For Sir Richard Branson and his family, the loss of Joan Branson was devastating enough.

Now an inquest has delivered an even more painful conclusion:

Her death was likely preventable.

Lady Branson, the billionaire entrepreneur’s wife and partner of more than half a century, died at age 80 on November 24, 2025, after developing a massive pulmonary embolism caused by deep vein thrombosis.

At an inquest in London, a coroner concluded that her life would likely have been saved had she been given preventive blood-thinning medication after she was admitted to hospital.

The finding has placed extraordinary focus on a decision that was not made.

Lady Branson had been admitted to The Lister Hospital in Chelsea on November 17 after suffering persistent pain following a fall at the family’s Necker Island home.

She had fractured her pelvis and right hip.

She was also considered to be at very high risk of developing a dangerous blood clot.

Yet despite a history of previous clots and her established use of anti-coagulant injections during flights and earlier hospital stays, she was not immediately given prophylactic Enoxaparin.

Seven days later, she was dead.

Senior coroner Professor Fiona Wilcox told Westminster Coroner’s Court that the absence of anti-coagulation likely contributed directly to Lady Branson’s death.

“I do find her death would have likely been prevented,” the coroner concluded.

It was a devastating finding for a family already grieving the woman they described as the heart of their lives.

Lady Branson’s daughter, Dr Holly Branson, had raised concerns with the court about her mother’s care.

She made clear that she did not wish to blame any individual doctor.

But she questioned why her mother had not been offered medication she had used repeatedly in the past.

According to Holly, her mother was accustomed to Enoxaparin injections and had taken them extensively while flying and during previous hospital admissions.

She also disputed suggestions that Lady Branson had simply refused the treatment.

“The suggestion she refused Enoxaparin due to prior pain or bleeding concerns is not consistent with her usual practice or attitude,” she told the inquest in a written statement.

Holly said that during the first two days she spent at her mother’s bedside, she never saw the medication offered.

Had she known it was not being administered, she said, she would have been deeply concerned.

There was another warning sign.

Lady Branson was also reportedly not wearing compression stockings for a period after admission.

When Holly noticed, she raised the issue with hospital staff.

The stockings were later provided.

But doctors told the inquest that stockings and low-dose aspirin alone would not have been enough to prevent the type of clot that eventually killed her.

The testimony revealed a series of difficult medical decisions, missed opportunities and communication failures.

Dr Basir Kunduzi, who was on duty at The Lister, told the court that he believed Lady Branson should have received anti-coagulant medication.

He accepted that prescribing it was his responsibility.

But after her fall, he feared there could be internal bleeding that blood thinners might worsen.

He therefore decided to delay treatment until a CT scan could rule out bleeding.

The problem was what happened afterward.

Dr Kunduzi documented that anti-coagulants had not been given, but expected the medical team taking over from him to review the decision.

He later told the inquest that the episode had changed how his team communicates.

He also said the decision would remain with him for the rest of his life.

Another doctor, Dr Nevil Pavithran, told the court that by November 18 the decision should have been straightforward.

He said Lady Branson should have received anti-coagulants within 12 hours of admission.

By then, he said, there was no bleeding risk that would have prevented treatment.

Consultant Dr Inaki Bovill also accepted that the blood-clot risk assessment should have been completed and anti-clot medication prescribed.

He told the coroner that he deeply regretted not identifying the problem and revisiting the decision.

“I should have revisited it,” he said.

The inquest also heard that the hospital had recently introduced a new electronic prescribing system.

Dr Bovill explained that under the previous system, it would have been immediately obvious from the drug chart whether anti-coagulants had been prescribed.

With the new system, he said, that visibility was not the same.

But he also accepted that ultimate responsibility remained with the consultant team.

Behind all of those clinical details was a family watching someone they loved deteriorate.

Lady Branson had originally fallen at Necker Island after apparently tripping over slippers beside her bed.

What began as a painful orthopedic injury ultimately led to something far more dangerous.

Limited mobility is a major risk factor for deep vein thrombosis, in which a clot forms in a deep vein, commonly in the leg.

If part of that clot breaks away and travels to the lungs, it can cause a pulmonary embolism.

That is what killed Joan Branson.

The inquest heard that the clot was “massive.”

For Richard Branson, the loss ended a relationship that had lasted around 50 years.

The couple married on Necker Island in 1989 and built a family together that included children Holly and Sam.

After Joan’s death, Branson described her publicly as the “most wonderful mum and grandmum.”

Her family’s tribute at the inquest painted a picture very different from the headlines surrounding wealth, Virgin and Necker Island.

They remembered her simply as Joan.

A wife.

A mother.

A grandmother.

A friend.

They described her as warm, compassionate and able to connect with people from all walks of life.

“She was the heart of our family,” they said.

Her relationship with Richard was described as one built on mutual strength and enduring affection.

That makes the coroner’s conclusion even harder to absorb.

Joan Branson was 80.

She had suffered a serious fall.

She had a known history of blood clots.

She was at high risk.

And according to the inquest, one preventive treatment could probably have changed what happened next.

For her family, that finding cannot bring her back.

It can only leave them with one of the most painful questions imaginable:

What if she had received the injection in time?