedroom window, if that window had been made from safety glass his injuries would not have been so extensive and may not have been lethal,” the report said.
“Homeowners who are concerned about the hazard of standard glass can seek advice from glass suppliers or the Window and Glass Association NZ."
The coroner acknowledged the family's loss, saying Samuel was "an adored son, family member, student, and friend to many".