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NEW YORK (AP) — The death of a young Connecticut woman who fell down stairs at a Manhattan subway station with her 1-year-old daughter appears to be related to a pre-existing medical condition, the city’s chief medical examiner said Wednesday.

Malaysia Goodson, 22, of Stamford, fell down the stairs at a midtown Manhattan station at around 8 p.m. Monday, according to the New York Police Department, whose officers found her unconscious next to a toppled over stroller. Her child was unharmed.

“While the cause of death is pending in this case, we can state that there is no significant trauma, and this fatality appears to be related to a pre-existing medical condition,” Chief Medical Examiner Dr. Barbara Sampson said.

The young mother’s death, which the Metropolitan Transportation Authority is investigating, sparked complaints about the lack of accessibility in the New York subway system. Only about a quarter of the city’s 472 subway stations have elevators, and the elevators that do exist are often out of service. The problem also makes it difficult for people in wheelchairs to use the subways, and disability-rights activists have staged frequent protests over the issue.

“This is a heartbreaking tragedy that never should have happened. The subway system is not accessible for everyone, and that’s an environment the MTA should not allow,” Mayor Bill de Blasio tweeted after the incident.

Shams Tarek, an MTA spokesman, said the station where Goodson fell does have escalators. Parents are generally advised not to ride escalators with strollers, however.

“This is an absolutely heart breaking incident,” the MTA said in a statement. “While the ultimate cause of the event is being investigated by the MTA, medical examiner, and the NYPD, we know how important it is to improve accessibility in our system.”

Andy Byford, who was appointed the MTA’s head of the subway system last year after running the Toronto Transit Commission, has set a goal of adding enough elevators to the system that after five years, no rider will be more than two stops away from an accessible station.