Sir Richard Branson’s wife may have survived had doctors given her blood-thinning treatment for a “massive” clot found on one of her lungs, an inquest has been told.
Lady Joan Branson died at the age of 80 in a London hospital last November, after developing complications linked to a back injury she sustained in a fall at the family’s Necker Island residence.
At Westminster Coroner’s Court on Wednesday, the hearing was told that her cause of death was a pulmonary embolism — a sudden and potentially fatal blockage of an artery in the lung — which followed deep vein thrombosis.
Joan had been admitted to The Lister Hospital in Chelsea on November 17, several weeks after falling at the private Caribbean retreat in the British Virgin Islands owned by her billionaire husband.
The inquest heard that the 80-year-old had a known history of blood clots going back to 2018 and had previously been given injections of an anticoagulant medication for flights and during earlier hospital stays.
But Professor Fiona Wilcox, senior coroner for Inner West London, told today’s inquest that Joan did not receive prophylactic anticoagulants, in particular Enoxaparin injections, prior to her death despite there being a ‘very high risk of developing deep vein thrombosis’.
Giving her conclusion, the coroner said: ‘I do find her death would have likely been prevented and the lack of anticoagulation did cause or contribute to her death probably.’
She added: ‘This 80-year old lady was admitted to the Lister Hospital on November 17, 2025 following a GP referral after persistent pain following a fall at home two weeks earlier. Sadly she passed away in hospital on November 24.’
Sir Richard Branson and his wife Joan had three children together
Joan’s daughter, Dr Holly Branson, sent an email to the court ahead of the inquest in which she expressed concern at how her mother was treated in hospital, but did not want to ‘attribute blame to any individual doctor’.
She questioned why her mother was not offered the medication, which she was said to have been ‘accustomed to’, and refused to accept that Joan refused to take it.
Dr Branson explained that Joan used the anti-blood clot injections ‘extensively while flying and during previous hospital admissions’ and always took them when advised.
She added: ‘The suggestion she refused Enoxaparin due to prior pain or bleeding concerns is not consistent with her usual practice or attitude.’
Dr Branson said that while she was at her mother’s side during the first two days, Enoxaparin ‘was never offered’.
‘Had I been aware she was not receiving Enoxaparin injections I would have been very concerned given her recent long haul travel and medical history,’ she added.
Dr Branson added that unless ‘the bleeding risk’ outweighed the benefit of busting clots, ‘I would have asked my mother to take it’.
She also claimed her mother had not been given anti-clot stockings to wear for up to 48 hours after her admission to hospital.
Dr Branson said: ‘I noticed she was not wearing them and asked the nurses. My impression from the doctors was that this was an oversight on their part. Of course, as soon as we discussed their importance, she wore them.’
Lady Branson, Sir Richard’s partner for 50 years, died last November
Dr Basir Kunduzi, who was on duty at Lister Hospital, was asked by the coroner whether he thought Lady Branson should have been on anti-coagulant injection.
‘I thought she should have been,’ he told the court, and accepted it was his responsibility to prescribe the drugs.
Asked to explain why he did not give the drugs, Dr Kunduzi said: ‘Since Lady Branson had a fall and had been mobilised since her fall, there was a risk of bleeding.’
He decided to delay prescribing anti-blood clot injections until he organised a CT scan to ensure there was no bleeding – which the drugs could worsen.
Dr Kunduzi wrote on her records that he had not given anti-clot drugs.
Asked how any other doctor would have known he had chosen not to give Lady Branson the drugs, Dr Kunduzi said he expected whoever took over from him to review his decision.
Dr Kunduzi said he now realises ‘the importance of communication between team members’ and has ‘changed’ his team practice.
He said the decision not to administer the anti-coagulants to Lady Branson would live with him for the rest of his life, adding: ‘I would like to express my deepest condolences to Lady Branson’s family.’
Dr Nevil Pavithran, who took over Lady Branson’s care, told the inquest she should have been given anti-coagulants within 12 hours of her admission to hospital.
Asked by the coroner whether it was a ‘straightforward’ decision to prescribe anti-coagulants, the doctor agreed that it was on November 18.
Sir Richard with Lady Branson and daughter Holly, who was previously a hospital doctor
Dr Pavithran added that ‘there was no bleeding risk’ from the drugs. He also said that she was ‘not likely’ to be wearing compression stockings.
He added that during a ward round late in the evening of November 18, the consultant on duty, Dr Inaki Bovill, asked for her to wear compression stockings.
Dr Ben Thomas, a consultant anaesthetist at the Lister, saw Lady Branson on the evening of November 19.
He was considering giving her a pain-killing injection into her spine – although he did not do so – and asked if she was on blood thinners. This was important because an injection into her spine could lead to excessive bleeding, he said.
