Coroner: 80-Year-Old's PE Death Followed Missed Anticoagulants

For patient safety and hospital quality leaders, this inquest is a textbook sentinel event: an 80-year-old orthopedic trauma patient with prior DVT history and prolonged immobility was assessed as 'extremely high risk' for clots, yet the admitting physician documented no bleeding risk assessment and delayed enoxaparin pending a CT scan. The coroner's finding that anticoagulation omission 'did cause or contribute to her death probably' should force VTE prophylaxis processes onto every acute-care audit agenda, particularly in private hospital networks.

A senior coroner has concluded that the death of Lady Joan Branson, 80, wife of Virgin Group founder Sir Richard Branson, was probably preventable and that the failure to administer prophylactic anticoagulants at HCA Healthcare's private Lister Hospital in Chelsea 'did cause or contribute to her death probably.' The finding, delivered by Professor Fiona Wilcox at Westminster Coroner's Court on 2026-09-09, followed a virtual inquest into a death that ended with a cardiac arrest on November 24 after Lady Branson developed a pulmonary embolism secondary to deep vein thrombosis.

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Lady Branson had been admitted to Lister Hospital on November 17 after falling weeks earlier on Necker Island, the Branson family's private island in the British Virgin Islands.

Lady Branson had been admitted to Lister Hospital on November 17 after falling weeks earlier on Necker Island, the Branson family's private island in the British Virgin Islands. The fall left her with a broken pelvis and hip. Haematologist Dr George Adams told the inquest that her immobility and fracture made her 'extremely high risk' for blood clots, with immobility and fracture the 'biggest risk factor by far.' Despite that assessment, no prophylactic anticoagulants were administered during her stay, and the coroner found the hospital did not provide enoxaparin or equivalent despite a 'very high risk of developing deep vein thrombosis.'

Her daughter, Dr Holly Branson, a physician, told the court in an email that Lady Branson had a history of blood clots dating to 2010 and would not have refused anticoagulants if offered. She wrote that she would have been very concerned had she known her mother was not receiving Enoxaparin injections given recent long-haul travel and medical history. She also said compression stockings were not in place and that doctors suggested this was an oversight on their part.

Admitting physician Dr Basir Kunduzi acknowledged he did not complete a bleeding risk assessment at admission. He said he thought Lady Branson 'should have been' receiving blood-clot prevention and that prescribing it was his responsibility. He explained he had decided to delay anticoagulation until a CT scan could rule out bleeding, which anticoagulants could worsen. Dr Nevil Pavithran separately testified that Lady Branson should have received her first dose of anticoagulation prophylaxis. The cumulative picture is of a high-risk patient whose venous thromboembolism prophylaxis was either omitted, delayed, or overlooked.