VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00312
Package ID: USCOURTS-cofc-1_14-vv-00312
Petitioner: Christina Breland
Filed: 2014-04-17
Decided: 2015-04-13
Vaccine: HPV
Vaccination date: 2011-04-18
Condition: seizure disorder and a mixed connective tissue disease
Outcome: dismissed
Award amount USD: 

AI-assisted case summary:
Christina Breland, born June 28, 1996, filed a petition on April 17, 2014, alleging that the human papillomavirus (HPV) vaccine administered on April 18, 2011, caused her to develop a seizure disorder beginning on April 20, 2011, and a mixed connective tissue disease that began in September 2013. The respondent was the Secretary of Health and Human Services. Medical records indicated that Christina had a history of seizures prior to receiving the HPV vaccine, including episodes of sleep apnea and a recommendation from a pediatric pulmonologist on March 3, 2010, to see a neurologist to rule out a seizure disorder. She also reported episodes of stiffening of the body and confusion approximately one year before her vaccination, and episodes of staring and spacing out in the month prior to vaccination. Following her HPV vaccination on April 18, 2011, she presented to the emergency department on April 20, 2011, with a generalized tonic-clonic seizure lasting five minutes. A rheumatologist diagnosed her with mixed connective tissue disease on December 5, 2013. During status conferences, the Special Master noted the difficulty in proving causation, and petitioner's counsel indicated a need for additional medical records and consultation with experts. Ultimately, petitioner's counsel moved for a decision on the written record, stating that two medical experts had been consulted. The respondent argued that the claim was not supported by medical records or expert opinion. Special Master Laura D. Millman granted the petitioner's motion and dismissed the case on April 13, 2015, finding that Christina failed to prove by a preponderance of the evidence that the HPV vaccine significantly aggravated her pre-existing seizure disorder or caused her mixed connective tissue disease. The public decision does not describe the specific medical theories of the consulted experts or the mechanism of injury. A subsequent decision on December 16, 2015, awarded attorneys' fees and costs totaling $9,805.12, based on a stipulation of fact between the parties, with $9,541.02 payable jointly to petitioner and the Law Office of John McHugh for attorneys' fees and costs, and $264.10 payable to petitioner for her costs. Petitioner was represented by John F. McHugh, and respondent was represented by Linda S. Renzi.

Theory of causation field:
Petitioner Christina Breland, born June 28, 1996, received an HPV vaccine on April 18, 2011. She alleged this vaccine caused a seizure disorder starting April 20, 2011, and a mixed connective tissue disease starting September 2013. Medical records showed pre-existing seizures and episodes suggestive of seizures prior to vaccination. Petitioner did not provide expert medical opinion or sufficient medical records to substantiate her claims that the HPV vaccine significantly aggravated her pre-existing seizure disorder or caused her mixed connective tissue disease. The Special Master granted petitioner's motion for a decision on the written record and dismissed the case on April 13, 2015, for failure to prove causation by a preponderance of the evidence, citing Althen v. Sec'y of HHS and Grant v. Secretary of Health and Human Services. The theory of causation was deemed "Off-Table." Attorneys' fees and costs totaling $9,805.12 were awarded on December 16, 2015, based on a stipulation of fact. Petitioner was represented by John F. McHugh, and respondent by Linda S. Renzi. Special Master Laura D. Millman presided over both decisions.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_14-vv-00312-0
Date issued/filed: 2015-05-13
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 04/13/2015) regarding 30 DECISION of Special Master Signed by Special Master Laura D Millman. (tlj) Copy to parties.
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Case 1:14-vv-00312-UNJ Document 31 Filed 05/13/15 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-312V
April 13, 2015
Not to be Published
***************************************
CHRISTINA BRELAND, *
*
Petitioner, *
*
v. * human papillomavirus (“HPV”) vaccine;
* seizure disorder; pre-existing seizures;
SECRETARY OF HEALTH * no expert witness; petitioner moves for
AND HUMAN SERVICES, * decision on written record; dismissed
*
Respondent. *
***************************************
John F. McHugh, New York, NY, for petitioner.
Linda S. Renzi, Washington, DC, for respondent.
MILLMAN, Special Master
DECISION1
On April 17, 2014, petitioner sued under the National Childhood Vaccine Injury Act, 42
U.S.C. §§ 300aa-10–34 (2006), alleging that human papillomavirus (“HPV”) vaccine
administered April 18, 2011 caused her a seizure disorder starting April 20, 2011, and a mixed
connective tissue disease, starting in September 2013. Medical records show that petitioner had
seizures predating her HPV vaccination. Petitioner does not have any support from either the
1 Because this decision contains a reasoned explanation for the special master’s action in this
case, the special master intends to post this decision on the United States Court of Federal
Claims’ website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347, 116
Stat. 2899, 2913 (Dec. 17, 2002). Vaccine Rule 18(b) states that all decisions of the special
masters will be made available to the public unless they contain trade secrets or commercial or
financial information that is privileged and confidential, or medical or similar information whose
disclosure would constitute a clearly unwarranted invasion of privacy. When such a decision is
filed, petitioners have 14 days to identify and move to redact such information prior to the
document’s disclosure. If the special master, upon review, agrees that the identified material fits
within the categories listed above, the special master shall redact such material from public
access.

