Tonya L. Jarvis v. HHS - Hepatitis B, neurological injury (2011)

Tonya L. Jarvis filed a petition on February 7, 2003, alleging that a hepatitis B vaccination she received on October 2, 2000 (the second of two required doses administered as a condition of employment) caused her to suffer a neurological injury.

Ms. Jarvis experienced a malar rash, facial tingling, and fever within two days of vaccination, and subsequently reported progressive weakness and sensory loss on the left side of her body.

After two evidentiary hearings, Chief Special Master Campbell-Smith denied compensation in a November 8, 2010 decision, finding that petitioner had failed to establish by a preponderance of the evidence that she suffered the neurological injury for which she sought compensation, applying the Broekelschen/Lombardi injury-first framework. The extensive diagnostic workup over approximately 18 months — including CT scans, multiple MRIs, EEGs, a nerve conduction study, and a lumbar puncture — was consistently normal.

Three treating physicians independently noted marked inconsistencies between petitioner's reported complaints and her behavior on examination, consistent with fictitious or functional findings. Dr.

Richard Johnson, whom petitioner's own expert described as "a towering figure in neurology," concluded that "all of the major findings are apparently fictitious," with a differential diagnosis of hysteria versus malingering. Dr.

Brian Schulman, a psychiatrist and neurologist, concluded that petitioner suffered from a factitious disorder — intentional simulation of physical symptoms to obtain treatment — and that her complaints "greatly exceed[ed] any evidence of underlying organic impairment." Petitioner's expert, Dr. Carlo Tornatore, hypothesized an inflammatory brain lesion too small or transient to detect by imaging, but the Special Master discounted this testimony as unsupported ipse dixit; Dr.

Tornatore himself conceded that many of petitioner's findings appeared fictitious and possibly attributable to concurrent psychiatric issues. On June 22, 2011, Judge Block of the Court of Federal Claims affirmed the Chief Special Master's decision and dismissed the petition with prejudice.

The Court found that the Chief Special Master had correctly applied Broekelschen and had not imposed an elevated evidentiary standard; the finding that no neurological injury was established was "all but inescapable in view of the record as a whole." No Althen causation analysis was required.