Shawn Orgel-Olson v. HHS - Td/Tetanus, Sweet’s syndrome and serum sickness (2022)

On March 19, 2015, Shawn Orgel-Olson, a 25-year-old man, filed a petition alleging that he suffered neurological injuries as a result of receiving Tetanus/Diphtheria (Td) and Hepatitis A vaccinations on August 3, 2012. Petitioner later narrowed his claim to allege that his diagnoses were Sweet’s syndrome and serum sickness.

Because these conditions are not listed on the Vaccine Injury Table, Petitioner was required to prove causation-in-fact under the Althen standard. Petitioner's expert, neurologist Dr.

Carlo Tornatore, opined that Mr. Orgel-Olson suffered from post-vaccinal Sweet’s syndrome and serum sickness, both caused by the vaccinations.

Dr. Tornatore testified that Sweet's syndrome is an autoinflammatory condition involving aberrant control of the innate immune response, and that a neurological form, "Neuro-Sweet syndrome," can affect the nervous system, most commonly causing aseptic meningitis or encephalitis.

He also opined that serum sickness is a Type III hypersensitivity reaction caused by immune complex deposition. Petitioner's treating physicians noted a variety of symptoms including dizziness, neck pain, head pressure, fatigue, joint pain, and rashes.

Several physicians suspected a vaccine reaction, but no definitive unifying diagnosis was consistently reached. Petitioner's rash biopsy showed "sparse perivascular infiltrate with neutrophils," which petitioner's expert considered evidence of inflammation, but respondent's experts argued was non-specific and insufficient for a diagnosis of Sweet's syndrome.

Respondent's experts, neurologist Dr. Phillip Low, dermatologist Dr.

Michael Girardi, and immunologist Dr. You-Wen He, disputed Petitioner's diagnoses and causation theory.

Dr. Low concluded that Petitioner's symptoms were typical of deconditioning and that his autonomic testing was normal, refuting claims of autonomic neuropathy.

Dr. Girardi opined that Petitioner's rashes were most consistent with hives and that there was no evidence of Sweet's syndrome or serum sickness, citing the lack of characteristic lesions, fever, and inflammatory markers.

Dr. He also concluded that Petitioner did not suffer from serum sickness or Sweet's syndrome, noting the absence of fever, rash at the time of initial examination, and inflammatory markers, and that Petitioner's symptoms were inconsistent with the self-limiting nature of serum sickness.

Special Master Daniel T. Horner found that Petitioner failed to establish by a preponderance of the evidence that he suffered from Sweet's syndrome or serum sickness, or that these conditions were caused by the vaccinations.

The Special Master noted that Petitioner's rashes were not consistent with the characteristic painful, fixed plaques of Sweet's syndrome, and the biopsy showed only sparse neutrophil infiltrate, which is not diagnostic. Furthermore, Petitioner lacked fever and inflammatory markers, which are hallmarks of Sweet's syndrome and serum sickness.

The Special Master also found that Petitioner's initial symptoms were not sufficient to establish aseptic meningitis, a key component of the neuro-Sweet's syndrome variant. The Special Master concluded that the suspicion of vaccine causation among treating physicians was largely based on temporality and the lack of a unifying diagnosis, and that Petitioner's expert's opinion was vague and inconsistent.

Consequently, the petition was dismissed.