Dr Thomas said Lady Branson was asked if she was on blood-thinning drugs and she ‘denied it, she said no, she avoided them, and didn’t like the bruising from the needles, but took them for flights’.
Later, Dr Thomas said he learned of Lady Branson’s death from a news report and called his colleague Dr Bovill.
He added: ‘He sounded distressed, he gave me a brief summary of what happened. I followed up to check he was OK by text message.’
In a further message to Dr Bovill discussing the case, Dr Thomas sent a text message at 6.21pm about anti-coagulants.
Dr Thomas wrote: ‘I asked for anti-coagulant on first meeting. She confirmed not normally taken and would only take a jab when flying.’
He explained: ‘I didn’t mean she declined medication, it was that she wasn’t routinely on it but specific to flying.’
Dr Thomas added: ‘I regret not going into further detail that day.’
Sir Richard and Lady Branson with children Holly and Sam on their wedding day on Necker Island in 1989
Describing how Lady Branson came to the hospital, Dr Bovill said she had had a fall at her home on Necker Island.
He said: ‘She described tripping over some slippers by her bed. She had fallen, unable to get up, was in a lot of pain and diagnosed in the British Virgin Islands having sustained fractures of the pelvis and right hip.’
Dr Bovill said he knew Lady Branson well, and also knew her daughter Dr Branson from many years ago because they worked at the same hospital trust.
He was aware Lady Branson had an umbrella-like metal filter in the major vein leading to the heart, the vena cava, to stop blood clots reaching the heart.
Based on the drug history, on the day of Lady Branson’s admission, Dr Bovill said she was not on anti-coagulants, although she was on a variety of other drugs including low-dose aspirin.
Dr Bovill saw her on November 17 and was not aware she had not been assessed for bleeding risks.
Asked if this had not been brought to his attention, Dr Bovill said: ‘I can’t recall being told about that. I can’t recall talking with Lady Branson. It was a very brief visit.’
Asked whether the VTE (Venous Thromboembolism) assessment ‘should have been carried out’ and clot busting drugs should have been prescribed on her admission on November 17, Dr Bovill replied: ‘Yes it should have been done and should have been prescribed. It was a regret it wasn’t spotted by me that evening.’
Dr Bovill said that the next day, after he finished his clinic at his NHS job at the Chelsea and Westminster Hospital at around 5pm, he travelled to Lister Hospital by moped.
He said on his ward round there were ‘no contra-indications’ to give Lady Branson the anti-clot drugs with the exception of whether she might have to receive a pain killing injection in the spine.
Going back to the decision not to give drugs on November 18, Dr Bovill said his ‘recollection was not completely clear, but I was reminded when I spoke [after Lady Branson’s death] with Dr Pavithran.
‘I was very distressed at what happened. My mind was numb and could not recall in detail’.
Dr Pavithran told Dr Bovill that ‘Lady Branson had declined injections because of pain and needles and bruising,’
The coroner asked Dr Bovill why he did not ‘simply persuade her to take it knowing she had taken it previously and needed it’.
Dr Bovill said: ‘I thought long and hard about this and reflected on it… I should have perhaps been much more forceful. It’s to my great regret I did not or it appears I did not but it would have been my normal practice to do so.’
Compression stockings and low-dose aspirin ‘would not have been sufficient’ to prevent blood clots, Dr Bovill said.
Asked if he ever revisited the decision not to prescribe the anti-clot drugs, Dr Bovill said: ‘Again, with great regret, I did not.’
Dr Bovill said one issue was that the Lister had adopted a new electronic drug prescribing system called Expanse.
He added: ‘Before [the use of this system] it would have been obvious on the drug chart whether prescribed or not prescribed.’
Dr Bovill stated: ‘I should have revisited it. We are still getting used to Expanse.’
Asked whether it was the job of ‘junior doctors’ to prescribe the anti-clot drugs and carry out the VTE assessment, Dr Bovill said: ‘It is in all places I’ve worked, but ultimately the responsibility does rest with the consultants, I have to accept that.’
In a statement read at the inquest by the coroner, family members described Lady Branson as a ‘deeply loved wife, mother, grandmother and friend’ who was ‘known for her warmth, kindness and unwavering compassion for others’.
They added: ‘She was the heart of our family and played a central role in creating a close, loving environment around her. She had a remarkable ability to connect with people from all walks of life, bringing together diverse groups of people.’
Lady Branson, born Joan Templeman in Glasgow, was described as ‘a trusted confidante to many’ known for ‘her generosity and acts of kindness’.
Describing her relationship with Sir Richard, the tribute said this was built on ‘mutual strength’ and ‘enduring affection’, adding: ‘She had a lasting impact on all who knew her.’
Virgin tycoon Sir Richard had described his wife as the ‘most wonderful mum and grandmum’ on Instagram after her death. The pair married on Necker Island in 1989.
