Melissa Silva v. HHS - Hepatitis B, Guillain-Barré Syndrome (“GBS”) (2014)

Melissa Silva filed a petition on December 16, 2009, alleging that a hepatitis B vaccine administered to her on October 17, 2007 caused her to develop Guillain-Barré syndrome. Ms.

Silva alleged that she experienced onset of pain, bilateral leg weakness, and burning sensations and paresthesias in her legs and hips in December 2007, approximately six to seven weeks after her vaccination. The case was initially assigned to Special Master Lord and transferred to Special Master Millman in September 2012.

Petitioner's expert, Dr. David S.

Younger, opined in July 2011 that Ms. Silva developed GBS six to seven weeks after her third hepatitis B vaccination, basing his opinion on an EMG and nerve conduction study performed by Dr.

Edgar Baucage in January 2008. Respondent's expert, Dr.

Winfried Raabe, filed a report in November 2011 finding that Ms. Silva had not visited a doctor or emergency room in December 2007 when she claimed GBS onset occurred.

Dr. Raabe also found that Dr.

Baucage's EMG and nerve conduction study did not conform to professional standards: the original typed report had been altered twice, a distal motor latency for the common peroneal nerve was within normal range, and the study had nine additional variances from standard practice. Dr.

Raabe concluded that the medical records did not document any neuromuscular symptoms in 2007 or 2008, that no medical provider had diagnosed Ms. Silva with GBS, and that clinical findings consistent with GBS were not documented at any time.

Following Dr. Raabe's report, Dr.

Younger withdrew from the case. Special Master Lord set a hearing, but the hearing was postponed after petitioner's counsel reported that Dr.

Younger was unable to serve as an expert. After petitioner's counsel filed a motion to withdraw on February 1, 2013, citing irreconcilable differences, Ms.

Silva proceeded pro se. She was unable to find a replacement attorney despite consulting five attorneys, all of whom declined to represent her after reviewing her medical records.

Multiple neurologists also declined to provide expert opinions while she was unrepresented by counsel. On June 9, 2014, Ms.

Silva made an oral motion to dismiss. Special Master Millman granted the motion and dismissed the case on June 11, 2014.

Petitioner had not satisfied any of the three Althen prongs: she had not presented through medical records or expert medical opinion a theory explaining how the hepatitis B vaccine could cause GBS; she had not shown a logical sequence of cause and effect, and had not even established that she had GBS; and she had not addressed the temporal relationship. The Vaccine Act does not permit ruling for a petitioner based on claims alone, unsubstantiated by medical records or medical opinion, under 42 U.S.C. § 300aa-13(a)(1).