{"package_id":"USCOURTS-cofc-1_15-vv-01146","decision_granule_id":"USCOURTS-cofc-1_15-vv-01146-0","petitioner_identifier":"Jessica Reape","is_minor":0,"age_at_vaccination":30.0,"age_unit_raw":"years","vaccine_type":"influenza","vaccination_date":"2012-09-25","condition_raw":"Tourette\n\nsyndrome","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2017-04-04","extraction_version":"gemini-v2","extracted_at":"2026-04-30T04:49:20.676131+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":17,"theory_of_causation":"Petitioner Jessica Reape, age 30, received an influenza (Flumist) vaccine on September 25, 2012, and alleged it caused Tourette's syndrome (TS) with onset approximately 17 days later. Petitioner's expert, Dr. Rosario Trifiletti, proposed an off-Table theory that a PARP1 gene mutation caused a haploinsufficiency, impairing glutamate regulation and leading to excitotoxicity and TS. He noted the Flumist vaccine contained glutamate. Respondent's expert, Dr. Donald Gilbert, disputed this theory, stating one mutation does not cause disease and that the theory was speculative and biologically inaccurate. Dr. Gilbert concluded Petitioner suffered from a psychogenic movement disorder. The Special Master, Herbrina Sanders, found Dr. Trifiletti's theory lacked a reliable medical basis and a logical sequence of cause and effect, and that the majority of medical evidence supported a psychogenic disorder. The petition was denied for insufficient proof of causation. Petitioner was represented by Daniel J. Mannix, and Respondent by Christine M. Becer. Decision date: April 4, 2017.","is_death":0,"date_of_death":null,"petition_filed_date":"2015-10-07","case_summary":"On October 7, 2015, Jessica Reape filed a petition under the National Vaccine Injury Compensation Program, alleging that the Flumist influenza vaccine she received on September 25, 2012, caused her to develop Tourette's syndrome (TS). Petitioner, who was 30 years old at the time of vaccination, reported that approximately 17 days later, she began experiencing uncontrollable muscle movements and vocal tics. Her past medical history included depression and anxiety, and she reported a family history of seizure disorder and a sister diagnosed with probable multiple sclerosis. Petitioner's initial presentation to her primary care physician, Dr. Karen Williams, noted that her symptoms were exacerbated by anxiety, and Dr. Williams observed that the movements ceased when Petitioner was not being observed. Dr. Williams prescribed alprazolam. Later that day, Petitioner presented to an emergency room with worsening symptoms, where she received valium, which suppressed the movements. The evaluating neurologist, Dr. Izadyar, noted atypical features for TS, including the late age of onset and rapid progression, and considered somatoform disorders in the differential diagnosis. Petitioner was discharged with a primary diagnosis of \"Abnormal jerking and walking movements and vocal tics, potentially secondary to TS versus a psychogenic disorder.\" She was prescribed clonazepam and zoloft. Petitioner subsequently sought answers through her own research and consulted with Dr. Rosario Trifiletti, a pediatric neurologist. Dr. Trifiletti ordered lab tests, some of which showed elevated titers for Coxsackie and EBV, and he suspected an infection activated by the flu vaccine. He recommended treatment with Biaxin and Valtrex, after which Petitioner reported significant improvement and resolution of symptoms. However, her symptoms recurred, and she continued to experience them, particularly after consuming certain foods. Dr. Trifiletti later proposed a theory that Petitioner had a PARP1 gene mutation, leading to a haploinsufficiency that impaired her ability to regulate glutamate, which was present in the Flumist vaccine. He posited that this led to glutamate excitotoxicity, infection, and the onset of tics. Petitioner also had an NLN gene mutation noted, which Dr. Trifiletti mentioned could relate to Tourette's, but did not incorporate into his causation theory. Petitioner's counsel, Daniel J. Mannix of Muller, Mannix & Hobbs, PLLC, filed a Motion for Decision on the Record. Respondent's counsel, Christine M. Becer of the United States Department of Justice, argued that Petitioner failed to meet the burden of proof under the Althen standard. Respondent presented an expert, Dr. Donald Gilbert, a pediatric neurologist and movement disorder specialist, who disputed Dr. Trifiletti's theory, calling it speculative and biologically inaccurate. Dr. Gilbert concluded that Petitioner suffered from a psychogenic movement disorder, a physical symptom of anxiety, and pointed to the opinions of other physicians who diagnosed her with conversion disorder. Special Master Herbrina Sanders reviewed the case on the record. The Special Master found that Dr. Trifiletti's theory lacked a reliable medical basis and a logical sequence of cause and effect. The medical records and expert opinions, particularly those of Dr. Gilbert and Dr. Mihaila (a movement disorder specialist who saw Petitioner during her acute illness and maintained his opinion of a non-organic cause), largely pointed towards a psychogenic disorder rather than a vaccine reaction. The Special Master noted that while there was a temporal proximity between the vaccination and symptom onset, it was insufficient to establish causation. The petition was denied for insufficient proof of causation, and the case was dismissed.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Herbrina Sanders Young","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Daniel J. Mannix","petitioner_attorney_firm":"Muller, Mannix & Hobbs, PLLC","petitioner_attorney_location":"Glen Falls, NY","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|daniel-mannix|","firm_canonical_key":"muller-mannix-and-hobbs","package_title":"REAPE v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01146","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01146.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01146.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_15-vv-01146-0","title":"REAPE v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 3/3/2017) regarding 40 DECISION of Special Master. Signed by Special Master Herbrina Sanders. (jk) Copy to parties.","date_issued":"2017-04-04","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_15-vv-01146/granules/USCOURTS-cofc-1_15-vv-01146-0/pdf","pdf_bytes":393117,"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-01146/USCOURTS-cofc-1_15-vv-01146-0"},{"granule_id":"USCOURTS-cofc-1_15-vv-01146-1","title":"REAPE v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 6/30/2017) regarding 46 DECISION of Special Master - Fees. Signed by Special Master Herbrina Sanders. (jk) Copy to parties.","date_issued":"2017-07-24","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}