Case 1:14-vv-00312-UNJ Document 31 Filed 05/13/15 Page 2 of 4
medical records or expert medical opinion that her first HPV vaccination significantly
aggravated her pre-existing seizures. Moreover, petitioner does not have any support from either
the medical records or expert medical opinion that HPV vaccine caused her to have a mixed
connective tissue disease whose onset was two years later.
On September 10, 2014, the undersigned held the first telephonic status conference with
counsel to discuss the difficulty of petitioner proving that HPV vaccine significantly aggravated
petitioner’s pre-existing seizure disorder or cause a mixed connective tissue disease whose onset
was two years later. Petitioner’s counsel stated he needed to obtain additional medical records.
On March 13, 2015, the undersigned held another telephonic status conference during
which petitioner’s counsel said he would consult an expert and, if petitioner were going to
proceed, he would file an amended petition to allege significant aggravation.
On April 13, 2015, the undersigned held another telephonic status conference during
which petitioner’s counsel said he had consulted two medical experts. He moved for a decision
on the record. Respondent’s counsel stated that petitioner’s claim is not supported by the
medical records or an expert medical opinion.
The undersigned GRANTS petitioner’s motion and DISMISSES this case for failure to
prove that HPV vaccine significantly aggravated petitioner’s pre-existing seizure disorder or
caused her mixed connective tissue disease.
FACTS
Petitioner was born on June 28, 1996.
On February 3, 2010, petitioner saw Dr. Alfonso Sim. Med. recs. Ex. 4, at 31. Petitioner
had a history of sleep apnea. Id. One week previously, it took her father ten minutes to wake
her. Id. On March 3, 2010, a pediatric pulmonologist recommended she see a neurologist to rule
out a seizure disorder. Id. at 30.
On April 18, 2011, petitioner received her first HPV vaccination. Id. at 1. She went to
Brookdale University Medical Center emergency department on April 20, 2011, complaining of
a generalized tonic-clonic seizure lasting five minutes. Med. recs. Ex. 3, at 20. She denied
fever. Id. One year previously, she had an episode of stiffening of the body followed by
confusion for about 10 minutes. Id. at 29. One month previously, i.e., March 2011, she had two
episodes of staring and spacing out for one to two minutes. Id.
On December 5, 2013, petitioner saw Dr. Jaya Srinivasan-Mehta, a rheumatologist, for
mixed connective tissue disease. Med. recs. Ex. 5, at 1.
2

