A Hamilton coroner investigating the death of a toddler in 2009 says he cannot determine whether the child was injured by being shaken or accidentally falling.
Hail-Sage McClutchie died from a brain haemorrhage at the age of 22 months, after having a seizure.
Coroner Peter Ryan said the toddler struck her head at least four times during a five-day stay with her mother, Kelly Percy, and Ms Percy's partner, Adrian Wilson-Minimita.
The child usually lived with Ms Percy's mother.
Mr Ryan said despite five days of vomitting, loss of appetite and energy, no one sought medical help for the child.
He said that was inexcusable and contributed to her death.
But he said there is too much uncertainty and difference of medical opinion to say whether the head injury was an accident.