Kathy Castaneda v. HHS - DTaP, pediatric acute-onset neuropsychiatric syndrome (PANS) (2020)

On September 25, 2015, Kathy Castaneda filed a petition on behalf of her minor son, N.A.C., seeking compensation under the National Childhood Vaccine Injury Program. The petition alleged that N.A.C. developed Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) as a result of the Pentacel, MMR, Hepatitis A, and Prevnar 13 vaccinations he received on September 26, 2012.

N.A.C. was nearly five years old at the time of vaccination. The claim was for an "off-Table" injury, meaning causation had to be proven.

Petitioner presented expert testimony from Dr. Kiki Chang, who opined that the vaccinations triggered an inflammatory response via cytokines, which crossed the blood-brain barrier and targeted the basal ganglia, leading to PANS.

Respondent presented expert testimony from Dr. Donald Gilbert, who questioned the proposed mechanism and timing, suggesting that N.A.C. likely had an underlying autism spectrum disorder.

The Special Master denied entitlement on May 18, 2020, finding that Petitioner failed to establish a reliable medical theory of causation. Specifically, the Special Master found that Petitioner did not demonstrate the necessary level of cytokine production, how cytokines would cross the blood-brain barrier, or why the basal ganglia would be specifically targeted.

The Special Master also noted the lack of treating physician diagnoses linking the vaccines to the condition and the absence of any immediate post-vaccination reaction. The Court of Federal Claims, in a decision issued March 9, 2021, affirmed the Special Master's decision.

The court found that while the petitioner established PANS, the proposed theory of causation was not adequately supported by evidence and was contradicted by credible expert testimony. The court found the Special Master's conclusion that the petitioner failed to meet her burden of proof was not arbitrary or capricious.

The petition was dismissed.