R.S. v. HHS - Influenza, Guillain-Barré syndrome (GBS) and polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome (2020)

R.S., a 41-year-old female, received an influenza vaccine on October 1, 2013. She subsequently developed symptoms including weakness, numbness, and pain, initially diagnosed as probable Guillain-Barré Syndrome (GBS) and later Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).

Over time, her condition evolved, and she was diagnosed with Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Gammopathy, and Skin Changes (POEMS) syndrome in August 2014. Petitioner argued that the flu vaccine caused GBS, which in turn led to POEMS syndrome.

Petitioner's experts, Drs. Latov and Parekh, supported this theory, suggesting a mechanism of chronic immune stimulation.

Respondent's experts, Drs. Lipe and Bourdette, argued that petitioner's symptoms from the outset were indicative of POEMS syndrome, not GBS, and that the flu vaccine was unrelated.

The Special Master denied entitlement, finding that petitioner failed to prove by a preponderance of the evidence that she suffered from GBS as a precursor to POEMS. The Special Master found the respondent's experts' opinions more persuasive, concluding that petitioner's symptoms were more consistent with POEMS syndrome from the beginning.

Furthermore, the Special Master found that petitioner failed to establish a sound and reliable medical theory linking the flu vaccine to GBS and subsequently to POEMS, noting that the proposed mechanism was novel and unsupported by sufficient scientific evidence. This decision was affirmed on review by the Court of Federal Claims, which found the Special Master's findings were not arbitrary or capricious.