Kristina Garrison v. HHS - Influenza, narcolepsy with cataplexy (2018)
Case summary [AI summaries can sometimes make mistakes]
Kristina Garrison, a 38-year-old adult, filed a petition on August 22, 2014, alleging that a trivalent influenza vaccine administered on November 9, 2011, caused her to develop narcolepsy with cataplexy. Ms.
Garrison reported experiencing excessive daytime sleepiness in mid-November 2011, followed by episodes of falling asleep and sudden collapses triggered by emotion in early December 2011. Her condition progressed, leading to further sleepiness, inability to concentrate, and more frequent collapses.
She sought treatment from various physicians, including Dr. Dan Nofzinger, who diagnosed her with narcolepsy and prescribed medication.
Later, Dr. Richard Hammond confirmed the diagnosis of narcolepsy with cataplexy and adjusted her treatment.
In November 2013, she was treated by Dr. Emmanuel Mignot, a sleep specialist, who noted her symptoms and recommended Xyrem.
Dr. Mignot informed Ms.
Garrison that individuals with a specific genetic susceptibility, like her HLA DQB1*0602 marker, could experience an autoimmune reaction after an H1N1 vaccination, leading to the destruction of hypocretin-producing neurons and resulting in narcolepsy and cataplexy. The respondent initially contested causation but later agreed not to contest entitlement, acknowledging Ms.
Garrison's diagnosis. On October 29, 2015, Special Master Thomas L.
Gowen ruled that Ms. Garrison was entitled to compensation, finding that she had established causation in fact based on a medical theory connecting the H1N1 component of the flu vaccine to an autoimmune reaction leading to narcolepsy in susceptible individuals.
The case then proceeded to the damages phase. On April 4, 2018, Special Master Gowen issued a decision on damages, awarding Ms.
Garrison a total of $1,017,346.24. This lump sum included $757,886.00 for lost past and future earnings, $220,973.00 for pain and suffering, $19,450.24 for past unreimbursable expenses, and $19,037.00 for first-year life care expenses.
Additionally, an amount sufficient to purchase an annuity for future life care expenses was to be paid. The petition was originally filed on August 22, 2014, and the final decision on damages was issued on April 4, 2018.
Petitioner was represented by Curtis R. Webb, and respondent was represented by Ryan D.
Pyles.
Theory of causation
Kristina Garrison, age 38, received a trivalent influenza vaccine on November 9, 2011. She developed narcolepsy with cataplexy, with symptoms beginning approximately two weeks post-vaccination. Petitioner alleged the flu vaccine caused her condition. Respondent initially contested causation but later agreed not to contest entitlement. Special Master Thomas L. Gowen found entitlement based on causation in fact, concluding that the H1N1 component of the flu vaccine could trigger an autoimmune reaction in genetically susceptible individuals (Petitioner tested positive for HLA DQB1*0602), leading to the destruction of hypocretin-producing neurons and resulting in narcolepsy and cataplexy. This theory was supported by expert opinion from Dr. Marcel Kinsbourne and medical literature, including epidemiological studies showing an increased prevalence of narcolepsy following H1N1 vaccination. The Special Master found a logical sequence of cause and effect and a proximate temporal relationship between the vaccination and the onset of symptoms. On April 4, 2018, Ms. Garrison was awarded $1,017,346.24 in a lump sum for lost earnings, pain and suffering, and past expenses, plus an amount for a future life care annuity. Petitioner's counsel was Curtis R. Webb; respondent's counsel was Ryan D. Pyles. Special Master Gowen issued the entitlement ruling on October 29, 2015, and the damages decision on April 4, 2018.