An inquest into the death of a man whose body was found in the Bondi Junction Westfield stairwell in 2017 begins.

Warning: Distressing content

The family of a man who went missing at a Westfield shopping centre have watched vision of the fateful moment he walked through a fire exit door and was never seen alive again.

Retired barber Bernard Gore, 71, was on a three-and-a-half week holiday to Sydney with his wife of 50 years, Angela, to visit one of their three adult children in December 2016.

The couple was staying in their daughter’s apartment in Woollahra, in the city’s east, and planned to return to Tasmania on January 11, 2017.

But on January 6, 2017, Mr Gore waited for the sun to come out before he set off to Westfield Bondi Junction at 12.30pm.

CCTV footage captured him on the 15-minute walk past a number of shops along Oxford St before he went inside the shopping centre.

He loved to walk and had arranged to meet his wife outside Woolworths at 1.15pm, as she hadn’t been ready to leave and was about 20 minutes behind.

Footage from inside the shopping centre shows him walking inside at 12.48pm, up the incline of level four and through door L407 at 12.50pm.

Mr Gore’s daughter, Melinda, cried as he disappeared in the vision shown on the TV screens in the NSW Coroners Court in Lidcombe today.

“There is no further CCTV footage of Bernard after the time Bernard entered the fire stairs,” counsel assisting the coroner, Anna Mitchelmore SC, said.

When Mr Gore didn’t show, his wife searched the areas they usually frequented before returning home at 2pm.

His family became “increasingly worried” as it got dark and reported him missing to police at 8pm, and later that night to Woolworths and Westfield security.

“Tragically, (it was) not until around 8am on January 27, 2017, that Bernard was found deceased in the fire stairs,” Ms Mitchelmore said.

“His body was found by a maintenance worker at the bottom of the stairwell he had entered.”

She said it had been “immensely distressing for his family” who spent three weeks with no idea where he had gone.

“Only for him to be found at the place for which he had set off on January 6,” Ms Mitchelmore said.

Mrs Gore sobbed and her shoulders shook as she sat in the public gallery hearing the details.

RELATED: Nightmare in Westfield – how Bernard Gore died after being trapped in Westfield shopping centre stairwell

Ms Mitchelmore said the 71-year-old was found lying in a “semi-kneeling position” in the stairwell.

“It appears that he had been sitting on a chair that was found near his body, and at some stage he had fallen forward and off the chair.”

His white hat was found in the stairwell along with a handkerchief, dentures, a men’s watch, a black comb, a glasses case and a $5 note.

Mr Gore left the Woollahra house wearing a black and red flannelette jacket and long pants with a pair of pyjama pants underneath.

The court heard he had previously gone missing in Hobart.

His son, Mark, had bought him a watch which had a GPS tracking device but Mr Gore didn’t wear it on January 6 as it wasn’t working.

His daughter, Melinda, had also given him a copy of her address and contact details on that particular day.

According to records obtained from the shopping centre, the push-button exit door at the bottom of the stairwell was not opened in the three-week period between when Mr Gore went missing and his body was discovered, as no alarm was activated.

At the time of his death, he was taking medication for hypertension and a mild cognitive impairment. His wife would stir the tablets into his morning coffee each day.

Ms Mitchelmore said the married couple “more or less had a routine when they attended Westfield”, having visited their daughters in Sydney many times over the years, and Mrs Gore would walk around the shops while her husband followed.

They would often visit the level-five food court to eat Chinese and then go to Woolworths to pick up groceries, she said.

Mr Gore would generally visit the toilets on level three and then get an ice cream from McDonald’s above Bondi Junction train station before the walk home.

Deputy State Coroner Derek Lee is this week overseeing a five-day inquest into Mr Gore’s death.

One security guard, who received details of the missing person report from Mr Gore’s daughter at about 9.36pm, said she had told him her father had early onset dementia.

He was a “rover” assigned to barricade Zone A of the two-zone shopping centre that evening and check that tenancy doors were secure.

He said a search of the fire stairs did not constitute part of his daily general duties but the fire exit doors were checked to be free of obstructions from the outside only on a daily basis.

The security guard said the external fire exit door at the bottom of the stairwell where Mr Gore’s body was found cannot be opened from outside the shopping centre.

The court heard the other fire exit doors within the stairwell locked once they were closed, including at least one door to a commercial premises which couldn’t be opened without a key.

The word “Exit” and arrows pointing downwards are in bright red paint on the stairwell walls.

In a statement, a detective who took charge of the case in 2018 described the management of the investigation as “poor”. He said there was miscommunication between security and police.

“Even in relation to what Woolworths was nominated – there was talk about Woolworths at Bondi Beach,” Detective Senior Constable Andrew Agostino said.

“There was a lot of information that was probably not accurate or correct.”

He said the Woollahra address and Westfield Bondi Junction should have been fully searched and eliminated completely before areas like nearby Centennial Park were looked at by police.

Ms Mitchelmore said a forensic entomologist analysed data that “indicated to him Bernard died a minimum of one to two weeks before his body was found”.

An expert will give evidence “of survivability without water being a maximum of three days”, and what he considers to be the most likely cause of Mr Gore’s death, she said.

Among the issues to be explored are the adequacy of the review of CCTV footage, the physical searches conducted by Westfield security and police, and the signage – both painted and illuminated – in the stairwell.

The court heard there are some 10-14 kilometres of fire stairs in Westfield Bondi Junction.

The barrister representing the NSW Commissioner of Police and other officers at the inquest described it as being “somewhat of a maze” with “a great many sets of fire doors”.

Ms Mitchelmore said she anticipates the inquest will hear there was no ‘Code Grey’ – the centre’s missing person procedure – called on January 6 or 7.

“It’s likely that it was a more informal search as opposed to a search … by a Code Grey.”

The inquest will also investigate why police and security formed the view in the early stages of their investigation that Mr Gore had never arrived at Westfield.

“The intention is to always conduct a coronial investigation in a thorough and comprehensive way,” Mr Lee said.

“It’s also the aim to identify whether there have been any shortcomings or deficiencies.

“Not for the purpose of assigning blame or fault (but) whether some important lessons can be learned from an otherwise traumatic event.”