Adina Small v. HHS - Influenza, Shoulder Injury Related to Vaccine Administration (SIRVA) / direct nerve trauma (2019)
Case summary [AI summaries can sometimes make mistakes]
Adina Small, a 72-year-old woman, filed a petition on May 11, 2015, alleging that her February 12, 2013, influenza vaccination caused a Shoulder Injury Related to Vaccine Administration (SIRVA) or a direct nerve injury. Petitioner claimed that immediately after the injection, she experienced pain radiating down her arm, which subsequently led to a limited range of motion and a "frozen shoulder." The respondent, the Secretary of Health and Human Services, argued that Ms.
Small had a pre-existing cervical spinal condition that caused pain radiating into her upper extremities and that she was actively treating for this condition around the time of her vaccination. Petitioner did not report any vaccine-related shoulder pain to her physicians until ten months after the vaccination.
Petitioner's neurologist, Dr. Nicholas Szumski, opined that the vaccine caused a nerve injury leading to frozen shoulder.
Respondent's expert, Dr. Jeffrey Allen Cohen, argued that Ms.
Small's symptoms were consistent with her pre-existing spinal condition and that a vaccine-induced nerve injury was unlikely. Special Master Daniel T.
Horner reviewed the case based on the written record, as the parties were unable to agree on a hearing date. He found that Ms.
Small failed to prove causation-in-fact under the Althen test. Specifically, the Special Master determined there was insufficient evidence of immediate injection-related pain, that any pain reported the day after vaccination was likely due to her pre-existing spinal condition, and that her pre-existing condition excluded her from meeting the criteria for a SIRVA.
Consequently, the petition was denied. Ms.
Small sought review of the Special Master's decision. The Court of Federal Claims, in a decision authored by Judge Richard A.
Hertling, affirmed the Special Master's decision, finding it was not arbitrary or capricious and that Ms. Small failed to prove causation under the Althen test for either a direct nerve injury or a SIRVA.
The court noted that Ms. Small's pre-existing spinal condition explained her symptoms and excluded her from the SIRVA definition.
The petition was denied.
Theory of causation
Petitioner Adina Small, age 72, alleged that her February 12, 2013, influenza vaccination caused a Shoulder Injury Related to Vaccine Administration (SIRVA) or a direct nerve injury. Petitioner's expert, neurologist Dr. Nicholas Szumski, opined that the vaccine caused an immediate injury to the lateral cutaneous nerve of the arm, leading to pain and subsequent development of frozen shoulder due to disuse. Respondent's expert, neurologist Dr. Jeffrey Allen Cohen, opined that petitioner's symptoms were consistent with her pre-existing cervical spinal stenosis and radiating pain, and that a vaccine-induced nerve injury was unlikely and not supported by the medical literature or petitioner's clinical course. Special Master Daniel T. Horner denied the claim, finding insufficient evidence of immediate post-vaccination shoulder pain and that the pain reported the day after vaccination was attributable to petitioner's pre-existing cervical condition. He also found that petitioner's pre-existing condition excluded her from meeting the SIRVA criteria. The Court of Federal Claims affirmed, agreeing that petitioner failed to establish causation-in-fact under the Althen test, specifically prong two (logical sequence of cause and effect), due to the lack of evidence of immediate injury and the strong evidence of a pre-existing condition explaining the symptoms. Petitioner's counsel was Ronald Craig Homer, and respondent's counsel was Lynn Christina Schlie. The decision was issued by Special Master Daniel T. Horner on December 2, 2019, and affirmed by Judge Richard A. Hertling on February 25, 2020. The claim was denied.
Source PDFs
USCOURTS-cofc-1_15-vv-00478