Noemi Frette v. HHS - DTaP, epilepsy/partial-onset seizures allegedly following DTaP vaccine (2017)

On November 13, 2014, Noemi Frette filed a petition on behalf of her minor son, N.F., alleging that the diphtheria-tetanus-acellular pertussis (DTaP) vaccine administered on April 2, 2013, caused epilepsy with onset within approximately one week. N.F. was born on February 2, 2013.

The petition alleged that N.F. suffered an encephalopathic event less than 72 hours after vaccination, qualifying as a "Table" claim, but this was later abandoned in favor of a causation-in-fact claim. Petitioner's mother stated that after the DTaP vaccine, N.F. developed fever and fussiness for several days.

Approximately one week later, she reported that N.F. began pulling away while breastfeeding, exhibiting a "weird look" on his face, body stiffness, and a lack of responsiveness, appearing to be in a "semi-conscious daze." These episodes reportedly continued during nursing and sleep for several weeks. The mother also stated that beginning in June 2013, these episodes evolved into more pronounced episodes with eye widening and breathing without behavioral arrest, lasting up to one minute, occurring approximately 15 times a day.

The parents did not seek medical attention from Dr. Sotelo or any other provider for nearly two months after the vaccination, transferring care to Dr.

Mark Webb in May 2013. Dr.

Webb's contemporaneous medical records were sparse and often undated, noting normal growth and development at four, six, and nine-month visits, and deferral of vaccinations. These records did not document the symptoms described by the parents.

Dr. Webb's first record of seizure-like symptoms was on February 6, 2014, at the 12-month visit, describing "intermittent episodes of tensing of the body without clear loss of consciousness" occurring over the "last 2-3 months," lasting no more than 15 seconds.

He referred N.F. to pediatric neurology. In an undated letter filed later, Dr.

Webb stated his records were incomplete and that the parents had reported fever, fussiness, lack of response to stimuli, and body stiffness after the vaccination, but he also stated he had not seen anything before February 2014 that warranted a neurology referral. Pediatric neurologist Dr.

Korwyn Williams evaluated N.F. on March 6, 2014, recording the parents' account of onset in June 2013, with episodes of eye widening and gagging/breathing without behavioral arrest lasting up to five seconds, associated with a mechanical smile or grimace. Dr.

Williams noted N.F. had never had episodes of staring and unresponsiveness, myoclonus, or generalized convulsions. A March 15, 2014 MRI was unremarkable except for mildly low-lying cerebellar tonsils.

A March 18, 2014 EEG showed abnormal findings, including probable left posterior-onset focal seizure with motor semiology. N.F. was diagnosed with partial-onset epilepsy and started on oxcarbazepine.

Petitioner's expert, pediatric neurologist Dr. Anthony Rodrigues, opined that N.F. suffered fever, encephalopathy, and seizures within one week of the DTaP vaccine, proposing a cytokine-mediated mechanism involving disruption of the blood-brain barrier and microglial stimulation.

Respondent's expert, pediatric epilepsy specialist Dr. Elaine Wirrell, agreed that N.F. had epilepsy but disputed the early onset, emphasizing that DTaP is associated, if at all, with immediate febrile seizures rather than afebrile seizures beginning weeks or months later, and that infants with encephalopathy would exhibit profound and persistent altered consciousness.

Special Master Thomas L. Gowen denied compensation on December 29, 2017, finding the third Althen prong (timing) dispositive.

He gave greater weight to contemporaneous medical records and Dr. Williams's history, finding no reliable evidence of encephalopathy or seizures within a week of the vaccine.

The most reliable onset history was June 2013, approximately two months after vaccination, which Special Master Gowen found too late for DTaP to cause afebrile seizures. Because the onset foundation was unreliable, Dr.

Rodrigues's opinion failed, and the Special Master did not rule on the broader immune-mechanism arguments. No compensation was awarded.

Petitioner was represented by Andrew D. Downing of Van Cott & Talamante, PLLC.