Sir Richard Branson's wife died aged 80 after suffering a 'massive' blood clot on one lung following a failure by doctors to give her medication, an inquest heard today.

Joan Branson passed away at a hospital in London following complications from a back injury suffered in a fall at the family's Necker Island home.

She tripped over some slippers by her bed, leaving her unable to get up – and was diagnosed with fractures of the pelvis and right hip.

Lady Branson returned to London and was admitted to Lister Hospital in Chelsea on November 17, 2025 after a GP's referral for 'persistent' pain two weeks after the fall.

She had a history of blood clots dating back to 2010 and previously had jabs of an anti-clotting drug when flying and during previous hospital admissions.

But Inner West London Coroner's Court was told today that the mother-of-three was not offered these injections at the hospital despite her medical issues.

One of her children, Dr Holly Branson, who previously worked at another hospital, said she 'does not accept' her mother refused to take the drugs after her admission.

Coroner Fiona Wilcox said: '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.'

Dr Branson did not attend the inquest – and neither did Sir Richard – but she sent an email to the court in which she expressed concern at her mother's treatment.

Reading this out today, the coroner explained that Dr Branson said her comments were not to 'attribute blame to any individual doctor', but added that 'she did not accept that her mother refused [anti-blood clotting drug] Enoxaparin injections'.

Dr Branson said her mother was 'accustomed to anti-coagulant [anti-blood clot] injections and never had difficulty with them.

'She used them extensively while flying and during previous hospital admissions' during travel from the family home on Necker Island in the British Virgin Islands.'

Dr Branson said her mother always took the injections when advised, adding: '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.'

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.

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.

Dr Thomas said: '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.'

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 he said 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.

The inquest continues.