Tabitha Price v. HHS - DTaP, anaphylactic reaction, seizure disorder, and secondary developmental delay (2019)
Case summary [AI summaries can sometimes make mistakes]
On July 7, 2011, Tabitha Price, as mother and natural guardian of D.P., filed a petition for compensation under the National Vaccine Injury Compensation Program. The petition alleged that D.P., who was approximately 15 months old, received Diphtheria-Tetanus-acellular-Pertussis (DTaP), Measles-Mumps-Rubella (MMR), and Pneumococcal Conjugate (Prevnar) vaccines on August 4, 2008.
Petitioner alleged that within two minutes of vaccination, D.P. suffered a severe anaphylactic reaction manifesting as a grand mal seizure. It was further alleged that D.P. experienced additional seizures several hours later and subsequently developed a seizure disorder and secondary developmental delay.
The respondent initially contested entitlement. Petitioner presented the testimony of neurologist Yuval Shafrir, M.D., and respondent presented the testimony of pediatric neurologist Peter Bingham, M.D.
Special Master Thomas L. Gowen issued a ruling on entitlement on October 29, 2015, finding that D.P. suffered a Table injury of anaphylaxis within four hours of receiving the DTaP and MMR vaccinations, and that D.P. was entitled to compensation.
The Special Master found that D.P. had presented a reasonable theory of causation and a logical cause-and-effect explanation relating the vaccinations to D.P.'s anaphylaxis and seizures, noting the significant timing of the event. The Special Master rejected the respondent's contention that the seizures were coincidental or due to an unrelated gastrointestinal illness.
Following the entitlement ruling, the parties stipulated to an award of damages. On January 2, 2019, Special Master Gowen issued a decision on the proffer, awarding D.P. compensation.
The award included a lump sum payment of $1,250,898.64 for lost earnings ($889,283.44), pain and suffering ($250,000.00), and first-year life care expenses ($111,615.20). Additionally, a lump sum payment of $17,342.98 was awarded to satisfy a State of Georgia WellCare Medicaid lien.
The award also included an amount sufficient to purchase an annuity contract for future life care expenses, with medical items growing at 5% annually and non-medical items at 4% annually. The total award, including the lump sums and the value of the annuity, exceeded $1.2 million.
Petitioner's counsel was Clifford Shoemaker of Shoemaker and Associates, and respondent's counsel was Robert Paul Coleman, III, of the United States Department of Justice.
Theory of causation
Petitioner Tabitha Price, on behalf of her minor son D.P., alleged that DTaP, MMR, and Prevnar vaccines administered on August 4, 2008, caused D.P. to suffer an anaphylactic reaction manifesting as a seizure within two minutes of vaccination, followed by subsequent seizures and a seizure disorder and developmental delay. Petitioner's expert, Yuval Shafrir, M.D., opined that D.P. suffered a cerebral anaphylaxis due to IgE antibodies to gelatin (present in DTaP and MMR vaccines) and the pertussis antigen (in DTaP), which had been developed from prior vaccinations. This sensitization led to mast cell degranulation in the brain upon re-exposure, causing a rapid anaphylactic reaction and seizures. Dr. Shafrir supported this theory with medical literature on anaphylaxis and analogies to reactions from bee and wasp stings affecting the central nervous system. Respondent's expert, Peter Bingham, M.D., argued that seizures are uncommon manifestations of anaphylaxis and suggested D.P. had idiopathic epilepsy that coincidentally began around the time of vaccination, possibly precipitated by a viral gastroenteritis, though evidence for the latter was lacking. Special Master Thomas L. Gowen found by preponderant evidence that D.P. suffered a Table injury of anaphylaxis within four hours of vaccination, supported by Dr. Shafrir's theory and the timing of the event, and that this injury caused ongoing seizures and developmental delay. The Special Master concluded that the anaphylactic reaction, particularly given the two-minute onset, was the most likely cause, rejecting alternative explanations of coincidence or unknown illness. The parties later stipulated to an award of $1,250,898.64 in lump sums for lost earnings, pain and suffering, and first-year life care expenses, plus $17,342.98 for a Medicaid lien, and an annuity for future life care expenses, totaling over $1.2 million.