The woman, who has yet to be named, was walking across the causeway at St Mary's lighthouse, off Whitley Bay in North Tyneside, with a group of divers preparing for a shore dive.
A wave is reported to have swept across the partially submerged causeway and washed three women into the sea. Due to the tide and lumpy sea conditions, they could not regain the land.
Passers-by who witnessed the incident called the Coastguard and an operation involving two helicopters and three RNLI craft was launched. Two of the women were pulled relatively quickly from the sea, reportedly in positions about 40m and 100m from the shore.
The third woman was not located until she was spotted from the shore by a member of Tynemouth Volunteer Life Brigade. She was hauled into an RNLI Inshore Lifeboat about 200m from the shore, after about an hour in the water.
The casualty was taken by ambulance to hospital, where she died about two hours later.
St Mary's Island is popular with divers, due to its sheltered, shallow reef areas and a wreck, the Janet Clark, which is suitable for divers of varying experience levels.
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