Hannah Combs v. HHS - HPV, vasovagal/reflex syncope (2018)

Filed 2014-09-22Decided 2018-02-15Vaccine HPV
denied

Case summary [AI summaries can sometimes make mistakes]

On September 22, 2014, Jenny Howard filed a petition on behalf of her minor daughter, Hannah Combs, seeking compensation under the National Vaccine Injury Compensation Program. The petition alleged that doses of the Human Papillomavirus (HPV) vaccine administered on November 9, 2011, February 3, 2012, and September 13, 2012, caused Hannah Combs to develop vasovagal/reflex syncope.

At the time of her first vaccination, Hannah was 13 years old and had a medical history including polycystic ovarian disease, hirsutism, hypothyroidism, anxiety, depression, and post-traumatic stress disorder. Her medical records document various episodes of feeling faint, dizziness, and actual fainting, with diagnoses including vasovagal reaction, hypoglycemia, and panic attacks.

Petitioner's expert, Dr. Patrick Nemechek, opined that the HPV vaccine caused autonomic damage leading to syncope.

However, his qualifications and the scientific basis for his theory were challenged. Respondent's expert, Dr.

Phillip Low, a neurologist specializing in autonomic disorders, testified that Petitioner's symptoms were consistent with vasovagal syncope of unknown etiology and that there was no evidence of true damage to her autonomic nervous system caused by the vaccine. Special Master Brian H.

Corcoran presided over the entitlement hearing. The Special Master found Petitioner's causation theory to be scientifically unreliable and unpersuasive.

The medical records did not establish a logical sequence of cause and effect linking the vaccine to her syncope. Therefore, Hannah Combs was denied entitlement to a vaccine injury award.

Petitioner was represented by Andrew D. Downing of Van Cott & Talamante, and Respondent was represented by Debra A.

Begley of the U.S. Department of Justice.

Theory of causation

Petitioner alleged that the HPV vaccine caused autonomic damage leading to vasovagal/reflex syncope. Petitioner's expert, Dr. Patrick Nemechek, opined that the HPV vaccine could damage the autonomic nervous system through microglial activation and chronic cytokine production, leading to hypoglycemia and subsequent syncope. Respondent's expert, Dr. Phillip Low, a neurologist specializing in autonomic disorders, testified that Petitioner's symptoms were consistent with vasovagal syncope of unknown etiology and that there was no evidence of true damage to her autonomic nervous system caused by the vaccine. Dr. Low found Dr. Nemechek's theory regarding microglial activation and cytokine production to be scientifically unreliable and unsupported by the medical literature. The Special Master found Petitioner's causation theory to be scientifically unreliable and unpersuasive, and that the medical records did not establish a logical sequence of cause and effect linking the vaccine to her syncope. The claim was denied. Petitioner was represented by Andrew D. Downing and Respondent by Debra A. Begley. Special Master Brian H. Corcoran issued the decision on February 15, 2018.

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