Doctors have been cleared of blame over the death of a great-grandmother who fell head-first off an operating table during surgery on a broken ankle.

Sylvia Whipp, 60, fell off the table at Oxford's John Radcliffe Hospital on October 20, 2003, and died from a pulmonary embolism in her lungs the next day.

However, at an inquest on Tuesday, Oxford Coroner Nicholas Gardiner ruled the blood clot had been caused by a fall in which she broke her ankle at her home, in Chillingworth Crescent, Wood Farm, Oxford.

The clot had travelled from her ankle to her lungs and she suffered a heart attack, the inquest heard.

Following the fall from the operating table, Mrs Whipp suffered bruising to the left side of her temple and a small graze on her elbow.

The hospital carried out a policy review and it now recommends that all patients weighing more than 45kg (about seven stone) are strapped to operating tables during major surgery.

Recording a verdict of accidental death, Mr Gardiner said: "In relation to the fall from the operating table, I'm quite satisfied that it played no part in Mrs Whipp's death."

He noted straps were now used, and said hypothetically a fall from a table could kill a patient if they struck their head hard enough on the floor.

However, while the family said the outcome of the inquest they had been waiting nearly three years for did give them a degree of closure, they still could not believe the fall was allowed to happen.

After the inquest, Mrs Whipp's daughter Mandy, 39, said: "I'm glad that they have brought measures in after what happened to mum, but I can't believe she was not strapped in in the first place.

"We will never get over this. I know what the coroner has concluded, but I still can't get my head around the fact that she went into hospital with a broken ankle, nothing else, and never came out."

Mrs Whipp's son Neil, 32, said his mother's death had affected him very badly.

He said: "I was in prison when she died and so I hadn't seen her for a long time. Mum always stuck up for me and I will just always wish I had had a chance to make my peace with her."

At the inquest it emerged that Mrs Whipp had not been given the blood-thinning drugs amlodipine and dythynapine for two days while she was in hospital, because her medical notes had not gone with her when she was moved from the medical assessment unit to a ward.

Giving evidence, anaesthetist Prof John Sear said: "It's not good medical practice, but I didn't think it was a good reason for not proceeding with the operation."

After the hearing, a spokesman for the John Radcliffe Hospital said: "We hope that the inquest has brought some closure to the family and we offer our sympathies to them for their loss.

"This was an extremely rare incident and, although the fall did not contribute in any way to Mrs Whipp's death, we appreciate the distress this will have caused.

"There's now a policy in place for special operating straps to be considered for use on all patients, if clinically appropriate to do so."