We present a rare case of fatal Pulmonary Embolism (PE) following elective wrist surgery in which such a risk is statistically negligible. The patient in this case was assessed pre-operatively for the risk of Venous Thromboembolism (VTE) using existing guidelines and was found to be of low/ moderate risk. Patients in the low/moderate risk group would not be routinely offered chemical VTE prophylaxis after surgery. Low Molecular Weight Heparin (LMWH) was given to this patient during their admission according to local Trust guidelines for in-patients. Despite measures being taken to prevent the risk of VTE, the patient was readmitted in a state of cardiac arrest after suffering a massive PE.