Lambert, 36, began dating Mid North Coast doctor Angela Jay long distance after matching with her on Tinder in August 2016.

The relationship, which lasted less than two months, deteriorated after Lambert became "controlling and possessive", threatened suicide, lied about deaths and created a false identity, findings by the NSW Coroner released on Friday reveal.

But Lambert's "insidious" manipulations were part of a much larger history of abuse against women, Acting State Coroner Teresa O'Sullivan found.

He was the subject of 10 apprehended violence orders from five separate women, including his former wife.

He was deported from the United States in 2015 for extorting a woman he dated while married.

He claimed diagnoses of psychological disorders including multiple personalities - up to nine at once - including "evil Paul".

He abused his wife throughout their divorce back in Queensland and was convicted of assault but paroled immediately.

He then moved to Sydney and met Dr Jay.

His escalating violence against Dr Jay reached fever pitch in late-2016 when he rented a room at a hotel near her hospital to stalk her.

He broke into Dr Jay's Port Macquarie home, ambushing and stabbing her 11 times in the chest, arms and legs days later on November 3.

He doused her with petrol and, bleeding heavily, she managed to escape to a neighbour's home.

Lambert fled the scene and sent messages to his mother where he spoke about the attack in third-person.

"He's fighting his way out and I can only hold on so long," he wrote.

Police gave chase and used road spikes to stop his car on the Pacific Highway.

Surrounded, Lambert ignored officers' requests for him to surrender. When he lunged at an officer with the knife they shot him dead.

The coroner ruled shooting Lambert was unavoidable given his actions and it "deeply affected" the officers who pulled the trigger, the coroner found.

"Senior Constable Damien Buckley said he reflects on the death every day and desperately wishes that there could have been a different outcome and that he could have 'sent Paul home' to his family," the judgment read.

"He even said he wishes he could have 'swapped spots' with Mr Lambert. Firing shots was clearly a last resort."

In Lambert's rental car investigators found his passport, traffic fines, personal effects and a note.

"Your (sic) all now at peace and free to live happy lives without me f---ing it up and being a toxic blight on this world and to you all," the note ends.

The coroner recommended NSW Police continue to explore non-lethal options for knife-wielding offenders, including shields. She also recommended NSW Police consider implementing information sharing systems to stop people with outstanding AVOs purchasing knives without a check.

On her Facebook page after the findings were handed down, Dr Angela Jay shared a message thanking the police for their bravery and praying that everyone impacted by this incident can find some closure.

“Today my thoughts are with my police heroes and their families as a conclusion is handed down at the Coroners Inquest this morning,” she wrote.

“I will never be able to articulate just how grateful I am for their brave actions on that horrible day.

“They have literally saved my life and allowed me the freedom to feel safe and happy again.”

This story first appeared on the Sydney Morning Herald