VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00826
Package ID: USCOURTS-cofc-1_14-vv-00826
Petitioner: J.K.
Filed: 2014-09-08
Decided: 2015-05-21
Vaccine: influenza
Vaccination date: 2011-09-21
Condition: seizure
Outcome: compensated
Award amount USD: 31357

AI-assisted case summary:
On September 8, 2014, J.K. filed a petition under the National Childhood Vaccine Injury Act, alleging that influenza and hepatitis A vaccines received on September 21, 2011, caused him to have a seizure the following day. The petitioner was 18 years old at the time of vaccination. Medical records indicated that the seizure occurred on September 22, 2011, and EMTs administered Valium, which stopped the seizure. J.K. was then taken to North Broward Medical Center. Subsequent medical evaluations, including an EEG and MRI on May 11, 2012, showed normal results, and he experienced no further seizures. A repeat EEG in December 2011 also showed no epileptiform activity. The treating physician, Dr. Ridwan Lin, noted that while the seizure was possibly related to the flu vaccine, J.K. also had a history of anxiety, panic attacks, and episodes of blacking out after smoking marijuana. Dr. Lin's diagnoses included a single episode generalized seizure possibly related to the flu vaccine, and later, falls possibly syncopal spells, advising against marijuana use. Petitioner's medical history also included diagnoses of severe anxiety disorder, fibromyalgia, and a thyroid disorder. Psychiatric evaluations revealed a history of paranoid type schizophrenia, aggressive behaviors, delusions, paranoia, somatic preoccupations, medication noncompliance, disorganized thought processes, and self-mutilation, with a diagnosis of schizophrenia, and later schizoaffective disorder, bipolar type. Petitioner did not file an expert report to support his claim of causation. Furthermore, the public decision states that J.K. did not prove he had more than six months of sequelae, as required by the Vaccine Act, and that several of his complaints, such as anxiety and panic attacks, pre-dated his vaccinations. On May 5, 2015, J.K. moved for a decision based on the existing record. Special Master Laura D. Millman granted this motion and dismissed the case on May 8, 2015, for failure to prove causation. Subsequently, on May 21, 2015, the parties stipulated to attorneys' fees and costs. Special Master Millman awarded $27,492.50 in attorneys' fees and $3,865.03 in costs, for a total of $31,357.53, payable by check to J.K. and the Law Office of Myles Jacobson for fees, and to J.K. for costs.

Theory of causation field:
Petitioner J.K., aged 18.2 years, received influenza and hepatitis A vaccines on September 21, 2011. The following day, he experienced a seizure. The public decision does not describe a specific medical theory connecting the vaccines to the seizure, nor does it name any experts. Petitioner did not file an expert report to support his claim of causation. Medical records indicated normal EEG and MRI results, and no further seizures. The treating physician noted the seizure was possibly related to the flu vaccine but also cited petitioner's history of anxiety, panic attacks, and marijuana use, which was associated with episodes of blacking out. Petitioner also had pre-existing conditions including anxiety and panic attacks. The Special Master dismissed the case for failure to prove causation and failure to prove more than six months of sequelae, as required by the Vaccine Act. The parties later stipulated to attorneys' fees and costs, totaling $31,357.53 ($27,492.50 in fees and $3,865.03 in costs), which Special Master Laura D. Millman awarded on May 21, 2015. The initial decision dismissing the claim was issued on May 8, 2015.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_14-vv-00826-0
Date issued/filed: 2015-05-08
Pages: 5
Docket text: PUBLIC DECISION (Redacted) (Originally filed: 5/6/15) regarding 28 DECISION of Special Master. Signed by Special Master Laura D Millman. (LJG) Copy to parties.
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Case 1:14-vv-00826-UNJ Document 33 Filed 05/08/15 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. xx-xxxV
Filed: May 6, 2015
Redacted and Reissued: May 8, 2015
Not to be Published
***************************************
J.K., *
*
Petitioner, *
*
v. * Influenza (“flu”) and hepatitis A vaccines;
* seizure; no sequelae; no expert report;
SECRETARY OF HEALTH * petitioner moves for decision on the
AND HUMAN SERVICES, * written record; dismissed
*
Respondent. *
***************************************
Myles D. Jacobson, Northampton, MA, for petitioner.
Lisa A. Watts, Washington, DC, for respondent.
MILLMAN, Special Master
DECISION1
On September 8, 2014, petitioner sued under the National Childhood Vaccine Injury Act,
42 U.S.C. §§ 300aa-10–34 (2006), alleging that either or both influenza (“flu”) and hepatitis A
vaccines he received on September 21, 2011 caused him to have a seizure the next day.
Evidence in the record shows that petitioner never had any subsequent seizures, although
he is prone to blacking out after he smokes marijuana. Petitioner never filed an expert report
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. Petitioner made a timely motion to redact the case number and petitioner’s name
from the decision on May 7, 2015. The undersigned grants petitioner’s motion and reissues this redacted
decision.

