BTB v. HHS - autism spectrum disorder (ASD) (2015)

Timothy and Deborah Bokmuller, as parents of their minor son BTB, filed a petition for vaccine compensation on August 13, 2008. They alleged that BTB's vaccinations caused him to suffer from acute disseminated encephalomyelitis (ADEM) or another underlying condition, making him susceptible to adverse vaccine reactions, and potentially autism spectrum disorder (ASD).

BTB was born on October 18, 2004. The petition was initially assigned to Special Master Gary Golkiewicz and later reassigned to Special Master George L.

Hastings. Petitioners secured representation by John McHugh on October 12, 2010.

An amended petition filed on May 4, 2011, specified that vaccinations, including MMR, Hib, and influenza on October 25, 2005, and DTP, pneumococcal, and varicella on January 27, 2006, possibly caused ADEM or "vaccine intolerance." A letter from Michael Waickman, M.D., accompanied the amended petition, suggesting BTB might suffer from ADEM and "vaccine intolerance," but did not assert a vaccine-caused injury. Petitioners experienced significant delays in filing an expert report, with multiple extensions granted between July 2012 and May 2015.

They were ordered to show cause why their petition should not be dismissed on three occasions due to failure to provide the necessary expert report. On May 1, 2015, Petitioners filed a Motion for a Decision on the Record, acknowledging their inability to find a medical expert to opine on the vaccine connection or the extent to which any vaccine damage was not already present due to an underlying condition.

The medical records indicate BTB received various vaccinations throughout his childhood, starting with the hepatitis B vaccine on November 2, 2004. He was diagnosed with colic, upper respiratory infections, viral enteritis, croup, pharyngitis, and ear infections on multiple occasions.

Concerns about hand flapping, lack of eye contact, and poor interaction at day-care led to a referral. On April 26, 2006, Dr.

Diana Wasserman diagnosed BTB with developmental delay, and on May 3, 2006, with "pervasive developmental disorder not otherwise specified" (PDD-NOS), a form of ASD. Later, on September 20, 2006, Dr.

Roizen reportedly felt BTB had autism, with which his parents concurred, although primary care records retained the PDD-NOS diagnosis. BTB also experienced gastrointestinal issues, including vomiting, diarrhea, gastric ulcers, and was diagnosed with hypogammaglobulinemia and IgA deficiency.

The Special Master noted that the medical records did not support the claim of a vaccine-caused injury or aggravation of a pre-existing condition. As Petitioners were unable to find a medical expert to opine that BTB suffered a vaccine-caused injury or that his ASD was affected by a vaccine, and no other evidence supported causation, the claim was denied.

The decision was issued by Special Master George L. Hastings on July 22, 2015.