Thomas Nigon was treated by his primary care physician, Dr. Thomas J. Malvar, for a blood clotting issue on September 13, 2017, at which time Dr. Malvar prescribed Eliquis, a blood thinner and anticoagulant. On January 25, 2018, Mr. Nigon underwent an ultrasound of his right leg which showed the prior deep vein thrombosis (DVT) had resolved with medication. Dr. Malvar therefore ordered a discontinuance of the Eliquis prescription. Mr. Nigon had no medical issues and sought no medical treatment from January 25, 2018 until April 26, 2019.
On April 26, 2019, Mr. Nigon fell down the steps at his home and suffered a leg injury. After the fall, Mr. Nigon presented himself to the emergency room at UPMC Jameson relative to complaints of the left leg injury and concerns about a DVT. Mr. Nigon was told by the medical staff at UPMC Jameson that he did not have a DVT, and he was instructed to follow up with an orthopedic surgeon of his choice for his left leg injury.
Mr. Nigon was seen by Brian F. Jewell, M.D., an orthopedic surgeon, on May 1, 2019 for his left leg injury. Dr. Jewell diagnosed Mr. Nigon with a high-grade tear of the left quadriceps that required surgery. Mr. Nigon advised Dr. Jewell of his history of blood clots. Mr. Nigon was instructed to seek standard pre-operative clearance from his PCP, Dr. Malvar.
Mr. Nigon met with Dr. Malvar on May 6, 2019, at which time, despite Dr. Malvar being aware of Mr. Nigon’s history of DVT, made no mention of his need for thromboprophylactic medication, and there was no discussion with Mr. Nigon relative to his increased risk of deadly blood clots affiliated with the pending surgery. Dr. Malvar cleared Mr. Nigon for surgery, without mentioning the blood clotting issue.
On May 9, 2019, Dr. Jewell performed a surgical left quadricep tendon repair on Mr. Nigon. After the surgery, Mrs. Nigon was provided with patient education per Dr. Jewell’s request, which allegedly excluded any reference to risk of clots and made no mention of thromboprophylaxis.
On May 14, 2019, Mr. Nigon was at home alone, recovering from the surgery. Mrs. Nigon was at work, where she received a call from her husband at approximately 9:00 a.m. informing her that he was in trouble. Mrs. Nigon rushed home and called an ambulance. Mr. Nigon died from a massive bi-lateral pulmonary embolism caused by DVT of his left lower extremity before the emergency medical technicians could get Mr. Nigon to the local hospital.
Mr. Nigon’s Estate filed a medical malpractice wrongful death and survival action against Dr. Malvar and others. The trial court granted summary judgment to Dr. Malvar, and the Estate appealed.
The Superior Court of Pennsylvania stated in its April 9, 2024 Opinion: “Read in their entirety, the estate’s expert reports raised a genuine issue of material fact by attributing Mr. Nigon’s DVT/PE and resulting death either in whole or in part to Dr. Thomas Malvar. Whether Dr. Thomas Malvar’s alleged breach of the standard of care was a proximate cause of Mr. Nigon’s death was a disputed issue that should have been reserved for a jury … Therefore, the trial court erred by granting summary judgment.”
Source Nigon v. Jewell, M.D., 2024 PA Super 68.
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