{"package_id":"USCOURTS-cofc-1_11-vv-00685","decision_granule_id":"USCOURTS-cofc-1_11-vv-00685-11","petitioner_identifier":"Trystan Sanchez","is_minor":1,"age_at_vaccination":5.7,"age_unit_raw":"months","vaccine_type":"DTaP; Hib; IPV; pneumococcal conjugate","vaccination_date":"2009-02-05","condition_raw":"Leigh syndrome / SDHA-related mitochondrial disease with neurodegeneration","condition_category":"mitochondrial","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2025-10-01","extraction_version":"manual-supplement-redo-2026-05-normal43","extracted_at":"2026-05-05 00:26:54","number_of_concurrent_vaccines":4,"dose_number":null,"time_to_onset_days":10,"theory_of_causation":"Six-month DTaP-containing vaccine set on February 5, 2009, age about 5.7 months, alleged to cause or significantly aggravate SDHA-related Leigh syndrome/mitochondrial neurodegeneration. NO COMPENSATION AWARD TO DATE; case has an unusually long procedural history after denial, motion practice, Federal Circuit reversal/remand, mandamus/protective-order proceedings, and 2025 findings. Petitioners Germain and Jennifer Sanchez relied on Dr. Lawrence Steinman and Dr. Dmitriy Niyazov, arguing vaccination triggered metabolic stress/decompensation, seizures, dystonia, and neurodegeneration. Respondent's experts, including Dr. Gerald Raymond, attributed Trystan's course to the genetic mitochondrial disorder and disputed vaccine causation and timing. Special Master Moran's 2025 findings addressed disputed post-vaccination facts on remand; no injury-compensation damages decision appears in the staged public text.","is_death":0,"date_of_death":null,"petition_filed_date":"2011-10-17","case_summary":"Trystan Sanchez, an infant, through his parents Germain and Jennifer Sanchez, filed a petition for compensation under the National Childhood Vaccine Injury Act of 1986 on October 17, 2011. The petition alleged that Trystan's six-month vaccinations on February 5, 2009, including the DTaP vaccine, caused or significantly aggravated his Leigh's syndrome, a severe neurological disorder diagnosed in late 2014. The Sanchezes argued that the vaccinations either caused the genetic condition to be expressed or worsened its course. The respondent, the Secretary of Health and Human Services, contested entitlement.\n\nSpecial Master Christian J. Moran initially denied compensation in a decision dated October 9, 2018. The Special Master found that while the Sanchezes presented a plausible medical theory that vaccines could cause the manifestation of Leigh's syndrome, the evidence did not demonstrate that this occurred in Trystan's case. The Special Master credited contemporaneous medical records over the family's testimony regarding the timeline of Trystan's decline, finding that Trystan's loss of skills began no earlier than May 2009, approximately three months after the vaccinations, which was too long a period to establish vaccine causation. The court of Federal Claims sustained this decision.\n\nHowever, the Federal Circuit vacated this decision and remanded the case, finding that the Special Master had not fully considered the petitioners' challenge-rechallenge theory and had made contradictory findings regarding Trystan's arm contortions, which were central to the causation analysis. The Federal Circuit directed the Special Master to clarify the timeline and causation issues.\n\nOn remand, the Special Master issued a second entitlement decision on August 26, 2020, again denying compensation. He found that while the first Althen factor (plausible medical theory) was met, the second (logical sequence of cause and effect) and third (proximate temporal relationship) factors were not. The Special Master concluded that Trystan's symptoms, including arm contortions on February 16, 2009, were consistent with a common cold and not indicative of a neurological injury, and that the onset of Trystan's neurological problems occurred too late to be linked to the vaccinations. The court of Federal Claims again sustained the Special Master's decision.\n\nPetitioners appealed again, and the Federal Circuit reversed the court of Federal Claims' decision, remanding the case to the Special Master for further consideration of entitlement, specifically regarding the timing of Trystan's arm contortions and the challenge-rechallenge theory. The Federal Circuit also noted that the Special Master might need to address whether Trystan's genetic mutations would have led to the same outcome regardless of the vaccinations.\n\nFollowing the second remand, the Special Master issued a third decision on August 26, 2020, again denying entitlement. The Special Master found that petitioners had not met their burden for the second and third Althen factors, concluding that the sequence of events was not logical and the temporal relationship was not proximate. The court of Federal Claims sustained this decision.\n\nSubsequently, the Federal Circuit reversed the court of Federal Claims' decision, remanding the case to the Special Master for further proceedings, specifically noting that the Special Master's findings regarding Trystan's arm contortions were contradictory and that the challenge-rechallenge theory had not been fully addressed. The Federal Circuit also suggested the Special Master might need to consider the role of Trystan's genetic mutations. The Special Master issued a decision on August 26, 2020, again denying compensation.\n\nPetitioners sought review of this decision, and the court of Federal Claims sustained the Special Master's denial. However, the Federal Circuit reversed this decision, remanding the case for further consideration of the causation issue, particularly concerning Trystan's arm contortions and the challenge-rechallenge theory. The Special Master issued a subsequent decision on August 26, 2020, again denying entitlement.\n\nIn a later opinion on March 22, 2021, the court of Federal Claims sustained the Special Master's August 26, 2020 decision, denying petitioners' motion for review. However, this decision was later reversed by the Federal Circuit on August 11, 2022. The case was remanded again. Most recently, on April 16, 2024, Chief Judge Elaine D. Kaplan denied Petitioners' Petition for a Writ of Mandamus, which sought to have the Court decide the Secretary's motion to reopen entitlement, but ordered the Special Master to unstrike Petitioners' motion to reopen and reinstate it on the docket, while denying the motion itself. Petitioners' subsequent motion for a protective order regarding Ms. Sanchez's testimony was denied on February 18, 2025, by Chief Judge Kaplan, who found no basis for the court to intervene in interlocutory matters before the Special Master.\n\nTo date, no compensation award has been made in this case.\n\nThe later supplemental materials do not add a damages award. They show continued remand proceedings, including 2025 findings of fact and conclusions of law after years of review, mandamus, and protective-order litigation. The staged public record still does not show an injury-compensation award.","is_minor_inferred":0,"is_pediatric_broad":1,"special_master":"Christian J. Moran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Lisa A. Roquemore; whom was Richard Gage","petitioner_attorney_firm":"Law Offices of Lisa A. Roquemore; Richard Gage, PC","petitioner_attorney_location":"Rancho Santa Margarita, CA; Cheyenne, WY","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|lisa-roquemore|whom-gage|","firm_canonical_key":"law-offices-of-lisa-a-roquemore","package_title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_11-vv-00685","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_11-vv-00685.