Finding into death of Beverley Joy Leggett

79y · Female·Pulmonary thromboembolism in the setting of right elective total hip replacement

A 79-year-old woman died from pulmonary embolism eight days after undergoing elective right total hip replacement. She received multimodal VTE prophylaxis including aspirin, early mobilisation, mechanical foot compression, and hypotensive anaesthesia. Post-operatively, she had delirium and confusion, which may have contributed to reduced mobility despite physiotherapy. Foot compression was discontinued on transfer to rehabilitation. The coroner found her treatment was appropriate and consistent with emerging evidence favouring multimodal prophylaxis over chemical anticoagulation alone for hip arthroplasty. The key clinical lesson relates to outdated national guidelines: current orthopaedic literature suggests multimodal prophylaxis without routine potent anticoagulants is safer and at least as effective as anticoagulant-based regimens, with anticoagulants possibly associated with higher all-cause mortality due to bleeding complications.