A 75-year-old Indiana woman who died after a brawl with Tim Hortons employees over her coffee order suffered a fatal flare-up of congestive heart failure triggered by the confrontation.

Anita Grayson died from “acute exacerbation of congestive heart failure in the setting of physical altercation” during the fight at Tim Hortons in Fort Wayne on May 13, according to WANE 15, citing the Allen County Coroner’s Office.

Officials listed Grayson’s manner of death as “undetermined” because it could not say whether it was natural, accidental or a homicide.

Anita Grayson, 75, died after a May 13 fight at a Tim Hortons in Fort Wayne, Indiana.Gofundme
Allen County Coroner Dr. E. Jon Brandenberger said the phrase “acute exacerbation” was key to understanding the ruling.

“Acute exacerbation means that the heart failure suddenly got much worse,” Brandenberger told WANE 15.

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“So, it’s like an acute flare-up of congestive heart failure. Then that will cause symptoms and possibly lead to death.”

Grayson collapsed following the fight when she allegedly punched a 20-year-old shift manager after being told to leave and ripped out a chunk of the employee’s hair during a struggle.

Police at the time said Grayson became angry over her Tim Hortons drive-thru order, argued with a 17-year-old employee and then fought with a 20-year-old shift manager after being told to leave.

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Police said Grayson punched a 20-year-old Tim Hortons shift manager during the dispute over her order.Fort Wayne Police Department
Investigators alleged Grayson punched the manager, and the two ended up wrestling on the floor. Police said Grayson pulled out a chunk of the manager’s hair before other employees separated them.

After the fight, Grayson sat at a table, made a phone call and later lay down on the floor. Employees checked on her and brought her water before she became unresponsive.

She was pronounced dead at a hospital after paramedics attempted to save her life.

Grayson died from an “acute exacerbation of congestive heart failure” following the altercation, the coroner said.Fort Wayne Police Department
Brandenberger said the physical struggle likely placed added stress on Grayson’s heart.

“The symptoms of congestive heart failure get worse when there is adrenaline flowing in a physical altercation, and then a sudden flare-up of the heart failure, which then can lead to symptoms, or hospitalization, and even death,” he said.

The coroner said his office strongly considered ruling the death natural because of Grayson’s underlying heart condition, but said the altercation made that classification inappropriate.

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The coroner ruled Grayson’s death “undetermined,” saying it could not be classified as natural, accidental or homicide.Fort Wayne Police Department
“It’s not like she was sitting in her chair or walking through Kroger and died from congestive heart failure,” Brandenberger said. “That would be natural. But there was something about this, the altercation, that made it unnatural.”

Investigators also considered accident and homicide before ruling both out.

“There has been exhaustive investigation and review in the evidence of this case,” Brandenberger said.

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Police said Grayson ripped out a chunk of the Tim Hortons manager’s hair during the struggle.Anita Grayson / Facebook
“The video was reviewed multiple times by the homicide detectives, by my staff, by the prosecutor, and by the forensic pathologist. Bodycam videos were reviewed. We listened to and transcribed the four 911 calls and multiple meetings.”

He said the case did not meet the definition of homicide because Grayson died from congestive heart failure, and the final report found she had no “significant contributory injuries” from the fight.

Police later released surveillance footage of the confrontation without audio, saying it was intended to counter misinformation circulating on social media.

Grayson’s daughter, Tawnda Grayson, called for the arrest of the Tim Hortons employees involved in the fight, accusing them of being responsible for her mom’s death.

“If our police here would just do what we pay our taxes for them to do, which is protect and serve, we wouldn’t be here,” Tawnda told WANE 15 at a protest following the incident. “Y’all have to lock them up, y’all don’t understand. My mother is gone… I want justice for my mom.”

The family has also pushed back against the police account and hired civil rights attorney Ben Crump to pursue potential litigation.

No Tim Hortons employees have been charged.

The Allen County Prosecutor’s Office said it will review the coroner’s final autopsy report before deciding whether any charges are warranted.