Pitey Morgan v. HHS - Influenza, longitudinally extensive transverse myelitis (LETM) / Neuromyelitis Optica Spectrum Disorder (NMOSD) (2020)

On October 7, 2015, Pitey Morgan filed a petition seeking compensation under the National Vaccine Injury Compensation Program, alleging that he developed longitudinally extensive transverse myelitis (LETM) as a result of an influenza vaccine received on October 16, 2012. Mr.

Morgan, who was 54 years old at the time of vaccination, had a history of lower back pain, radiculopathy, degenerative disc disease, and prostatitis predating the vaccination. Following the vaccination, he experienced a rapid decline in leg strength, urinary retention, and numbness.

Medical evaluations and imaging suggested an inflammatory process in the spinal cord. Initially, some treating physicians and Mr.

Morgan's expert, Dr. Carlo Tornatore, believed he had LETM, possibly caused by the flu vaccine through molecular mimicry.

However, respondent's expert, Dr. Subramaniam Sriram, and later treating physicians, concluded that Mr.

Morgan's condition was more consistent with Neuromyelitis Optica Spectrum Disorder (NMOSD), a chronic, relapsing demyelinating disease, despite negative tests for the typical AQP4-IgG antibodies. The Chief Special Master denied compensation on December 4, 2019, finding that the evidence preponderated in favor of an NMOSD diagnosis and that Mr.

Morgan failed to establish a reliable theory that the flu vaccine caused his NMOSD. The Special Master noted that while acute demyelinating conditions like TM are often monophasic, NMOSD is a chronic, relapsing condition, and that establishing a vaccine link to chronic demyelinating diseases is less consistent in program cases.

The Special Master found Mr. Morgan's proposed theory of molecular mimicry lacked sufficient evidence connecting it specifically to the flu vaccine and NMOSD.

The Special Master also found that the progression of Mr. Morgan's symptoms over several years was not reasonably attributable to the vaccination.

On review, the United States Court of Federal Claims affirmed the Special Master's decision on June 17, 2020. The court found the Special Master's determination that Mr.

Morgan suffered from NMOSD was not arbitrary or capricious, as it was supported by expert testimony and medical records, including evidence of dissemination in space and lesions in the periventricular region of the brain. The court also agreed that Mr.

Morgan failed to meet the burden of proof for causation under the Althen prongs, particularly regarding the link between the flu vaccine and a chronic demyelinating condition like NMOSD, and that his arguments did not demonstrate the Special Master's conclusion was wholly implausible. Petitioner was represented by Sylvia Chin-Caplan and Timothy J.

Mason, and respondent was represented by Joseph H. Hunt, C.

Salvatore D’Alessio, Catharine E. Reeves, Heather L.

Pearlman, and Zoe Wade. The decision was issued by Chief Special Master Brian H.

Corcoran and reviewed by Judge Ryan T. Holte.