Case 1:14-vv-00312-UNJ Document 31 Filed 05/13/15 Page 3 of 4
DISCUSSION
To satisfy her burden of proving causation in fact, petitioner must prove by preponderant
evidence: “(1) a medical theory causally connecting the vaccination and the injury; (2) a logical
sequence of cause and effect showing that the vaccination was the reason for the injury; and (3) a
showing of a proximate temporal relationship between vaccination and injury.” Althen v. Sec’y
of HHS, 418 F.3d 1274, 1278 (Fed. Cir. 2005). In Althen, the Federal Circuit quoted its opinion
in Grant v. Secretary of Health and Human Services, 956 F.2d 1144, 1148 (Fed. Cir. 1992):
A persuasive medical theory is demonstrated by “proof of a logical
sequence of cause and effect showing that the vaccination was the
reason for the injury[,]” the logical sequence being supported by a
“reputable medical or scientific explanation[,]” i.e., “evidence in
the form of scientific studies or expert medical testimony[.]”
418 F.3d at 1278.
Without more, “evidence showing an absence of other causes does not meet petitioners’
affirmative duty to show actual or legal causation.” Grant, 956 F.2d at 1149. Mere temporal
association is not sufficient to prove causation in fact. Id. at 1148.
Petitioner must show not only that but for HPV vaccine, she would not have seizures or
mixed connective tissue disease, but also that the vaccine was a substantial factor in significantly
aggravating her seizure disorder and causing her mixed connective tissue disease. Shyface v.
Sec’y of HHS, 165 F.3d 1344, 1352 (Fed. Cir. 1999).
The Vaccine Act does not permit the undersigned to rule for petitioner based on her
claims alone, “unsubstantiated by medical records or by medical opinion.” 42 U.S.C. § 300aa-
13(a)(1). In this case, petitioner’s medical records do not substantiate petitioner’s claim of
significant aggravation or causation. Moreover, petitioner has not filed an expert medical
opinion substantiating her claim of significant aggravation or causation.
The undersigned GRANTS petitioner’s motion for a decision on the written record and
DISMISSES this case for petitioner’s failure to prove by a preponderance of the evidence the
matters required in the petition. 42 U.S.C. § 300aa-13(a)(1).
CONCLUSION
This petition is DISMISSED. In the absence of a motion for review filed pursuant to
RCFC, Appendix B, the clerk of the court is directed to enter judgment herewith.2
2 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party, either
separately or jointly, filing a notice renouncing the right to seek review.
3

Case 1:14-vv-00312-UNJ Document 31 Filed 05/13/15 Page 4 of 4
IT IS SO ORDERED.
April 13, 2015 s/Laura D. Millman
DATE Laura D. Millman
Special Master
4

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DOCUMENT 2: USCOURTS-cofc-1_14-vv-00312-1
Date issued/filed: 2015-12-16
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 11/25/2015) regarding 36 DECISION Fees Stipulation/Proffer Signed by Special Master Laura D Millman. (tlf) Copy to parties.
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Case 1:14-vv-00312-UNJ Document 37 Filed 12/16/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-312V
Filed: November 25, 2015
Not for Publication
*************************************
CHRISTINA BRELAND, *
*
Petitioner, * Attorneys’ fees and costs decision based on
* stipulation of fact
*
v. *
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
*
*************************************
John F. McHugh, New York, NY, for petitioner.
Linda S. Renzi, Washington, DC, for respondent.
MILLMAN, Special Master
DECISION AWARDING ATTORNEYS’ FEES AND COSTS1
On November 25, 2015, the parties filed a stipulation of fact in which they agreed on an
appropriate amount for attorneys’ fees and costs in this case.
Petitioner submitted her request for attorneys’ fees and costs to respondent. Petitioner
requests $9,805.12, consisting of $9,541.02 in attorneys’ fees and costs and $264.10 in petitioner’s
1 Because this unpublished decision contains a reasoned explanation for the special master’s action in this
case, the special master intends to post this unpublished decision on the United States Court of Federal
Claims’s website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899,
2913 (Dec. 17, 2002). Vaccine Rule 18(b) states that all decisions of the special masters will be made
available to the public unless they contain trade secrets or commercial or financial information that is
privileged and confidential, or medical or similar information whose disclosure would constitute a clearly
unwarranted invasion of privacy. When such a decision is filed, petitioner has 14 days to identify and
move to redact such information prior to the document=s disclosure. If the special master, upon review,
agrees that the identified material fits within the banned categories listed above, the special master shall
redact such material from public access.

Case 1:14-vv-00312-UNJ Document 37 Filed 12/16/15 Page 2 of 2
costs. Respondent does not object to this amount. The undersigned finds this amount to be
reasonable. Accordingly, the court awards:
a. $9,541.02, representing reimbursement for attorneys’ fees and costs. The award
shall be in the form of a check payable jointly to petitioner and the Law Office of
John McHugh in the amount of $9,541.02; and
b. $264.10, representing reimbursement for petitioner’s costs. The award shall be
in the form of a check payable to petitioner in the amount of $264.10.
In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of the
court is directed to enter judgment herewith.2
IT IS SO ORDERED.
Dated: November 25, 2015 s/ Laura D. Millman
Laura D. Millman
Special Master
2 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party, either separately or
jointly, filing a notice renouncing the right to seek review.
2