A DELAY in performing an operation on an elderly woman who fractured a hip while watering a lavender plant at home could have caused her death some days later, an inquest in Hereford heard.

Herefordshire coroner David Halpern recorded a verdict of misadventure on 80-year-old Cornelia Smart.

"We don't know much about thrombosis but it can be a fatal outcome of immobility," said Mr Halpern.

"It does appear that delays in undertaking the operation could have caused, contributed or increased Mrs Smart's susceptibility to the fatal problem that occurred."

Mrs Smart, of Beaconsfield Park, Ludlow, was taken to Hereford County Hospital on September 14 last year with a fractured hip and was operated on three days later.

Later she developed chest pain and shortness of breath and died on September 30 after a cardiac arrest.

Dr Paul Dunn, a consultant pathologist at Worcester Royal Hospital, said the two to three day wait before surgery may have contributed to the fatal thrombosis.

Her husband Thomas Smart read out a national newspaper report at the inquest, which said an elderly person with such an injury should be operated on within 24 hours if possible.

"My wife went 62 hours without food or drink and this could have been a contributory factor to her death," he said.

Laith Majeed, a consultant orthopaedic surgeon at Hereford County Hospital, said Mrs Smart arrived at the hospital on a very busy weekend in the emergency ward, with nine or 10 similar cases.

"We had them on the list and we planned to do Mrs Smart on the Monday and that did not materialise. We planned to operate the following day, and there were unforeseen delays on that particular day. The following day, I did the operation myself, and Wednesday was my day off."

Mr Majeed said the operation had gone well.

"I think the earlier we do the operations the better, but the risk cannot be eliminated. It's known that earlier the operation the better, and that's why we booked her on the first day," he said.

Mrs Smart died from a pulmonary embolism, femoral vein thrombosis following an operation on a fracture.

After the inquest, Frank Sibly, clinical director of orthopaedics, said he and his colleagues aimed to operate on all patients with fractures on the next available operating list, subject to the patient's general medical condition being stable.

Early morning meetings had been introduced to discuss the operations scheduled for that day and whether a planned patient admission needed to be deferred in order to treat a patient with a fracture.