Madison Turkupolis v. HHS - HPV, neurocardiogenic syncope; basilar migraine (2014)
Case summary [AI summaries can sometimes make mistakes]
On June 7, 2010, Jill Turkupolis filed a petition on behalf of her minor daughter, Madison Turkupolis, alleging that the second administration of the human papillomavirus vaccine (Gardasil) on September 10, 2007, caused neurological injuries, specifically neurocardiogenic syncope and basilar migraine. Madison Turkupolis later reached the age of majority and became the petitioner.
The case involved extensive medical testimony from Dr. Svetlana Blitshteyn for the petitioner and Dr.
John MacDonald for the respondent, both neurologists. Dr.
Blitshteyn testified that Gardasil caused Madison's autonomic disorder, manifesting as neurocardiogenic syncope and basilar migraines, likely through an immune-mediated mechanism or molecular mimicry, noting that neurocardiogenic syncope is related to POTS, which can have an autoimmune basis. Dr.
MacDonald contended that Madison's symptoms were primarily explained by a pre-existing tendency towards migraine, which he believed could cause autonomic nervous system changes and syncope, and that the temporal association between the vaccine and symptom onset was coincidental, with no objective evidence of an immune-mediated reaction. The Special Master reviewed extensive medical records detailing Madison's history of dizziness, lightheadedness, loss of consciousness, and headaches, with various diagnoses including peri-exertional syncope, vasovagal syncope, conversion disorder, and migraine variants.
The court found that the petitioner failed to establish a medical theory causally connecting the vaccine to her condition, as the evidence did not sufficiently support neurocardiogenic syncope being an autoimmune disease triggered by the vaccine. The court also found the temporal relationship, particularly the long interval between vaccination and symptom onset, and the subsequent symptom-free period, did not support causation.
Ultimately, the Special Master determined that the petitioner had not met her burden of proof under the Althen standard and dismissed the petition. The decision was issued by Special Master Laura D.
Millman on May 30, 2014.
Theory of causation
Petitioner alleged that the HPV vaccine (Gardasil) administered on September 10, 2007, caused neurocardiogenic syncope and basilar migraine. Petitioner's expert, Dr. Svetlana Blitshteyn, proposed that Gardasil caused an autonomic disorder, likely through an immune-mediated mechanism or molecular mimicry, positing that neurocardiogenic syncope is related to POTS, which can have an autoimmune basis. Respondent's expert, Dr. John MacDonald, argued that Madison's symptoms were primarily explained by a pre-existing migraine tendency, which could cause autonomic changes, and that the vaccine-temporal link was coincidental. The Special Master found that petitioner failed to establish a medical theory causally connecting the vaccine to the alleged injuries, noting that the evidence did not sufficiently support neurocardiogenic syncope as an autoimmune disease triggered by the vaccine. The court also found the temporal relationship and subsequent symptom-free period did not support causation. The petition was dismissed as petitioner failed to meet the burden of proof under the Althen standard. Attorneys involved were Ronald C. Homer for the petitioner and Voris E. Johnson for the respondent. Special Master Laura D. Millman issued the decision on May 30, 2014.
Source PDFs
USCOURTS-cofc-1_10-vv-00351