Jody L. Nordwall v. HHS - DTaP, death from positional asphyxia (2008)

On January 18, 2005, Jody L. Nordwall, on behalf of her deceased son Mateo "Mat" Tori, filed a petition for compensation under the National Vaccine Injury Compensation Program.

Mat, born November 7, 2002, was a healthy infant except for acid reflux for which he was prescribed Zantac. On January 17, 2003, at approximately 2 p.m., Mat received his first dose of the DTaP vaccine during a well-child visit.

That evening, his father, Dr. José Tori, put Mat to sleep swaddled in a blanket and propped between three pillows to manage his acid reflux.

Dr. Tori testified he checked on Mat around 4:00 a.m. on January 18, 2003, after being awakened by his daughter.

Ms. Nordwall returned home from work around 8:30 a.m. on January 18, 2003, and found Mat blue and not breathing.

CPR was administered, and Mat was transported to the hospital, where he was pronounced dead at 10:07 a.m. that morning, approximately 18 hours after his vaccination. The Medical Examiner's autopsy concluded Mat died from positional asphyxia.

The petitioners alleged that the DTaP vaccine caused Mat's death. The case involved conflicting expert testimony.

Petitioner's expert, Dr. John Shane, a neuropathologist, opined that Mat's brain tissue slides showed extensive vasogenic edema characteristic of vaccine-related encephalopathy, with "halos" around blood vessels indicating fluid leakage.

He attributed Mat's death to vaccine-induced encephalopathy, emphasizing the temporal relationship to the vaccine. Respondent's expert, Dr.

Lucy Rorke-Adams, a pediatric neuropathologist, opined that the slides showed no encephalopathy, that the dilated spaces around blood vessels were shrinkage artifact, not edema, and that there was no spongiform change indicating cytotoxic edema. She concluded the Medical Examiner's finding of positional asphyxia was correct, noting congestion and hemorrhages in the heart, lungs, and spleen consistent with asphyxial death.

Special Master Christian J. Moran, in a decision dated February 19, 2008, credited Dr.

Rorke-Adams's testimony over Dr. Shane's, finding that the petitioner failed to prove either a table injury or causation in fact.

The Special Master determined that Mat had not suffered an acute encephalopathy as defined by regulation and that the evidence did not establish a logical sequence of cause and effect linking the vaccination to the injury. He relied on the Medical Examiner's report and Dr.

Rorke-Adams's expert opinion that Mat died from positional asphyxia. The Special Master found Dr.

Rorke-Adams more persuasive due to her superior credentials and confident, well-organized demeanor, and also found her interpretation of the evidence, including the brain weight and the state of the anterior fontanelle, more credible. The Court of Federal Claims, Judge Wolski, reviewed the Special Master's decision.

In an opinion dated July 24, 2008, the Court sustained the denial of compensation. The Court noted that while there were aspects of Dr.

Rorke-Adams's testimony that could be considered undermining her credibility, such as a mathematical error regarding Mat's brain weight, it was not the court's role to second-guess the Special Master's credibility determinations or reweigh the evidence. The Court found that the Special Master had considered all relevant evidence and articulated a rational basis for his decision.

The petition was dismissed with prejudice.