P.H. v. HHS - Rotavirus, intussusception with recurrent obstruction, surgeries, diarrhea, anemia, and scarring (2017)

On November 14, 2014, Ashley Puroll, as parent and natural guardian of her son, P.H., filed a petition for compensation under the National Vaccine Injury Compensation Program. She alleged that P.H. suffered intussusception requiring surgical intervention, caused by the rotavirus vaccine administered on August 12, 2014.

P.H. was born on June 2, 2014. Early medical records noted feeding issues and gas.

At his two-month well-child visit on August 12, 2014, he had no recent illness and received several immunizations, including the rotavirus vaccine. On August 17, 2014, P.H. began vomiting and refusing to eat, leading to an emergency room visit on August 18, 2014, where he was discharged with instructions to follow up.

When his condition did not improve, he was taken to another hospital, where an abdominal x-ray suggested a small-bowel obstruction. He was transferred to DeVos Children's Hospital.

On August 19, 2014, an upper GI study indicated a distal bowel obstruction. An air enema failed to reduce the intussusception, and P.H. underwent exploratory surgery, during which approximately four centimeters of bowel, including the distal ileum, and his appendix were removed.

He initially recovered but later experienced dysphagia and diarrhea. The respondent conceded that the rotavirus vaccine caused P.H.'s intussusception, that the timing was medically appropriate, and that no other alternate cause was identified.

An initial damages award in June 2015 was withdrawn due to unexpected complications. P.H. experienced vomiting and watery diarrhea for six to eight weeks, followed by abdominal distention and cessation of passing gas.

He underwent a second exploratory surgery on June 21, 2015, where multiple adhesions were removed. He subsequently developed a C. difficile infection, treated with antibiotics, and was hospitalized for nine days.

On October 4, 2015, he underwent a third surgery for bowel obstruction, during which approximately sixteen centimeters of bowel were removed, and adhesions were addressed. P.H. continued to struggle with diarrhea, diaper dermatitis, abdominal pain, scarring, and iron deficiency anemia.

Gastroenterologist Dr. Andrew Singer attributed the diarrhea to diminished bile absorption following the removal of the terminal ileum.

Dr. Peter Freswick noted other possible causes, including sugar malabsorption, but later testing indicated that while P.H. absorbed iron well, the volume of diarrhea affected his ability to absorb it.

P.H.'s mother described daily diarrhea, frequent diaper rash, pain from surgical scarring, and self-consciousness about his abdominal scar. Chief Special Master Nora Beth Dorsey issued an entitlement ruling on October 14, 2016, and a reissued published damages decision on July 28, 2017.

She awarded a total of $293,930.96, comprising $250,000.00 for actual pain and suffering (the Vaccine Act maximum), $20,910.21 for a State of Michigan Medicaid lien payment, and $23,020.75 for another State of Michigan Medicaid lien payment. The Special Master found that P.H.'s three surgeries, C. difficile infection, anemia, persistent diarrhea, dermatitis, abdominal pain, and scarring warranted the maximum pain-and-suffering award.

Petitioner was represented by Paul R. Brazil of Muller Brazil, LLP.