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She was partially naked and was 'painted with blood', according to reports, and 'managed to escape down the hall with the cord of a curling iron that he was using to strangle her still wrapped around her neck'.
An FBI report on the attack stated: '[The woman], fearing death was imminent, asked the passenger to relay to her family how much she loved them.'
The victim suffered a deep laceration to her left cheek, skull fracture and a wound to the back of the head which required staples.
According to the lawsuit: 'He [Pujayasa] beat her head and face so hard that she experienced shifting of her teeth. All of the trauma to her head produced a traumatic brain injury.'
She suffered bites to the hands which left marks; a spinal fracture, swelling, bruising and lacerations to the face, scalp, head, neck, back, front of torso, arms, and legs and abrasions on both arms.
Cord marks were left on her neck from being repeatedly strangled. She has suffered a long-term brain injury due to being beaten about the head and having her oxygen supply cut off with repeated strangulation.
Jane Doe, who is married without children, also suffers flashbacks and PTSD from the horrific ordeal.
Although fellow passengers made urgent 911 calls to security that night, no Holland America staff responded immediately to the reports of an attack.
One guest told a staff member that 'they head a woman saying ''he's trying to kill me'''.
According to the lawsuit, an insufficient number of security personnel were on duty and the emergency calls made by concerned fellow passengers did not reach a security office directly but the front desk.
The front desk employee 'triaged' the call, Mr Hickey told Daily Mail Online, but only deemed it 'medium priority'. Documents revealed that a day earlier, a blocked toilet had been 'high priority'.
Only one 'roving security guard' was on duty that night, on a ship holding around 3,000 people, Mr Hickey said.
When cruise personnel finally arrived in the hallway, it was front desk member of staff and not security.
The staff member had no master key to access the cabin and merely knocked gently on the door and asked: 'Madam? Madam?', a witness reported.
There was no attempt to break down the door to reach the endangered passenger.
The lawsuit alleged that Holland America 'allowed the perpetrator, a junior room service attendant, who beat and attempted to murder the passenger, to have more access to room keys and thus to cabins than the person responding to an emergency on board'.
The cruise ship docked in Honduras and the victim was airlifted to a Florida hospital.