Peter C. Harrington v. HHS - Influenza, Guillain-Barré syndrome (GBS) (2018)

On July 17, 2015, Peter C. Harrington filed a petition seeking compensation under the National Vaccine Injury Compensation Program, alleging that the influenza vaccine he received on October 24, 2014, caused him to develop Guillain-Barré syndrome (GBS).

Mr. Harrington, age 40, had a history of hypertension, allergies, abdominal pain, and obesity, and had been treated for a sore throat, nasal congestion, body aches, and headaches the week prior to vaccination.

Thirteen days after the vaccination, on November 6, 2014, he presented to the emergency room with complaints of heaviness, shortness of breath, and muscle weakness. He was diagnosed with anxiety, dysrhythmia, dehydration, anemia, and an electrolyte imbalance.

He was admitted to the hospital on November 10, 2014, with persistent muscle weakness, discoordination, and dysphagia, and was evaluated by neurologist Dr. Marcus Schmitz, who considered the possibility of acute inflammatory polyneuropathy related to the vaccine but expressed skepticism about a GBS diagnosis.

Diagnostic tests, including a lumbar puncture showing slightly elevated protein and normal white blood cell count, and MRIs of the brain and spinal cord, did not confirm GBS. He was treated with steroids and discharged on November 14, 2014, with a likely diagnosis of post-viral syndrome.

He experienced a second hospital visit on November 18, 2014, for malaise and weakness, but no concerning problems were noted. He was seen by neurologist Dr.

Henry Porter on November 19, 2014, who noted normal MRIs and stated that Petitioner's physical examinations were not consistent with GBS, though he included GBS as a possible diagnosis. Petitioner continued to experience symptoms and was diagnosed with anemia and vitamin B12 deficiency by Dr.

Porter. By December 2014, a third neurologist, Dr.

David Bear, found all nerve conduction studies to be within normal limits and no evidence of diffuse peripheral polyneuropathy. None of Mr.

Harrington's treating physicians concluded he had GBS. On January 14, 2015, Dr.

Porter noted Petitioner's symptoms had "completely resolved" and attributed them to weakness dating back to October 2014, with low B12 levels being treated. Subsequent records in 2015 and 2016 continued to note B12 deficiency, hypertension, fatigue, and paresthesia, but no GBS diagnosis or connection to the flu vaccine.

Petitioner stated that his neurologists did not treat him for GBS because his symptoms were not typical and test results were not definitive, and he felt they were trying to avoid reporting it. He continued to experience fatigue, jaw weakness, tingling, body aches, difficulty concentrating, and mood changes, with normal test results.

Petitioner's expert, Dr. William Shackelford, opined in two reports that Petitioner had a "typical Guillain-Barré reaction" caused by the flu vaccine, stating that treaters could find "no other cause" for his symptoms.

Dr. Shackelford's reports were found to be conclusory and unsupported by scientific literature.

Respondent's expert, Dr. Jeffrey Cohen, a neurologist, concluded that Petitioner's symptoms were inconsistent with GBS based on established diagnostic criteria, noting that Petitioner never displayed bilateral flaccid paralysis, had normal strength on examination, lacked decreased or absent reflexes, and experienced fluctuating symptoms inconsistent with the GBS nadir.

Dr. Cohen suggested Petitioner's symptoms could be attributed to anxiety with hyperventilation.

Special Master Brian H. Corcoran denied entitlement, finding that Petitioner failed to establish he had GBS or that the vaccine caused his symptoms.

The Special Master found Dr. Shackelford's opinion unpersuasive and conclusory, and Dr.

Cohen's opinion credible. The Special Master noted that while GBS was added to the Vaccine Injury Table for the flu vaccine after the petition was filed, Petitioner had not established he actually had GBS.

The Special Master also found Petitioner failed to satisfy the three prongs of the Althen test for non-Table injuries, as Dr. Shackelford's causation theory was unreliable and unsupported, and there was no logical sequence of cause and effect demonstrated.

Petitioner appealed the Special Master's decision. Senior Judge Mary Ellen Coster Williams of the Court of Federal Claims affirmed the Special Master's decision, finding that Petitioner failed to establish he had GBS for a Table claim and failed to establish causation in fact for a non-Table claim.

The Court found the Special Master's assessment of the expert testimony, particularly the unpersuasiveness of Dr. Shackelford and the credibility of Dr.

Cohen, was not arbitrary or capricious. The Court also noted that the absence of an alternate explanation does not establish causation.

Petitioner's claim was denied.