I.D. v. HHS - DTaP, significant neurological deficits (2017)
Case summary [AI summaries can sometimes make mistakes]
On October 17, 2013, Jessica and Ryan Dean, on behalf of their minor child I.D., filed a petition for compensation under the National Vaccine Injury Compensation Program. They alleged that I.D. developed "significant neurological deficits" as a result of receiving the Diphtheria-Tetanus-acellular Pertussis (DTaP) and Haemophilus Influenzae Type b (Hib) vaccines on February 24, 2011.
I.D. was approximately five months old at the time of vaccination. The petition stated that I.D. experienced an immediate reaction including screaming, fever, and projectile vomiting, followed by lethargy and later abnormal movements.
However, contemporaneous medical records did not document these immediate reactions or significant neurological issues. Records from April 2011 noted concerns about hand flapping, and a pediatric neurologist diagnosed benign stereotypies of childhood.
I.D. later received speech and occupational therapy for feeding issues and speech delay. Petitioners presented expert testimony from Dr.
David Axelrod and Dr. Harvey Cantor, who proposed a theory that the vaccines could cause cytokine upregulation, leading to blood-brain barrier disruption and subsequent neurological injury.
Respondent presented expert testimony from Dr. Lawrence Brown, a pediatric neurologist, who opined that the medical records did not support a vaccine-induced encephalopathy or other immediate injury.
The Special Master, Brian H. Corcoran, found that Petitioners failed to establish a reliable causation theory and that the contemporaneous medical records did not support the alleged immediate vaccine reaction or subsequent neurological injury.
The court gave more weight to the treating neurologist's diagnosis of benign stereotypies and the normal EEG results. Ultimately, the Special Master concluded that it was not more likely than not that I.D.'s developmental problems were related to the vaccinations and denied the petition.
The decision was issued on July 10, 2017.
Theory of causation
Petitioners alleged that the DTaP and Hib vaccines administered on February 24, 2011, to five-month-old I.D. caused significant neurological deficits. Petitioners' experts, Dr. David Axelrod (immunology) and Dr. Harvey Cantor (pediatric neurology), proposed a theory that the vaccines caused upregulation of proinflammatory cytokines, which in turn disrupted the blood-brain barrier, allowing harmful substances to enter the central nervous system and cause damage. Dr. Axelrod also posited that the tetanus toxoid component of the DTaP vaccine could bind to neuronal gangliosides, leading to injury. Respondent's expert, Dr. Lawrence Brown (pediatric neurology), argued that the medical records did not support a vaccine-induced encephalopathy or immediate injury, and that I.D.'s symptoms were consistent with benign stereotypies of childhood. Special Master Brian H. Corcoran found Petitioners' causation theory unreliable, noting that the cited literature, such as Kashiwagi and Rochfort, did not sufficiently support the proposed mechanism of vaccine-induced cytokine upregulation leading to long-term neurological damage. The Special Master also found that the medical records did not corroborate the alleged immediate post-vaccination reaction or subsequent neurological injury, giving more weight to the contemporaneous diagnosis of benign stereotypies by treating neurologist Dr. Ronald Davis and normal EEG results. The petition was denied because Petitioners failed to establish by a preponderance of the evidence that the vaccines caused I.D.'s developmental problems. The case was decided on the record without a hearing.
Source PDFs
USCOURTS-cofc-1_13-vv-00808