A clot formed through deep-vein thrombosis and travelled to her lungs, causing a pulmonary embolism described in court as “massive”. Lady Joan suffered a cardiac arrest and died on November 24.
Haematologist Dr George Adams assessed her risk of clotting as “extremely high”. He told the hearing that appropriate anticoagulation would probably have prevented her from dying.
Dr Nevil Pavithran said the first preventative dose should have been administered within 12 hours of admission. He acknowledged that he “should have been more forceful” about ensuring the treatment was given.
Why was anticoagulant medication not prescribed?
Dr Basir Kunduzi, who was on duty at the hospital, said he initially wanted Lady Joan to undergo a CT scan to rule out internal bleeding. Anticoagulants reduce clotting but can make existing bleeding worse, so the concern itself had a medical basis.
The problem came after that decision. Dr Kunduzi recorded that Lady Joan had not received anticoagulant medication and assumed the doctor taking over would review the situation. The expected review did not produce the necessary treatment.
He told the inquest that the decision was something he would have to live with and offered his “deepest condolences to Lady Branson’s family”. He also said the death had prompted him to reflect on communication between doctors.
Consultant Dr Inaki Bovil accepted that a venous thromboembolism assessment should have been completed and suitable medication prescribed.
“It should have been done and should have been prescribed,” he told the court. “It was a regret it wasn’t spotted by me that evening.”
The evidence therefore spread responsibility across the admitting doctor, resident medical officer and consultant, alongside the missing immediate clot-risk assessment. Focusing on one prescription decision would leave out rather a lot of the medical process that was supposed to catch it.
What did the coroner decide?
Professor Wilcox concluded on September 9, 2026, that The Lister Hospital’s failure to provide preventative anticoagulation probably contributed to Lady Joan’s death.
The coroner found that proper medication would likely have prevented the pulmonary embolism. She stopped short of finding neglect, explaining that Lady Joan had not been left without treatment altogether.
The conclusion updated earlier reporting from the hearing, when evidence was still being heard and no formal finding had been delivered.
The Lister Hospital is owned and operated by HCA Healthcare. Dr Bovil said the hospital had carried out extensive work to strengthen its prevention of venous thromboembolism following Lady Joan’s death. The inquest evidence leaves an obvious practical test for those changes: whether immobile patients with fractures now receive immediate risk assessments, timely decisions on anticoagulants and basic measures such as anti-clot stockings.
How has the Branson family responded?
Lady Joan and Richard Branson had been together for around five decades and married in 1989. They had three children: Holly Branson, Sam Branson and Clare Sarah Branson, who died at four days old after being born three months prematurely.
Holly said the family wanted lessons to be learned rather than blame placed on one individual. That position broadly reflected the inquest evidence, which identified a wider failure of assessment, prescribing and communication.
After his wife’s death, Richard Branson described her as “the most wonderful mum and grandmum our kids and grandkids could have ever wished for”.
“She was my best friend, my rock, my guiding light, my world,” he wrote. “Love you forever, Joan x.”
