Audrey Morgan v. HHS - Tdap, gastroparesis and abdominal migraines (2018)
Case summary [AI summaries can sometimes make mistakes]
Audrey Morgan, who was 12 years old at the time, received four vaccines, including Tdap, Varicella, Hepatitis A, and meningococcal, on April 15, 2009. She alleged that these vaccinations caused her to develop gastroparesis and abdominal migraines.
Her parents initially filed the petition on her behalf due to her age, but she later amended it to her full name after turning 18. Audrey and her parents testified that her symptoms, primarily nausea, began within days of the vaccination and worsened over the following months, leading to a gastroparesis diagnosis in the fall of 2009.
Petitioner presented expert testimony from an immunologist, Dr. Eric Gershwin, and a gastroenterologist, Dr.
John Santoro, who proposed an autoimmune theory of causation involving molecular mimicry, suggesting the meningococcal vaccine was the most likely culprit. Respondent presented expert testimony from Dr.
Randy Longman, a gastroenterologist and mucosal immunologist, who opined that gastroparesis is typically idiopathic or caused by viral infections, and that an autoimmune mechanism initiated by vaccination was highly improbable. The court found that Petitioner failed to establish a reliable medical or scientific theory connecting the vaccines to her gastroparesis, as required by the Althen prongs for off-Table claims.
The court noted that the medical literature, particularly the Pande article, offered only limited support and had not been further corroborated. Furthermore, the court found the evidence insufficient to establish that gastroparesis is autoimmune in nature or that the specific vaccines caused such a process in Audrey.
The court also found that the temporal progression of her symptoms was not sufficiently consistent with the proposed autoimmune theory. Although the court found that Audrey's symptoms began after vaccination, it concluded that she had not met her burden of proof for causation.
Therefore, the petition was denied. The decision was issued by Special Master Brian H.
Corcoran on January 11, 2018.
Theory of causation
Petitioner Audrey Morgan, age 12, received Tdap, Varicella, Hepatitis A, and meningococcal vaccines on April 15, 2009, and subsequently developed gastroparesis and abdominal migraines. Petitioner's experts, Dr. Eric Gershwin (immunologist) and Dr. John Santoro (gastroenterologist), proposed an autoimmune theory of causation via molecular mimicry, suggesting the meningococcal vaccine was the most likely cause. Respondent's expert, Dr. Randy Longman (gastroenterologist and mucosal immunologist), argued that gastroparesis is typically idiopathic or viral in origin and that an autoimmune mechanism from vaccination is highly improbable. The Special Master, Brian H. Corcoran, found that Petitioner failed to establish a reliable medical or scientific theory connecting the vaccines to her gastroparesis, did not demonstrate a logical sequence of cause and effect, and did not show a proximate temporal relationship consistent with the proposed theory. The Pande article was considered but given limited weight due to its age, limited scope, and lack of corroboration. The court found insufficient evidence that gastroparesis is autoimmune or that the vaccines caused such a process. The temporal progression of symptoms was also deemed inconsistent with the proposed theory. Consequently, the petition was denied on January 11, 2018.
Source PDFs
USCOURTS-cofc-1_12-vv-00077