{"package_id":"USCOURTS-cofc-1_14-vv-00439","decision_granule_id":"USCOURTS-cofc-1_14-vv-00439-1","petitioner_identifier":"Hannah Huelsenbeck","is_minor":1,"age_at_vaccination":16.0,"age_unit_raw":"years","vaccine_type":"HPV","vaccination_date":"2011-08-05","condition_raw":"psuedotumor cerebri/idiopathic intracranial hypertension (“IIH”)","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"dismissed","award_amount_usd":null,"decision_date":"2018-03-01","extraction_version":"gemini-v2","extracted_at":"2026-04-30T02:44:54.891884+00:00","number_of_concurrent_vaccines":1,"dose_number":2,"time_to_onset_days":10,"theory_of_causation":"Petitioner alleged that the HPV vaccine caused Ms. Huelsenbeck's pseudotumor cerebri/idiopathic intracranial hypertension (IIH) and chronic headaches. Petitioner's expert, Dr. Lawrence Steinman, proposed a theory involving molecular mimicry and the alum adjuvant in the HPV vaccine. He posited that alum activates an inflammasome, leading to cytokine production that stimulates the trigeminal ganglion and causes headaches. Additionally, he suggested alum enhances cross-reactions between vaccine components and myelin basic protein (MBP) in cerebral blood vessels, impairing spinal fluid reabsorption and causing increased intracranial pressure characteristic of IIH. Respondent's expert, Dr. Michael Kruer, countered that Ms. Huelsenbeck's symptoms were due to her diagnosed IIH and that no reliable scientific evidence linked vaccines to IIH or injury to the blood-brain barrier. Dr. Kruer also disputed the proposed mechanisms, questioning the significance of protein homology for molecular mimicry and the capacity of alum to induce pathogenic cytokine expression. The Special Master, Brian H. Corcoran, found Dr. Steinman's theory unreliable due to a lack of direct scientific evidence linking the HPV vaccine to IIH or chronic headaches, and because the medical records did not support the proposed mechanisms. The Special Master noted that Ms. Huelsenbeck's headaches resolved with IIH treatment and that there was no evidence of vasculitis. The claim was dismissed for failure to establish causation by a preponderance of the evidence.","is_death":0,"date_of_death":null,"petition_filed_date":"2018-01-11","case_summary":"On January 11, 2018, Leigh Rolshoven, as guardian of Hannah Huelsenbeck, filed a claim seeking compensation under the National Vaccine Injury Compensation Program. The petition alleged that Ms. Huelsenbeck developed pseudotumor cerebri/idiopathic intracranial hypertension (IIH), persistent headaches, and other adverse reactions following her second dose of the human papillomavirus (HPV) vaccine, Gardasil, administered on August 5, 2011. Ms. Huelsenbeck, who was 16 years old at the time, had a history of ADHD and had previously experienced headaches and vision problems. Following the second HPV vaccine dose, she reported headaches starting around August 15, 2011, which were initially diagnosed as migraines. Her condition persisted, with increased severity and associated nausea and vomiting, leading to a hospitalization in February 2012. During this hospitalization, her symptoms were attributed to stress and anxiety, but a possible link to the HPV vaccination was noted. Subsequently, Ms. Huelsenbeck was diagnosed with pseudotumor cerebri (PC), equivalent to IIH, due to elevated cerebrospinal fluid pressure. Treatment with Diamox and Lasix led to improvement, and her headaches largely resolved. She received a third HPV vaccine dose on December 30, 2011, with no immediate documented reaction. Headaches recurred later, and she was treated by various specialists, including an ophthalmologist and a neurologist, who managed her PC diagnosis. The medical records indicated that her headaches often resolved with treatment for PC, though they recurred at times. Petitioner's expert, Dr. Lawrence Steinman, proposed a theory that the HPV vaccine, through molecular mimicry and the alum adjuvant, could cause headaches separate from the IIH diagnosis. He suggested that the vaccine could trigger an immune response that stimulates cytokines, causing pain, and also enhance cross-reactions with myelin basic protein (MBP) in cerebral blood vessels, leading to increased CSF pressure. Respondent's expert, Dr. Michael Kruer, opined that Ms. Huelsenbeck's symptoms were attributable to her underlying IIH diagnosis and that the medical literature did not support a link between vaccines and IIH. Dr. Kruer also challenged the reliability of Dr. Steinman's proposed mechanisms, including molecular mimicry and the role of alum. The Special Master, Brian H. Corcoran, found that the petitioner failed to establish causation by a preponderance of the evidence. The court found Dr. Steinman's theory to be unreliable, noting a lack of direct scientific evidence linking the HPV vaccine to IIH or similar chronic headache syndromes, and that the petitioner's medical records did not support the proposed mechanisms. The decision highlighted that Ms. Huelsenbeck's headaches largely resolved after treatment for IIH, and there was no evidence of vasculitis. The claim was dismissed.","is_minor_inferred":null,"is_pediatric_broad":1,"special_master":"Brian H. Corcoran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Mark Sadaka","petitioner_attorney_firm":"Mark T. Sadaka, LLC","petitioner_attorney_location":"Englewood, NJ","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|mark-sadaka|","firm_canonical_key":"mark-t-sadaka","package_title":"ROLSHOVEN v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00439","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00439.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00439.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_14-vv-00439-0","title":"ROLSHOVEN v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/19/2017) Regarding 63 DECISION of Special Master - Interim Attorney's Fees (Signed by Special Master Brian H. Corcoran). 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SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 6/26/2018) Regarding 75 DECISION of Special Master - Fees (Signed by Special Master Brian H. Corcoran). (cr) Service on parties made.","date_issued":"2018-08-02","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}