Paul Mondello v. HHS - Hepatitis A, seizure disorder (2018)
Case summary [AI summaries can sometimes make mistakes]
Paul Mondello, born October 2, 1943, received a Twinrix hepatitis A and B vaccine on November 15, 2013. He subsequently developed a seizure disorder.
The initial petition was dismissed by the Special Master for lack of evidence of causation. The petitioner appealed, and the Court of Federal Claims reversed, finding that there was at least some evidence suggesting a theory of causation and that the Special Master had erred in assigning the burden of disproving alternative causes to the petitioner.
The case was remanded for further proceedings. On remand, the Special Master heard testimony from Mr.
Mondello and his treating neurologist, Dr. Suzanne Bourque.
Dr. Bourque opined that the vaccine, in combination with Mr.
Mondello's comorbidities and the subsequent administration of cyproheptadine, contributed to his seizures. Respondent presented an expert, Dr.
Thomas Leist, who disagreed, attributing the seizures solely to cyproheptadine and finding no evidence of a vaccine reaction or aseptic meningitis. After considering the evidence, including testimony and expert reports, Special Master Mindy Michaels Roth found that Mr.
Mondello was entitled to compensation, satisfying the Althen prongs for causation. The parties subsequently reached a stipulation for damages, and on April 16, 2018, the court awarded Mr.
Mondello $50,995.29 in compensation. Petitioner was represented by Verne E.
Paradie, Jr., and respondent was represented by Darryl R. Wishard.
The Special Master was Mindy Michaels Roth.
Theory of causation
Paul Mondello, born 10/02/1943, received a Hepatitis A vaccine on 11/15/2013. He developed a seizure disorder. The Special Master initially dismissed the claim for lack of causation. The Court of Federal Claims reversed, remanding for further proceedings. On remand, petitioner's treating neurologist, Dr. Suzanne Bourque, testified that the Hepatitis A vaccine, in combination with Mr. Mondello's comorbidities (including prior head injury, alcoholism, and chronic pain) and the subsequent administration of cyproheptadine, lowered his seizure threshold and triggered the seizures. Dr. Bourque suspected aseptic meningitis as a possible vaccine reaction, evidenced by elevated CSF protein, headache, nausea, and vomiting. Respondent's expert, Dr. Thomas Leist, opined that cyproheptadine was the sole cause of the seizures and that there was no evidence of a vaccine reaction or aseptic meningitis. Dr. Leist attributed Mr. Mondello's symptoms in the week following vaccination to his comorbidities. Special Master Mindy Michaels Roth found Dr. Bourque's opinion more compelling, concluding that the Hepatitis A vaccine, in combination with comorbidities and cyproheptadine, caused the seizures, satisfying the Althen prongs. Petitioner was awarded $50,995.29 in a lump sum. Attorneys for petitioner were Verne E. Paradie, Jr., and for respondent was Darryl R. Wishard. Decision date: 04/16/2018.