Finn Hopkins v. HHS - Hib, bilateral sensorineural hearing loss (2008)
Case summary [AI summaries can sometimes make mistakes]
On December 11, 2000, Greg and Helen Hopkins filed a petition for compensation under the National Vaccine Injury Compensation Act on behalf of their son, Finn Hopkins, alleging that he suffered bilateral sensorineural hearing loss as a result of receiving the Haemophilus influenzae type B (HIB), diphtheria-pertussis-tetanus (DPT), and oral polio (OPV) vaccines on December 10, 1998. Finn was 18 months old at the time of vaccination.
His parents had previously delayed vaccinations due to an aversion to them. Finn had no documented hearing problems prior to vaccination, though he had been diagnosed with mild otitis media at six months and sinusitis at thirteen months.
His parents sought an audiological evaluation on March 23, 1999, due to concerns about his speech clarity and word acquisition, and because his sister, Ruby, had recently been diagnosed with hearing loss. Otoacoustic Emissions Testing in April 1999 suggested abnormal cochlear function in both ears.
By May 1999, Finn was confirmed to have moderate sensorineural hearing loss in his left ear and moderately-severe loss in his right ear. Treating ENT Dr.
Randall Ow assessed the condition as "probable hereditary hearing loss." A VAERS report filed by treating pediatrician Dr. Thad Woodward on June 14, 1999, attributed Finn's hearing loss to the December 10, 1998 vaccinations, with an adverse event onset noted as April 1999.
In August 1999, Dr. Woodward expressed curiosity about both children developing hearing loss after DPT vaccination but stated he did not personally believe it was the likely cause.
Genetic testing revealed Finn, his sister Ruby, and their father carried the M34T mutation in the Connexin 26 deafness gene. The consulting geneticist characterized the mutation as a benign polymorphism but noted the family history was consistent with autosomal recessive nonsyndromic hearing loss due to a different gene.
Treating physicians, including Drs. Endres, Ow, Massengill, and Stephan, attributed the hearing loss to heredity rather than the vaccinations.
The Chief Special Master initially found no persuasive evidence of the onset of Finn's hearing loss following the vaccinations, making a proximate temporal relationship difficult to establish. Petitioners' expert, Dr.
Carlo Tornatore, proposed a theory that the vaccine acted as an environmental trigger for hearing loss in a genetically predisposed individual, attempting to back-calculate the onset from Finn's speech delay. The government's expert, Dr.
Mankarious, sharply rejected this calculation, stating that speech delay is not a reliable indicator of the timing of hearing loss onset. The Chief Special Master credited the government's experts, finding Dr.
Tornatore lacked the necessary knowledge and experience, and concluded that the onset of Finn's hearing loss was unknown. The Court of Federal Claims initially heard Finn's and Ruby's cases together but remanded them for separate consideration due to distinct medical facts.
On remand, the Chief Special Master issued separate decisions but made no substantive changes. The court affirmed the denial of Finn's claim, finding that petitioners failed to establish the proximate temporal relationship prong (due to the difficulty of determining onset in a young child with no pre-vaccination hearing tests) and the logical sequence of cause and effect prong (as the medical literature did not document an association between these vaccines and sensorineural hearing loss, and treating physicians attributed the loss to heredity).
Compensation was denied. Petitioner counsel was not named.
Respondent counsel was not named. The Special Master was Gary Golkiewicz.
The court's decision was issued by Judge Horn.
Theory of causation
Petitioners alleged that Finn Hopkins' bilateral sensorineural hearing loss was caused by the HIB, DTP, and OPV vaccines received on December 10, 1998. Petitioners' expert, Dr. Carlo Tornatore, proposed a theory that the vaccines acted as an environmental trigger for hearing loss in a child with a genetic predisposition, specifically citing the M34T mutation in the Connexin 26 gene found in Finn and his father. Dr. Tornatore attempted to link the onset of hearing loss to the vaccination period by back-calculating from Finn's speech delay. Respondent's expert, Dr. Mankarious, strongly refuted this method, stating that speech delay is not a reliable indicator of the timing of hearing loss onset and that the timing of onset for Finn's hearing loss was unknown. The Chief Special Master, Gary Golkiewicz, found Dr. Mankarious's testimony more credible and concluded that Dr. Tornatore lacked the necessary expertise and that the factual basis for his opinion was questionable. The Chief Special Master also noted that treating physicians attributed the hearing loss to heredity. The court affirmed the denial, finding that petitioners failed to establish a proximate temporal relationship due to the unknown onset and the difficulty of testing hearing in young children, and failed to establish a logical sequence of cause and effect, as the medical literature did not support a link between the vaccines and sensorineural hearing loss, and treating physicians pointed to genetic factors. The court found the Chief Special Master's decision was not arbitrary or capricious, despite criticism of his discrediting of Dr. Tornatore, as he acted within his discretion in weighing expert testimony. Compensation was denied.
Source PDFs
USCOURTS-cofc-1_00-vv-00746