Case 1:14-vv-00826-UNJ Document 33 Filed 05/08/15 Page 2 of 5
supporting his allegation that either one or both of his vaccinations caused his seizure.
Moreover, he has not proven that he had more than six months of sequelae as the Vaccine Act
requires. A number of the illnesses of which he complains, such as anxiety and panic attacks,
pre-date his vaccinations.
On May 5, 2015, petitioner filed a status report, in lieu of a motion, stating he “wishes the
Special Master to rule on his Petition based on the existing record.”
The undersigned GRANTS petitioner’s “motion” and DISMISSES this case for failure
to prove that either one or both flu and hepatitis A vaccines caused petitioner’s seizure.
FACTS
Petitioner was born on July 8, 1993.
On September 21, 2011, he received flu and hepatitis A vaccines. Med. recs. Ex. 17, at 7,
8.
On September 22, 2011, Margate Fire Rescue Field Notes record a fall/seizure/hematoma
over petitioner’s right eye. Med. recs. Ex. 2, at 1.2 He had a history of gastroenteritis and was
on Zytec and Prevacid. Id. Petitioner’s father found him unconscious on the floor seizing. Id.
The EMTs gave him 5 mg of Valium, and petitioner’s seizure stopped. Id. Petitioner vomited
and was suctioned. Id. He was intubated and taken to North Broward Medical Center. Id.
On May 29, 2012, Dr. Ridwan Lin of Broward Health North Clinic wrote a letter
describing his May 11, 2012 visit with petitioner. Med. recs. Ex. 3, at 1. Dr. Lin noted that
petitioner had been hospitalized at North Broward Medical Center in September 2011 after a
generalized seizure. Id. Petitioner had received flu vaccine before the seizure, but “it was
unclear whether they were related.” Id. Petitioner’s EEG was normal. Id. Petitioner’s brain
MRI was normal. Id. Petitioner was prescribed Ritalin, but he self-discontinued. Id. A repeat
EEG in December 2011 showed some slowing but no epileptiform activity. Id. Petitioner had
been doing well neurologically with no recurrent seizure. Id. Petitioner had multiple other
complaints, including anxiety and panic attacks. Id. He had been diagnosed with severe anxiety
disorder and sees a psychiatrist. Id. Petitioner also had headache, insomnia, and pain in his
knees. Id. He claimed he had thyroid abnormalities. Id. He had a history of food poisoning
and gastroenteritis. Id. Petitioner had used marijuana. Id. On physical examination, petitioner
did not have swelling in his knees. Id. He had a depressed mood. Id. Dr. Lin’s diagnosis was
single episode generalized seizure possibly related to flu vaccine. Id. at 2. Petitioner had no
epileptiform activity. Id. Dr. Lin recommended petitioner see a psychiatrist to manage his
anxiety and panic attacks. Id.
2 Petitioner initially used letters to designate exhibits instead of numbers. See Order, Nov. 25, 2014, ECF
No. 10 (re-designating the lettered exhibits as numbered exhibits).
2

