Forrest Q. Spahn v. HHS - tetanus-diphtheria, significant aggravation of obsessive-compulsive disorder ("OCD"); tics (2017)
Case summary [AI summaries can sometimes make mistakes]
On June 12, 2009, Lori Hessler, mother of Forrest Q. Spahn, filed a petition on behalf of her son, who was born in 1991.
The petition alleged that a tetanus-diphtheria (Td) vaccination received by Mr. Spahn on June 19, 2007, at age 15, caused a significant aggravation of his pre-existing obsessive-compulsive disorder (OCD) and led to the development of tics.
The respondent was the Secretary of Health and Human Services. Mr.
Spahn's experts, Dr. Burk Jubelt (neurologist) and Dr.
H. Vasken Aposhian (toxicologist), opined that thimerosal in the Td vaccine could cause tics.
They relied on studies involving infants and cell cultures, which the Secretary's experts, Dr. Michael Kohrman (pediatric neurologist) and Dr.
Jeffrey Johnson (toxicologist), argued were not applicable to Mr. Spahn's case due to significant differences in age, dosage, and health status.
The court noted that Mr. Spahn's experts failed to adequately address the dose-response relationship and the differences between the cited studies and Mr.
Spahn's specific circumstances. The court also found Mr.
Spahn's arguments regarding birth anoxia and a CPOX4 genetic mutation to be unsupported by reliable evidence. The Secretary filed a motion for summary judgment, which was granted by Special Master Christian J.
Moran on September 11, 2014. The case was dismissed, and no compensation was awarded for the alleged injury.
A subsequent decision on July 31, 2017, reissued the Special Master's decision, making it publicly available after redactions were addressed. Later, on December 13, 2017, the Special Master awarded petitioner attorneys' fees and costs in the amount of $162,044.12.
The Secretary sought review of this award, arguing the Special Master failed to independently determine the reasonableness of the fees. Judge Lydia Kay Griggsby, in a decision filed July 9, 2018, found that while the Special Master erred by not independently assessing the reasonableness of the fees, this error was harmless as the requested amount was deemed reasonable by the court.
The court sustained the Special Master's award of $162,044.12 in attorneys' fees and costs.
Theory of causation
Petitioner Forrest Q. Spahn, vaccinated with tetanus-diphtheria (Td) vaccine on June 19, 2007, at age 15, alleged the vaccine caused a significant aggravation of his pre-existing obsessive-compulsive disorder (OCD) and led to the development of tics. Petitioner's experts, Dr. Jubelt and Dr. Aposhian, opined that thimerosal in the Td vaccine could cause tics, citing studies such as Verstraeten and Andrews, which examined infants receiving multiple vaccine doses. The Secretary's experts, Dr. Kohrman and Dr. Johnson, argued these studies were inapplicable due to significant differences in age (adolescent vs. infant), dosage (single 25 µg dose vs. multiple higher doses), and health status (pre-existing OCD vs. healthy infants). The court found that the cited studies did not provide a reliable basis for extrapolating to Mr. Spahn's case, particularly regarding the dose-response relationship. Petitioner's alternative theory involving a CPOX4 genetic mutation, supported by Dr. Aposhian and citing the Woods study, was also rejected due to a lack of evidence that Mr. Spahn possessed the mutation and the study's focus on chronic mercury vapor exposure, not a single vaccine dose. The court granted summary judgment for the respondent, finding no genuine dispute of material fact and that petitioner failed to establish the reliability of his experts' opinions. The case was dismissed on entitlement. Subsequently, attorneys' fees and costs totaling $162,044.12 were awarded, with the court finding the amount reasonable despite the initial denial of entitlement.