M.H. v. HHS - MMR, acute disseminated encephalomyelitis (ADEM) (2019)

Heather Spracklen and Joe Higgins, on behalf of M.H., a minor, filed a petition under the National Childhood Vaccine Injury Act of 1986, alleging that the measles-mumps-rubella (MMR) vaccine administered on May 10, 2013, caused M.H. to develop acute disseminated encephalomyelitis (ADEM). M.H. was born on April 26, 2012, with intrauterine growth restriction and low birth weight.

Her development was reportedly normal through her twelve-month checkup, at which time she received the MMR vaccine. On May 27, 2013, M.H. experienced an episode where she seemed to go limp, and she was taken to Stillwater Medical Center.

The following morning, she appeared to have a seizure and was transported to Saint Francis Hospital due to an inability to move her arms or legs or lift her head. A brain MRI was normal, but a cervical spine MRI revealed a large lesion.

Neurologist Dr. David Siegler diagnosed quadriplegia, suspected an infectious or inflammatory process, and initiated steroid treatment.

M.H. was later diagnosed with transverse myelitis by several treating physicians, including Dr. Siegler and Dr.

Michael Chang, an infectious disease specialist. Dr.

Chang noted that M.H. had not suffered any preceding illness and stated he would report the case to the Vaccine Adverse Events Reporting System (VAERS), though he considered a vaccine causation unlikely. M.H. underwent rehabilitation and continued to receive medical care, with later medical records noting weakness and delayed speech and language skills.

Petitioners retained neurologist Dr. Steven Lovitt, who opined that M.H. suffered from ADEM.

The respondent retained pediatric neurologist Dr. Peter Bingham, who disagreed with the ADEM diagnosis.

A hearing was held on February 8, 2019, after which Special Master Christian J. Moran directed the parties to focus on the ADEM diagnosis.

In a decision dated July 31, 2019, Special Master Moran denied compensation. He found that the petitioners had not proven by a preponderance of the evidence that M.H. suffered from ADEM.

The Special Master noted that M.H.'s treating doctors consistently diagnosed her with transverse myelitis and did not diagnose ADEM. Furthermore, the Special Master found that Dr.

Lovitt's opinion was not consistent with the medical records, particularly the absence of abnormalities on M.H.'s brain MRIs, which are a key criterion for ADEM. The Special Master also found that the evidence did not persuasively support a finding of encephalopathy, another required criterion for ADEM.

Finally, the Special Master determined that M.H.'s current disabilities, including speech and language delays, were not necessarily due to ADEM and that their delayed onset was inconsistent with the typical acute presentation of ADEM. As the threshold diagnosis of ADEM was not established, the Special Master did not analyze causation under the Althen prongs.

Petitioners were represented by John Robert Howie Jr., and respondent was represented by Darryl R. Wishard.

No compensation was awarded.