{"package_id":"USCOURTS-cofc-1_13-vv-00735","decision_granule_id":"USCOURTS-cofc-1_13-vv-00735-0","petitioner_identifier":"Savannah Smithson","is_minor":1,"age_at_vaccination":null,"age_unit_raw":"years (minor - age not in source, verified)","vaccine_type":"HPV","vaccination_date":"2012-11-05","condition_raw":"adrenal deficiency and dysautonomia, which presented as postural orthostatic tachycardia syndrome (POTS)","condition_category":"dysautonomia","autism_spectrum_adjacent":0,"outcome":"dismissed","award_amount_usd":null,"decision_date":"2019-04-02","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:30:54.267296+00:00","number_of_concurrent_vaccines":1,"dose_number":1,"time_to_onset_days":null,"theory_of_causation":"Petitioner Savannah Smithson alleged that HPV vaccines administered on November 5, 2012, and February 4, 2013, caused adrenal deficiency and dysautonomia, presenting as POTS. The public decision does not describe the specific mechanism of causation proposed by the petitioner. Petitioner's experts included Dr. Ramesh Adiraju, Dr. David Axelrod, Dr. Patrick Nemechek, and Dr. Mitchell Miglis. Respondent's experts were Dr. Kenneth Mack and Dr. Arnold Levinson. Key issues raised by the Special Master and respondent's experts included the lack of a gold-standard tilt-table test for POTS diagnosis and the failure to establish a causal link between the HPV vaccine and the alleged conditions. Petitioner ultimately moved to dismiss her petition, concluding she could not meet her burden of proof. Special Master Christian J. Moran dismissed the petition for insufficient proof on April 2, 2019. Attorneys for the petitioner were Andrew D. Downing and for the respondent was Lara A. Englund. No award was made as the petition was dismissed.","is_death":0,"date_of_death":null,"petition_filed_date":"2013-09-25","case_summary":"Savannah Smithson, through her parents initially, filed a claim for compensation on September 25, 2013, alleging that the HPV vaccines she received on November 5, 2012, and February 4, 2013, caused her to develop adrenal deficiency and dysautonomia, specifically postural orthostatic tachycardia syndrome (POTS). Ms. Smithson was substituted as the petitioner after reaching the age of majority. Over several years, Ms. Smithson submitted expert and treating physician reports to support her claim. The respondent, the Secretary of Health and Human Services, opposed eligibility, arguing that the evidence did not support the diagnosis or causation. Petitioner's initial expert reports from Dr. Ramesh Adiraju were found to be incomplete and deficient. Subsequent reports from Dr. David Axelrod and Dr. Patrick Nemechek also raised concerns. Respondent's experts, Dr. Kenneth Mack and Dr. Arnold Levinson, noted that a gold-standard tilt-table test for POTS had not been performed. Treating physicians Dr. Michael Gerber and Dr. Stewart Tatem provided letters regarding the POTS diagnosis, but without detailing diagnostic criteria or first-hand accounts. Dr. Nemechek's reports and autonomic testing results were also found to have deficiencies and failed to address respondent's expert concerns. Petitioner then obtained a report from Dr. Mitchell Miglis, but concerns remained regarding the diagnostic testing and the association between the HPV vaccine and dysautonomia. The Special Master noted that without evidence associating the HPV vaccination to POTS, compensation could not be awarded, citing Hibbard v. Sec'y of Health & Human Servs. On April 2, 2019, Ms. Smithson moved to dismiss her petition, stating her conclusion that she would likely be unable to meet her burden of proof. Special Master Christian J. Moran granted the motion, dismissing the petition for insufficient proof, finding that Ms. Smithson had been provided a full and fair opportunity to present her case but failed to meet the preponderance of the evidence standard required for a compensable vaccine injury. The decision was issued on April 9, 2019, and posted on May 6, 2019.","is_minor_inferred":0,"is_pediatric_broad":1,"special_master":"Christian J. Moran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Andrew D. Downing","petitioner_attorney_firm":"Van Cott & Talamante, PLLC","petitioner_attorney_location":"Phoenix, AZ","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|andrew-downing|","firm_canonical_key":"van-cott-and-talamante","package_title":"SMITHSON et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00735","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00735.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00735.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_13-vv-00735-0","title":"SMITHSON et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 4/9/2019) regarding 119 DECISION of Special Master Signed by Special Master Christian J. Moran. (MRG) Service on parties made.","date_issued":"2019-05-06","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_13-vv-00735/granules/USCOURTS-cofc-1_13-vv-00735-0/pdf","pdf_bytes":221286,"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_13-vv-00735/USCOURTS-cofc-1_13-vv-00735-0"},{"granule_id":"USCOURTS-cofc-1_13-vv-00735-1","title":"SMITHSON et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 08/15/2019) regarding 127 DECISION of Special Master - Fees Signed by Special Master Christian J. Moran. (hh) Service on parties made.","date_issued":"2019-09-10","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}