{"package_id":"USCOURTS-cofc-1_08-vv-00185","decision_granule_id":"USCOURTS-cofc-1_08-vv-00185-0","petitioner_identifier":"James Holmes","is_minor":1,"age_at_vaccination":14.0,"age_unit_raw":"years","vaccine_type":"Td","vaccination_date":"2005-08-17","condition_raw":"seizure disorder","condition_category":"seizure_disorder","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2014-04-24","extraction_version":"gemini-v2","extracted_at":"2026-04-30T04:35:39.580347+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":1,"theory_of_causation":"Petitioner alleged that a Td vaccination on August 17, 2005, caused a seizure disorder. Petitioner's expert, Dr. Marcel Kinsbourne, theorized that the Td vaccination triggered complex febrile seizures, leading to epilepsy and cognitive impairments, mediated by proinflammatory cytokines released due to local inflammation at the injection site. He argued that petitioner experienced a low-grade fever and that the seizures, though brief, were complex and febrile, fitting the criteria for increased risk of epilepsy. Respondent's expert, Dr. Shlomo Shinnar, countered that petitioner did not have febrile seizures due to his age (14), lack of significant fever (recorded temperatures were 97.6°F, 100°F oral, 99.9°F rectal), and the short duration of the seizures, which he stated do not typically cause epilepsy. Dr. Shinnar emphasized that febrile seizures are predominantly childhood illnesses, rarely occurring in adolescents. The Special Master denied compensation, finding petitioner failed to establish causation. The Special Master found Dr. Kinsbourne's opinion lacked factual support, particularly regarding the presence of fever, and that Dr. Shinnar's testimony was more credible. The court affirmed, finding no error in the Special Master's determination that petitioner did not establish a medically plausible and logically sequenced causal link between the vaccination and his seizure disorder, considering his age and the lack of evidence of a febrile illness. The case was litigated as an \"off-table\" claim. Petitioner's counsel was Richard Gage, and respondent's counsel included Ryan D. Pyles. Special Master was Denise K. Vowell. Court decision date: April 24, 2014.","is_death":0,"date_of_death":null,"petition_filed_date":"2008-03-18","case_summary":"On March 18, 2008, James Holmes, born May 16, 1991, filed a petition for vaccine compensation on his behalf, alleging that a tetanus and diphtheria (Td) vaccination administered on August 17, 2005, caused him to develop a seizure disorder. The petition was filed by his mother, Christina Loudermilk, while he was still a minor. The respondent is the Secretary of Health and Human Services. Petitioner alleged that the Td vaccination triggered complex febrile seizures, leading to epilepsy and cognitive impairments, mediated by cytokines. Petitioner's expert, Dr. Marcel Kinsbourne, a neurologist specializing in developmental neurological disorders, opined that the vaccination caused inflammation and cytokine release, leading to fever and seizures. He cited medical records indicating petitioner's temperature was \"warm\" and that he had a \"small inflammatory reaction\" at the vaccination site. Dr. Kinsbourne also interpreted certain observations as indicative of focal seizures originating in the left hemisphere of the brain. He relied on the Annegers study, which found an increased risk of epilepsy after complex febrile seizures. Petitioner's treating physicians, including Drs. Stocker, Llobet, Schultz, and Yang, noted the temporal proximity of the seizures to the vaccination, with some suggesting a vaccine reaction. Dr. Llobet noted \"seizure – s/p Td\" and that seizures were a listed adverse reaction. Dr. Schultz's impression was \"Seizure by history, most likely secondary to tetanus toxoid immunization.\" Dr. Yang suggested a reaction to vaccine components, possibly horse serum, though this was later found to be incorrect. A neurologist, Dr. Philip Miner, who treated petitioner, diagnosed him with epilepsy and noted the seizures were of \"unclear etiology.\" A neuropsychological evaluation by Dr. Lisa Mottram indicated cognitive deficits, suggested to be a result of the seizure disorder. Respondent's expert, Dr. Shlomo Shinnar, a pediatric neurologist and epilepsy specialist, disagreed with Dr. Kinsbourne's causation theory. Dr. Shinnar testified that petitioner did not have febrile seizures because he was fourteen years old at the time, the minimum threshold for fever in relevant studies was typically 101 degrees Fahrenheit, and petitioner's recorded temperatures were 97.6 degrees after the first seizure and 100 degrees orally/99.9 degrees rectally after the second. He stated that febrile seizures are rare in adolescents and that seizures must be prolonged (over thirty minutes) to cause brain injury and epilepsy. Dr. Shinnar also suggested that petitioner's cognitive impairments were likely due to medication. Special Master Denise K. Vowell denied compensation, finding that petitioner failed to establish causation. The Special Master found Dr. Kinsbourne's opinion less persuasive than Dr. Shinnar's, noting errors in Dr. Kinsbourne's interpretation of medical records, particularly regarding petitioner's temperature and the presence of fever. She found no reliable evidence of fever during the first seizure and only a slight elevation after the second, which was below the threshold for febrile seizures. The Special Master also found that febrile seizures are primarily childhood illnesses, rarely occurring in adolescents. She further noted that the seizures were too short to cause epilepsy and that the treating physicians' opinions were not sufficiently substantiated or were based on incorrect assumptions. The Court of Federal Claims, in an opinion by Judge Victor J. Wolski, affirmed the Special Master's decision. The court found no error in the Special Master's evaluation of causation, her assessment of expert credibility, or her weighing of the treating physicians' opinions. The court sustained the Special Master's denial of compensation, concluding that petitioner failed to establish a logical and medically supported causal connection between the Td vaccination and his seizure disorder. Petitioner's counsel was Richard Gage. Respondent's counsel included Ryan D. Pyles, Tony West, Mark W. Rogers, Vincent J. Matanoski, and Catharine E. Reeves. The Special Master was Denise K. Vowell. The court decision was issued under seal on April 8, 2014, and reissued for publication on April 24, 2014.","is_minor_inferred":1,"is_pediatric_broad":1,"special_master":"Denise K. Vowell","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Richard Gage; Donald Gerstein","petitioner_attorney_firm":null,"petitioner_attorney_location":"Cheyenne, WY","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|richard-gage|donald-gerstein|","firm_canonical_key":null,"package_title":"HOLMES v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_08-vv-00185","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_08-vv-00185.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_08-vv-00185.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_08-vv-00185-cl-extra-858894","title":"James Holmes v. Secretary of Health and Human Services","docket_text":"Supplementary opinion from CourtListener cluster 858894","date_issued":"2013-04-02","pdf_url":null,"pdf_bytes":null,"triage_decision":"keep","triage_reason":"CL supplement: James Holmes v. Secretary of Health and Human Services","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_08-vv-00185/USCOURTS-cofc-1_08-vv-00185-cl-extra-858894"},{"granule_id":"USCOURTS-cofc-1_08-vv-00185-0","title":"HOLMES v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"JUDGE VACCINE REPORTED OPINION and ORDER re: 84 Opinion and Order on Motion for Review, Signed by Judge Victor J. Wolski. (jd) Copy to parties.","date_issued":"2014-04-24","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_08-vv-00185/granules/USCOURTS-cofc-1_08-vv-00185-0/pdf","pdf_bytes":265178,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_08-vv-00185/USCOURTS-cofc-1_08-vv-00185-0"}]}