Joseph Bourche v. HHS - Hepatitis B, vasculitis, IgA nephropathy, endocarditis (2020)

Mari Bourche, as Personal Representative of the Estate of Joseph Bourche, filed a claim alleging that the hepatitis B vaccine administered to her husband on April 23, 2014, caused vasculitis, which in turn led to a staph infection, endocarditis, and ultimately his death on January 16, 2016. Mr.

Bourche, born in 1959, had pre-existing kidney disease requiring dialysis and a pacemaker for heart trouble prior to the vaccination. Petitioner's theory was that the vaccine induced immune complexes, leading to vasculitis, which allowed bacteria to enter his body, causing a heart valve infection (endocarditis) and contributing to his death.

Respondent argued that the hepatitis B vaccine does not cause vasculitis and that Mr. Bourche's conditions were more likely caused by his underlying IgA nephropathy, a staph infection, or a reaction to the antibiotic vancomycin.

The court found that the evidence did not preponderate in petitioner's favor. Key findings included that Mr.

Bourche did not develop vasculitis until June or July 2014, approximately two months after the vaccination, which was outside the medically acceptable timeframe for vaccine causation. Furthermore, skin biopsies did not show the expected IgG antibodies, undermining the immune complex theory.

The court also found that vancomycin was a more likely cause of the vasculitis, given the timing of its onset. Finally, the court determined that the endocarditis, even if vaccine-related, did not substantially contribute to Mr.

Bourche's death, as his cardiac function had fluctuated and he had multiple confounding health issues. Therefore, compensation was denied.