There's no doubt Sophie Pascoe gave her all to win her fourth straight Paralympic title in the 200m individual medley (SM9) in Tokyo last night, throwing up and blacking out shortly after claiming her 16th medal. 

Having already become New Zealand's greatest Paralympian with 15 medals before she hit the water in Tokyo, the Kiwi swimmer has only kicked on from there. 

After joining the elite club of fewer than 40 athletes to have claimed 10 gold medals at a Summer Games when she won gold in the 100m freestyle (S9) event in Tokyo on Tuesday night, she picked up an 11th gold in the 200m individual medley (SM9) on Wednesday night. 

It completed a famous fourpeat – adding to gold medals she had won in the discipline in Beijing, London and Rio. 

Gold medalist Sophie Pascoe reacts during the women's 200m Individual Medley - SM9 medal ceremony on day 8 of the Tokyo 2020 Paralympics. Photo / Getty 

After the race she said that will be her final ever 200m individual medley race after throwing up and briefly blacking out on the side of the pool. 

Coach Matt Ingram and physio Megan Munro were quick to help her and the medal ceremony was moved while Pascoe received oxygen to recover. 

"I did really leave it all out there and even left some on the side of the pool. But that is what a fight is all about and I really wanted it, I wanted to make it a four-peat. It just came down to that last 10 metres not breathing. That comes down to the skills that Roly [Crichton] and I have been working on for many years doing this race. 

"I can say you have just witnessed my last ever 200 IM. I will be cutting the events down now so it is nice to finish on a positive and with a gold. The mentality in that race was just to fight and dig deep. It came down to experience and that is what got me this gold medal. 

"To come away with the four-peat I'm proud of myself. I'm so lucky to have Matt [Ingram] and Megan [Munro] on the side of the pool to get me medical attention. The fact the IPC moved the medal ceremony just shows how much respect they have for the athletes." 

Sophie Pascoe celebrates gold medal number four in the 200IM. Photo / Getty 

Pascoe got a great start off the blocks and was ahead by more than a second after the butterfly leg. The gap remained steady through the backstroke leg, before Pascoe extended her lead with an impressive breaststroke leg. 

However, things got a little close for comfort on the freestyle as Hungarian Zsofia Konkoly almost overcame Pascoe's three-second lead in the sprint home, only to come up just 0.27 seconds short. 

It was Pascoe's 11th Paralympics gold, her 19th medal (seven silver, one bronze), and her second gold of the Tokyo campaign. It was a similar finish to Pascoe's 100m freestyle final; a tight affair after which she admitted she wasn't sure she had won the race when she touched the wall. 

Pascoe's wasn't the only New Zealand medal on Wednesday, as sprinter Danielle Aitchison claimed her second of the Paralympic Games, picking up bronze in the women's 100m (T36) final. After claiming silver in the 200m event, Aitchison did well to finish the 100m event strong - holding on for the bronze by just 0.02 seconds, but missing the silver by the same margin. China's Shi Yiting took out the event, setting a new world record. 

Fellow Kiwis Nikita Howarth, Jesse Reynolds and Tupou Neiufi also took to the pool for medal races on Wednesday night. After a strong start to her 100m breaststroke (SB7) final, Howarth found herself in a battle for second and third with the USA's Jessica Long and Australia's Tiffany Thomas Kane, but was unable to match her counterparts down the final 25m and ultimately finished in fourth. 

In the men's 200m individual medley (SM9) final, Reynolds was the seventh-fastest qualifier and finished the final in the same position, while Neiufi finished fifth in the women's 50m freestyle (S8) final. 

Earlier, para-cyclist Rory Mead completed a gruelling men's H1-2 road race in fifth place, while veteran shooter Michael Johnson barely missed out on a chance to add another Paralympic medal to his collection. 

Johnson, 47, fell agonisingly short of the top-eight place he needed in qualifying to book a spot in the final of the R5 mixed 10m air rifle prone SH2, finishing ninth with a score of 635.2 points. 

That left the Kiwi 0.2 points outside of the top eight and meant he came away empty-handed from a second event in Tokyo.