Erin Quackenbush-Baker v. HHS - Influenza, significant aggravation of multiple sclerosis (2018)
Case summary [AI summaries can sometimes make mistakes]
Erin Quackenbush-Baker, a 36-year-old adult, filed a claim on October 16, 2014, alleging that a trivalent influenza vaccination received on November 20, 2013, significantly aggravated a pre-existing but asymptomatic case of multiple sclerosis (MS). The respondent elected to litigate the case.
Petitioner presented expert testimony from Dr. Lawrence Steinman, M.D., and respondent presented expert testimony from Dr.
Thomas Leist, M.D. An entitlement hearing was held on February 2, 2017, with testimony from the petitioner and both experts.
Following the hearing, Special Master Thomas L. Gowen issued a ruling on March 14, 2018, finding that the petitioner had established entitlement to compensation.
The Special Master determined that the petitioner had proven by a preponderance of the evidence that the flu vaccine caused-in-fact a significant aggravation of her MS, satisfying the six prongs of the Loving test for off-Table significant aggravation claims. The Special Master found that the petitioner's MS was likely latent before the vaccination and that the vaccine triggered a significant aggravation, supported by Dr.
Steinman's theory of molecular mimicry and a medically acceptable temporal relationship between the vaccination and the onset of symptoms. The respondent did not successfully prove that a factor unrelated to the vaccine was the principal cause of her injury.
A separate damages decision was issued on July 18, 2018. The parties stipulated to a total award of $1,100,466.81.
This award included a lump sum payment of $1,093,123.68 for life care expenses for the first year, lost earnings, pain and suffering, and past unreimbursable expenses. Additionally, a lump sum payment of $7,343.13 was made to satisfy a State of Arizona Medicaid lien.
The remainder of the award was to be used to purchase an annuity for future life care expenses, with non-medical items growing at 3% annually and medical items at 5% annually. The annuity payments were to be life-contingent.
Theory of causation
Petitioner Erin Quackenbush-Baker, age 36, received a trivalent influenza vaccination on November 20, 2013, and subsequently experienced a significant aggravation of pre-existing, asymptomatic multiple sclerosis (MS). Petitioner alleged an off-Table injury. The Special Master found entitlement based on Dr. Lawrence Steinman's theory of molecular mimicry, positing that homology between components of the Fluvirin vaccine and myelin proteins could trigger an autoimmune response leading to MS aggravation. This theory was supported by studies showing cross-reactivity between influenza virus hemagglutinin peptides and myelin proteins, and a medically acceptable temporal relationship (onset of symptoms approximately 40-41 hours post-vaccination) consistent with a recall immune response. The Special Master found that the petitioner's MS was likely latent before vaccination, and the vaccine triggered a significant increase in lesions and symptoms. Respondent's expert, Dr. Thomas Leist, argued against causation, citing lack of epidemiological evidence and suggesting prior symptomatic MS or unrelated factors. The Special Master rejected respondent's arguments, finding insufficient evidence of prior symptoms or unrelated causes. The case resulted in a stipulated award of $1,100,466.81, including lump sums for past expenses, lost earnings, pain and suffering, and a Medicaid lien, plus an annuity for future life care expenses. Special Master Thomas L. Gowen issued the entitlement ruling on March 14, 2018, and the damages decision on July 18, 2018. Attorneys for petitioner were Curtis R. Webb, and for respondent was Christine M. Becer.
Source PDFs
USCOURTS-cofc-1_14-vv-01000