Case 1:14-vv-00826-UNJ Document 33 Filed 05/08/15 Page 3 of 5
On June 1, 2012, petitioner saw Dr. Lin again. Med. recs. Ex. 5, at 3. Dr. Lin wrote that,
since his past visit, petitioner had had episodes of blacking out where he fell. Id. He denied loss
of consciousness. Id. He had no visual loss, language disturbance, focal weakness, or sensory
loss. Id. Dr. Lin wrote, “These episodes occur after he smokes marijuana.” Id. Petitioner still
had anxiety and panic attacks and pain in his wrists and knees. Id. He had an appointment to see
a rheumatologist. Id. He was no longer taking Topamax. Id. Dr. Lin’s diagnosis was falls, but
he was not clear if they were syncopal spells. Id. at 4. He advised petitioner against continuing
to smoke marijuana. Id. He prescribed a repeat EEG and recommended petitioner see a
psychiatrist for anxiety and panic attacks. Id.
On November 12, 2013, Dr. Lin wrote that a rheumatologist diagnosed petitioner with
fibromyalgia. Id. at 5. Petitioner said his pediatrician diagnosed him with a thyroid disorder. Id.
Petitioner said he yawned a lot. Id.
On January 27, 2014, petitioner had an initial psychiatric evaluation at University
Hospital and Medical Center with Dr. Robert Antoine. Med. recs. Ex. 13, at 12. Petitioner had a
history of paranoid type schizophrenia, aggressive and impulsive behaviors, irrationality,
threatening his father, delusions, paranoia, somatic preoccupations, medication noncompliance,
disorganized thought processes, self-mutilation, and was smoking one gram per day of marijuana
to gain weight. Id. at 12–13. Petitioner started smoking marijuana when he was 16 or 17 years
old (in 2009 or 2010 before his 2011 vaccinations). Id. at 13. He stopped three months ago. Id.
Petitioner’s mother had manic depression and died when he was five years old. Id. His father
used to grow cannabis before stopping three years ago after petitioner went to the police. Id.
Petitioner’s speech was rambling. Id. He had somatic preoccupations, and his judgment and
insight were poor. Id. Dr. Antoine diagnosed petitioner with schizophrenia, and wanted to rule
out schizoaffective disorder, bipolar disorder with psychosis, cannabis-induced psychotic
disorder, and/or eating disorder not otherwise specified. Id.
From January 18 to 25, 2014, petitioner was at University Hospital and Medical Center.
Id. at 52. Dr. Tanveer Sobhan wrote that petitioner was focused on food. Id. He was
hyperverbal, tangential, and paranoid. Id. He had cravings for marijuana. Id.
From March 21, 2014 to September 9, 2014, a total of 173 days, petitioner was at New
Directions for Young Adults, diagnosed with schizoaffective disorder, bipolar type. Med. recs.
Ex. 12, at 1. He had a continued lack of commitment to sobriety. Id. at 2. He needed insight
into his problem with substance abuse. Id.
DISCUSSION
To satisfy his 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
3

Case 1:14-vv-00826-UNJ Document 33 Filed 05/08/15 Page 4 of 5
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 either or both flu and hepatitis A vaccines, he
would not have seized, but also that either or both vaccines was a substantial factor in causing his
seizure. Shyface v. Sec’y of HHS 165 F.3d 1344, 1352 (Fed. Cir. 1999).
Moreover, even if petitioner proved that either or both flu and hepatitis A vaccines
caused his seizure one day later, he would still have to prove that he had more than six months of
sequelae. 42 U.S.C. § 300aa-11(c)(1)(D)(i).
The Vaccine Act does not permit the undersigned to rule for petitioner based on his
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
causation both in terms of causation of his one seizure and of his having sequelae for more than
six months. Moreover, petitioner has not filed an expert medical opinion substantiating his claim
of causation in fact.
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.3
3 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.
4

Case 1:14-vv-00826-UNJ Document 33 Filed 05/08/15 Page 5 of 5
IT IS SO ORDERED.
May 8, 2015 s/Laura D. Millman
DATE Laura D. Millman
Special Master
5

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DOCUMENT 2: USCOURTS-cofc-1_14-vv-00826-1
Date issued/filed: 2015-06-11
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 05/21/2015) regarding 36 DECISION Fees Stipulation/Proffer Signed by Special Master Laura D Millman. (tlj) Copy to parties.
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Case 1:14-vv-00826-UNJ Document 39 Filed 06/11/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-826V
Filed: May 21, 2015
Not for Publication
*************************************
JOSHUA KUPKA, *
*
Petitioner, * Attorneys’ fees and costs decision based on
* stipulation of fact
v. *
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
*
*************************************
Myles D. Jacobson, Northampton, MA, for petitioner.
Lisa A. Watts, Washington, DC, for respondent.
MILLMAN, Special Master
DECISION AWARDING ATTORNEYS’ FEES AND COSTS1
On May 21, 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 his request for attorneys’ fees and costs to respondent. During
informal discussions, respondent raised objections to certain items in petitioner’s application.
Based on these objections, petitioner amends his application for attorneys’ fees and costs to
request $31,357.53, consisting of $27,492.50 in attorneys’ fees and $3,865.03 in petitioner’s costs.
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-00826-UNJ Document 39 Filed 06/11/15 Page 2 of 2
Respondent does not object to this amount. The undersigned finds this amount to be reasonable.
Accordingly, the court awards:
a. $27,492.50, representing reimbursement for attorneys’ fees. The award shall be in
the form of a check payable jointly to petitioner and the Law Office of Myles Jacobson
for $27,492.50; and
b. $3,865.03, representing reimbursement for petitioner’s costs. The award shall be in
the form of a check payable to petitioner for $3,865.03.
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: May 21, 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