{"package_id":"USCOURTS-cofc-1_08-vv-00696","decision_granule_id":"USCOURTS-cofc-1_08-vv-00696-1","petitioner_identifier":"Eileen Callahan","is_minor":0,"age_at_vaccination":45.166666666666664,"age_unit_raw":"years","vaccine_type":"MMR","vaccination_date":"2007-10-02","condition_raw":"multiple sclerosis (MS)","condition_category":"transverse_myelitis","autism_spectrum_adjacent":0,"outcome":"dismissed","award_amount_usd":null,"decision_date":"2014-09-25","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:28:58.782229+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":0,"theory_of_causation":"MMR Oct 2, 2007 → claimed encephalomyelitis or exacerbation of underlying MS; onset claimed 40 minutes post-vaccination (left thigh numbness). Dr. Shaffer (petitioner): post-vaccination encephalomyelitis — no theory given, no 40-minute onset explanation. Dr. Shields (petitioner): 'underlying demyelinating process, strongly suggestive of MS' + MMR exacerbation — no theory; contradicted by his own normal exam; refused to testify. Dr. Bielawski (respondent): no autoimmune mechanism possible in 40 minutes to remote site; thigh numbness = lateral femoral cutaneous neuropathy (compression in obese patients); brain MRI nonspecific (migraine-consistent); McDonald criteria not met; prior cholera/typhoid vaccination = different antigen memory, no generalized cross-reactivity inference. SM Millman Sept 4, 2014: DISMISSED — all 3 Althen prongs failed; 40-minute onset not medically appropriate (De Bazan: 11-hour ADEM onset too short). DB decision_date '2014-09-04' = SM header date (wrong); corrected to 2014-09-25 (granule date_issued).","is_death":0,"date_of_death":null,"petition_filed_date":"2008-09-30","case_summary":"Eileen Callahan was born on August 1, 1962. She received an MMR vaccination in her left upper arm on October 2, 2007. According to her account, approximately forty minutes after the vaccination, she experienced numbness in her left anterior thigh, and subsequently developed additional neurological symptoms including numbness in her left face, left arm, and leg, as well as fatigue and difficulty with concentration. She had a significant medical background: she had gained approximately eighty-five pounds over the preceding three years, at the time weighed two hundred pounds at five feet three inches, had experienced fatigue since contracting mononucleosis at age seventeen, and had a history of menstrual-associated migraine. She also reported that approximately twenty years earlier, at around age twenty-two, she had experienced diminished sensation on the left side of her face after receiving vaccines for cholera, typhoid, and possibly yellow fever. Her thyroid condition had been previously diagnosed.\n\nMs. Callahan was evaluated by numerous physicians. On October 2, 2007, a physician noted that the etiology of her symptoms was uncertain but doubted they were related to the recent MMR vaccination. On October 11, 2007, neurologist Dr. Rong Chen found no substantial neurological deficit on physical examination — no signs of myelopathy or neuropathy — but noted what he characterized as \"give way\" weakness, indicating voluntary effort to feign weakness. On November 3, 2007, a brain MRI showed scattered focal areas of abnormal signal intensity; these findings were nonspecific and could represent end artery infarcts, post-vaccination encephalomyelitis, Lyme disease, Epstein-Barr virus, sarcoidosis, vasculopathy, or migraine. On March 3, 2008, an MRI of the cervical spine showed no multiple sclerosis or demyelinating disease and only minimal bulging discs. Neurologist Dr. Anthony Reder at the University of Chicago, who evaluated Ms. Callahan in January 2008, found a relatively normal physical examination, and noted cognitive problems and fatigue.\n\nMs. Callahan filed her petition on approximately September 30, 2008. Her first attorney stated at the initial status conference in December 2008 that she had no diagnosis and was looking for an expert. After her first attorney withdrew in late 2009, Ms. Callahan proceeded pro se for over three years before obtaining counsel Richard Moeller in March 2013. Petitioner submitted the report of Dr. William Shaffer, a treating neurologist at the University of Chicago, who stated that Ms. Callahan had post-vaccination encephalomyelitis following the MMR vaccine, but offered no medical theory explaining the connection and did not address whether a forty-minute onset interval was appropriate for causation. Petitioner also submitted the report of Dr. Lawrence Shields, who physically examined Ms. Callahan and found that her strength was adequate throughout, her muscle appearance was normal, she had no focal atrophy or wasting, her tone was normal, her deep tendon reflexes were obtainable, she had no Babinski sign, and her sensation was intact throughout. Notwithstanding these entirely normal findings, Dr. Shields diagnosed Ms. Callahan with an \"underlying demyelinating process, strongly suggestive of multiple sclerosis,\" and opined that the MMR vaccination had caused an exacerbation of her underlying condition. He offered no medical theory as a basis for this opinion and did not explain how a forty-minute onset interval was appropriate. Dr. Shields subsequently refused to testify for Ms. Callahan.