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_11-vv-00685.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_11-vv-00685-0","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 02/17/2016) regarding 135 DECISION of Special Master - Interim Attorney's Fees. Signed by Special Master Christian J. Moran. (SP) Copy to parties.","date_issued":"2016-03-09","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-1","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/9/18) regarding 205 DECISION of Special Master. Signed by Special Master Christian J. Moran. (MRG) Service on parties made.","date_issued":"2018-11-09","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-1/pdf","pdf_bytes":521406,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'decision of special master'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-1"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-2","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"JUDGE VACCINE REPORTED OPINION re: 217 Order on Motion for Review, Judge Vaccine Order/Opinion. Signed by Judge Patricia E. Campbell-Smith. (TQ) Service on parties made.","date_issued":"2019-03-06","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-2/pdf","pdf_bytes":227051,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-2"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-3","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 08/26/2020) regarding 253 DECISION on Remand. Signed by Special Master Christian J. Moran. (hh) Service on parties made.","date_issued":"2020-09-22","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"no decision/ruling/opinion signal in docketText","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-4","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"**REVERSED PURSUANT TO 284 C.A.F.C. MANDATE, DATED AUGUST 11, 2022. ** JUDGE VACCINE REPORTED OPINION initially filed February 12, 2021, 273 JUDGE VACCINE OPINION denying 260 Motion for Review, and SUSTAINING the special master's August 26, 2020 253 decision. Signed by Judge Patricia E. Campbell-Smith. (TQ) Service on parties made. Modified on 8/16/2022 to indicate opinion has been reversed. (dls).","date_issued":"2021-03-22","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-4/pdf","pdf_bytes":384308,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-4"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-5","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"**REVERSED PURSUANT TO 284 C.A.F.C. MANDATE, DATED AUGUST 11, 2022. ** JUDGE VACCINE REPORTED OPINION initially filed February 12, 2021, 273 JUDGE VACCINE OPINION denying 260 Motion for Review, and SUSTAINING the special master's August 26, 2020 253 decision. Signed by Judge Patricia E. Campbell-Smith. (tjk) Service on parties made. Due to Clerk's Office error this documents was previously removed. Modified on 8/18/2022 (tjk).","date_issued":"2021-03-22","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-5/pdf","pdf_bytes":387829,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-5"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-6","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 12/8/2021) regarding 280 DECISION of Special Master - Interim Attorney's Fees. Signed by Special Master Christian J. Moran. (amb) Service on parties made.","date_issued":"2022-01-04","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-7","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 03/17/2023) regarding 325 Order on Motion for Leave to File, Signed by Special Master Christian J. Moran. (ceo) Service on parties made.","date_issued":"2023-04-11","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"docketText matches skip keyword 'motion'","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-8","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"JUDGE VACCINE UNREPORTED OPINION (PUBLIC VERSION) re: 470 Sealed Opinion and Order on Petitioners' Petition for a Writ of Mandamus; Petitioners' Motion Requesting Claims Court Entertain Respondents Motion to Reopen Judgment on Entitlement. Signed by Chief Judge Elaine D. Kaplan. (tbs) Service on parties made.","date_issued":"2024-04-16","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-8/pdf","pdf_bytes":228286,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-8"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-9","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 08/14/2024) regarding 500 Order on Motion for Protective Order. Signed by Special Master Christian J. Moran. (ceo) Service on parties made.","date_issued":"2024-10-24","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"docketText matches skip keyword 'motion'","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-10","title":"SANCHEZ et al v. 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(aa) Service on parties made.","date_issued":"2025-02-18","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-11/pdf","pdf_bytes":221912,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-11"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-12","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 02/13/2025) regarding 536 Order, Scheduling Order, Signed by Special Master Christian J. Moran. (ceo) Service on parties made.","date_issued":"2025-09-29","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"docketText matches skip keyword 'scheduling order'","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-13","title":"SANCHEZ et al v. 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(ceo) Service on parties made.","date_issued":"2025-10-22","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-14/pdf","pdf_bytes":816291,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'findings of fact'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-14"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-15","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 10/01/2025) regarding 610 Findings of Fact & Conclusions of Law. Signed by Special Master Christian J. Moran. (ceo) Service on parties made.","date_issued":"2025-10-23","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_11-vv-00685/granules/USCOURTS-cofc-1_11-vv-00685-15/pdf","pdf_bytes":365403,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'findings of fact'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_11-vv-00685/USCOURTS-cofc-1_11-vv-00685-15"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-16","title":"SANCHEZ et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 4/16/2025) regarding 573 Order on Motion for Miscellaneous Relief. Signed by Special Master Christian J. Moran. (ceo) Service on parties made.","date_issued":"2026-01-12","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"docketText matches skip keyword 'motion'","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_11-vv-00685-17","title":"SANCHEZ et al v. 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