{"package_id":"USCOURTS-cofc-1_15-vv-01066","decision_granule_id":"USCOURTS-cofc-1_15-vv-01066-3","petitioner_identifier":"N.A.C.","is_minor":1,"age_at_vaccination":4.97,"age_unit_raw":"years","vaccine_type":"Pentacel","vaccination_date":"2012-09-26","condition_raw":"pediatric acute-onset neuropsychiatric syndrome (PANS)","condition_category":"encephalitis_encephalopathy","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2020-05-18","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:39:16.329267+00:00","number_of_concurrent_vaccines":3,"dose_number":null,"time_to_onset_days":0,"theory_of_causation":"Petitioner alleged that N.A.C., aged 4.97 years, developed Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) following vaccinations with Pentacel, MMR, Hepatitis A, and Prevnar 13 on September 26, 2012. Petitioner's expert, Dr. Kiki Chang, proposed an off-Table theory of causation involving a vaccine-induced inflammatory response. This theory posited that vaccinations trigger cytokine production, leading to increased permeability of the blood-brain barrier, allowing cytokines to cross into the brain and target the basal ganglia, resulting in PANS. Dr. Chang cited studies suggesting a link between inflammation and psychiatric disorders and noted that PANS requires acute onset of symptoms. Respondent's expert, Dr. Donald Gilbert, countered that the proposed mechanism was unlikely, citing the short timeframe between vaccination and symptom onset (approximately 30 hours) as implausible for such a cascade. Dr. Gilbert also suggested N.A.C. may have had underlying autism spectrum disorder and questioned the scientific basis and diagnostic criteria for PANS. The Special Master denied entitlement, finding that Petitioner failed to establish a sound and reliable medical theory of causation under the Althen standard. Specifically, the Special Master found a lack of evidence regarding the level of cytokine production, the mechanism by which cytokines would cross the blood-brain barrier, and why the basal ganglia would be specifically targeted. The Special Master also noted the absence of treating physician opinions linking the vaccines to the condition and the lack of post-vaccination reactions. The Court of Federal Claims affirmed, agreeing that the petitioner failed to meet her burden of proof regarding causation, finding the proposed theory inadequately supported and contradicted by credible expert testimony. The court noted that while the petitioner established PANS, the theory of causation failed on all three Althen prongs. The petition was dismissed.","is_death":0,"date_of_death":null,"petition_filed_date":"2015-09-25","case_summary":"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.","is_minor_inferred":null,"is_pediatric_broad":1,"special_master":"Katherine E. Oler","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Andrew D. Downing","petitioner_attorney_firm":"Van Cott & Talamante, PLLC","petitioner_attorney_location":"Phoenix, AZ","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|andrew-downing|","firm_canonical_key":"van-cott-and-talamante","package_title":"CASTANEDA v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01066","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01066.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01066.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_15-vv-01066-0","title":"CASTANEDA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 12/19/2016) regarding 37 DECISION of Special Master - Interim Attorney's Fees Signed by Special Master Laura D Millman. (tlf) Copy to parties.","date_issued":"2017-01-13","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_15-vv-01066-1","title":"CASTANEDA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 6/21/2019) regarding 92 DECISION of Special Master - Interim Attorneys' Fees. Signed by Special Master Katherine E. Oler. (dd) Service on parties made.","date_issued":"2019-08-26","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_15-vv-01066-2","title":"CASTANEDA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"**RE-DOCKETED 112 TO CORRECT FILING ERROR** PUBLIC DECISION (Originally filed: 5/18/2020) regarding 107 DECISION of Special Master. Signed by Special Master Katherine E. Oler. (sl) Service on parties made.","date_issued":"2020-07-08","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_15-vv-01066/granules/USCOURTS-cofc-1_15-vv-01066-2/pdf","pdf_bytes":573971,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'decision of special master'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_15-vv-01066/USCOURTS-cofc-1_15-vv-01066-2"},{"granule_id":"USCOURTS-cofc-1_15-vv-01066-3","title":"CASTANEDA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"JUDGE VACCINE REPORTED OPINION re: 117 Order on Motion for Review, Judge Vaccine Order/Opinion Signed by Senior Judge Eric G. Bruggink. (jpk1) Service on parties made.","date_issued":"2021-03-09","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_15-vv-01066/granules/USCOURTS-cofc-1_15-vv-01066-3/pdf","pdf_bytes":350594,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_15-vv-01066/USCOURTS-cofc-1_15-vv-01066-3"},{"granule_id":"USCOURTS-cofc-1_15-vv-01066-4","title":"CASTANEDA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 03/15/2021) regarding 122 DECISION of Special Master - Fees Signed by Special Master Katherine E. Oler. (kp) Service on parties made.","date_issued":"2021-04-20","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}