Philip Tetlock And Barbara Tetlock Administrators Of The Estate Of J.T., Deceased v. HHS - HPV, amyotrophic lateral sclerosis (ALS); acute disseminated encephalomyelitis (ADEM); FUS ALS Genetic Mutation (2018)
Case summary [AI summaries can sometimes make mistakes]
Philip and Barbara Tetlock, as administrators of the estate of their deceased daughter J.T., filed a petition on January 27, 2010, alleging that her third Human Papillomavirus (HPV) vaccine, administered on March 1, 2007, caused her death on March 15, 2009. J.T. was 13 years old at the time of vaccination.
Petitioners contended that the HPV vaccine triggered acute disseminated encephalomyelitis (ADEM), which in turn caused her to develop amyotrophic lateral sclerosis (ALS), leading to her death from respiratory failure. Respondent argued that J.T.'s ALS and death were caused by an unrelated factor, specifically a FUS P525L genetic mutation.
J.T. began experiencing weakness and pain in her left leg approximately three months after vaccination, following a fall during physical education. Her condition rapidly deteriorated over the next year and a half, leading to respiratory failure and death.
An autopsy revealed severe loss of motor neurons and cytoplasmic inclusions consistent with ALS. Genetic testing identified the FUS P525L mutation, strongly associated with juvenile ALS.
Petitioners' experts, Dr. Lawrence Steinman and Dr.
Paul Utz, argued that the HPV vaccine initiated ADEM through molecular mimicry, which then triggered J.T.'s ALS. They pointed to autopsy findings of inflammation and demyelination as evidence of ADEM.
Respondent's experts, Dr. Gerald Raymond and Dr.
Arun Venkatesan, contended that J.T. suffered solely from ALS, caused by her FUS P525L genetic mutation, and that there was no evidence of ADEM or a vaccine link. They argued that the autopsy findings were consistent with ALS and that J.T.'s clinical presentation and diagnostic tests did not support an ADEM diagnosis.
The Special Master, Chief Special Master Nora Beth Dorsey, found that petitioners failed to prove J.T. had ADEM and that her ALS was caused by the FUS P525L mutation, unrelated to the vaccine. The petition was denied.
Theory of causation
Petitioners alleged that the March 1, 2007, HPV (Gardasil) vaccination administered to 13-year-old J.T. caused her to develop ADEM, which then triggered ALS, leading to her death on March 15, 2009. Petitioners' experts, Dr. Lawrence Steinman and Dr. Paul Utz, proposed that the HPV vaccine triggered ADEM via molecular mimicry, citing homology between HPV proteins and myelin basic protein (MBP) and aquaporin type 4 (AQP4). They further theorized that this ADEM then triggered J.T.'s ALS, which was also influenced by her FUS P525L genetic mutation. Respondent's experts, Dr. Gerald Raymond and Dr. Arun Venkatesan, argued that J.T.'s condition was solely ALS caused by the FUS P525L mutation, a known genetic cause of juvenile ALS. They contended that J.T. did not have ADEM, citing her clinical course, diagnostic tests (EMG, MRI, CSF), lack of response to immunosuppressants, and autopsy findings as inconsistent with ADEM and consistent with ALS. The Special Master found that petitioners failed to prove J.T. had ADEM and that her ALS was caused by the FUS P525L mutation, unrelated to the vaccine. The petition was denied.
Source PDFs
USCOURTS-cofc-1_10-vv-00056