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Cape Town – The Western Cape High Court heard on Thursday how 23-year-old sex worker Nokuphila Kumalo died from “blunt trauma injury to the trunk”.

Senior forensic pathologist Dr Linda Liebenberg testified in the murder trial of acclaimed international artist Zwelethu Mthethwa.

The State alleges that Mthethwa murdered the sex worker in Woodstock in April 2013 by kicking and stomping on her.

Liebenberg compiled two autopsy reports, one soon after the murder, and the second in 2014 after the investigating officer showed her CCTV footage that captured the attack.

Cross-examined by defence lawyer William Booth, Liebenberg told the court that she was puzzled by the lack of blood in Kumalo’s abdomen.

She said 400 millilitres was not enough on its own to be the only “mechanism of death”, and so she had to consider alternative causes not apparent to the naked eye, such as whether the victim was intoxicated.

Liebenberg said a gross laceration of Kumalo’s liver would have killed her by a “mechanism of blood loss”. This had contributed to her death, but what killed her was “blunt injury to the trunk”.

She told the court that she had been concerned about the lack of blood loss, but that after viewing CCTV footage of the incident, she had more information.

She conceded that the issue of “commotio cordis” would not have arisen had she not viewed the footage.

“Commotio cordis” is a disruption of heart rhythm caused by a blow to the area directly over the heart, and Liebenberg believes this may have happened in the case of Kumalo.

In the first two seconds of the CCTV footage, Liebenberg said one could see Kumalo stumble on screen, and then try and get up.

When Booth asked her if she could exclude that Kumalo was dead already when the the kicking and stomping happened, Liebenberg said she couldn’t rule it out, but it was a “rare possibility”.

She told the court she believed Kumalo had been flat on her back as the “chances of stomping causing injury was much higher” and the severity of the tear to the liver “fits better with her on her back lying on a hard surface”.

Mthethwa has pleaded not guilty to the murder and is currently out on bail of R100 000.

The trial is expected to resume on Monday when a Zimbabwean witness will take the stand.