\n\nRespondent's expert, Dr. Martin Bielawski of Johns Hopkins, concluded that there was no objective clinical or diagnostic evidence to support a diagnosis of multiple sclerosis or post-vaccination encephalomyelitis. He testified that he was \"unaware of any autoimmune mechanism that can produce central or peripheral neurological injury or inflammation/demyelination to an area remote from the injection site in 40 minutes.\" He explained that left anterior thigh numbness is a focal peripheral symptom that cannot arise from demyelination in the brain or spinal cord; the most plausible explanation was compression of the left lateral femoral cutaneous nerve, a peripheral nerve commonly compressed in overweight patients. He further stated that Ms. Callahan's brain MRI findings were nonspecific and did not fulfill the 2010 revised McDonald criteria for multiple sclerosis; they were consistent with her history of migraine. Her cervical MRI showed no spinal cord abnormality. He noted that a prior vaccination with cholera and typhoid would create immunological memory for cholera and typhoid antigens, not for MMR antigens, and that no inference of universal cross-reactivity could be drawn from her prior vaccine reaction.\n\nSpecial Master Millman issued her decision on September 4, 2014, dismissing the petition. The special master held that Ms. Callahan had failed to satisfy all three prongs of the Althen test. On prong one, she found that Dr. Shaffer's report was skeletal and conclusory, offering no medical theory connecting the vaccination to neurological injury and not addressing the forty-minute onset interval. Dr. Shields' report was self-contradictory: he found no objective neurological problem on his own examination but nevertheless diagnosed multiple sclerosis based on Ms. Callahan's self-reported symptoms and her manifesting awkward gait before him; he gave no theory and did not explain how a forty-minute onset could cause demyelinating disease. On prong two, the expert opinions submitted were insufficient to establish a logical sequence of cause and effect. On prong three, forty minutes was not a medically appropriate interval; the Federal Circuit held in De Bazan v. Secretary of Health and Human Services that even an eleven-hour onset for acute disseminated encephalomyelitis following tetanus vaccination was too short to support causation. The special master further noted that even if significant aggravation had been properly alleged, the medical records did not establish any difference in neurological condition before and after the MMR vaccination, and Ms. Callahan had never been shown to have multiple sclerosis or encephalomyelitis. Having had more than six years and the assistance of two competent attorneys to build her case, Ms. Callahan had a full and fair opportunity to present her claim.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Laura D. Millman","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Richard H. Moeller","petitioner_attorney_firm":"Moore, Corbett, Heffernan, Moeller & Meis LLP","petitioner_attorney_location":"Sioux City, IA","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|richard-moeller|","firm_canonical_key":"moore-corbett-heffernan-moeller-and-meis","package_title":"CALLAHAN v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_08-vv-00696","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_08-vv-00696.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_08-vv-00696.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_08-vv-00696-0","title":"CALLAHAN v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 09/04/2014) regarding 69 DECISION of Special Master Signed by Special Master Laura D Millman. 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(tlj) Copy to parties.","date_issued":"2014-12-01","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_08-vv-00696/granules/USCOURTS-cofc-1_08-vv-00696-1/pdf","pdf_bytes":241253,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'stipulation'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_08-vv-00696/USCOURTS-cofc-1_08-vv-00696-1"}]}