Wearing high heels for the first time in years sparked a tragic chain of events - culminating in the death of a 39-year-old woman from a blood clot.

Antoinette Sackett-Wood, who was obese, fractured her right ankle after slipping over in the shoes.

The Royal Mail night-shift worker, from Snodland, visited Maidstone Hospital A&E department the next day.

Staff diagnosed the fracture and referred her to the fracture clinic a few days later.

But an inquest into her death has heard that although hospital staff referred to guidelines for prescribing drugs which could prevent DVT, there was nothing listed for patients with casts or for patients who were not staying in hospital.

Orthopaedic registrar Richard Freeman told how he had seen her on December 7, 2011 and gave her a weight-bearing, below the knee cast on her right ankle.

He checked the National Institute for Clinical Excellence (NICE) guidelines about if she should receive anti-DVT medication - but on finding none, she was not prescribed any.

Her cast was due to reviewed at the clinic in five weeks. But two weeks later, she developed a sickness bug and took to her bed.

In a statement, her mother Susan Wood said: "For many years my daughter Antoinette suffered from ill health including brittle bones and having to take many prescribed drugs and steroids, causing her to put on weight."

She told how her daughter became bed ridden with diarrhoea and vomiting, but when her GP was unable to visit, her condition deteriorated. On December 21 she rang 999 for her.

When she got to Maidstone Hospital, Miss Sackett-Wood, of Roman Road, was blue and her breathing rapid.

Staff diagnosed she was suffering from a pulmonary embolism – or blockage in an artery – but she went into cardiac arrest and resuscitation attempts failed.

Pathologist Dr David Rouse told the hearing Miss Sackett-Wood's DVT could not have been directly related to her fractured ankle.

If that had been the case, the blood clot would have happened within seven to nine days of the accident, rather than 17 days later.

Giving the medical cause of death as a pulmonary embolism - with Deep Vein Thrombosis and a soft tissue injury from a fractured ankle with obesity as a contributory factor - he said it was likely that laying in bed with the sickness while wearing the cast may have led to a restricted blood flow in her right leg.

Dr Rouse said: "It makes the fracture a possible cause but not a probable one."

Assistant deputy coroner Allison Summers said taking to her bed while wearing the cast was the most likely cause of her developing the DVT.

Recording a verdict of death by natural causes at the Archbishop's Palace in Maidstone, Mrs Summers said: "The central question is whether this pulmonary embolism arose from her ankle injury, or whether it can be regarded as a naturally occurring event. She had been bed bound for several days with what appears to be an unrelated bug.

"Having heard the evidence that where there is to be a deep vein thrombosis arising from a leg injury and any subsequent immobilisation occurs within five to seven days, on the balance of probabilities I believe this was a natural death."

A spokesman for NICE said their recommendations were produced on advice from the Department of Health.