{"package_id":"USCOURTS-cofc-1_16-vv-00701","decision_granule_id":"USCOURTS-cofc-1_16-vv-00701-2","petitioner_identifier":"Lisa Antalosky","is_minor":0,"age_at_vaccination":41.0,"age_unit_raw":"years","vaccine_type":"influenza","vaccination_date":"2014-10-15","condition_raw":"advanced obstructive lung disease secondary to constrictive bronchiolitis","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"compensated","award_amount_usd":1078449,"decision_date":"2023-11-02","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:43:16.367876+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":0,"theory_of_causation":"Petitioner Lisa Antalosky, age 41, received an influenza vaccine on October 15, 2014. She alleged that a sub-clinical viral infection, combined with the flu vaccine, caused her to develop advanced obstructive lung disease secondary to constrictive bronchiolitis. Petitioner's expert, Dr. Eric Gershwin, proposed a theory of cytokine-driven bystander activation, positing that the viral infection caused initial inflammation and cytokine production in her lungs, and the flu vaccine then triggered bystander cells, leading to a cascading inflammatory response and chronic lung damage. Respondent's experts, Dr. Derek Byers and Dr. Emil Bardana, argued that the vaccine was irrelevant and that a viral infection or other inhaled injury was the likely cause, finding no scientific support for the vaccine-induced causation theory. Special Master Katherine E. Oler, in a Ruling on Entitlement dated March 23, 2022, found that Petitioner met her burden of proof under the Althen standard, establishing a sound medical theory, a logical sequence of cause and effect, and a proximate temporal relationship between the vaccination and her injury. The parties subsequently stipulated to damages, and on November 2, 2023, Special Master Oler issued a Decision Awarding Damages, granting a total of $1,078,449.55, comprising a lump sum for first-year life care expenses, lost earnings, pain and suffering, and past unreimbursable expenses, with the remainder to be paid via a life-contingent annuity for future life care needs.","is_death":0,"date_of_death":null,"petition_filed_date":"2016-06-16","case_summary":"On June 16, 2016, Lisa Antalosky filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered from advanced obstructive lung disease secondary to constrictive bronchiolitis following receipt of her October 15, 2014, influenza vaccine. Petitioner, born in 1973, was 41 years old at the time of vaccination. Prior to October 2014, her medical history included hypothyroidism, seasonal allergies, anxiety/depression, and irritable bowel syndrome. She had experienced bronchitis in middle school and pneumonia at age 12. In January 2012, she was treated for an acute upper respiratory infection with acute bronchospasm and prescribed an albuterol inhaler. She had received four prior seasonal influenza vaccinations. \n\nFollowing her October 15, 2014, flu vaccination, Petitioner reported experiencing wheezing within hours, which progressed to a cough and shortness of breath over the following weeks. She was evaluated by her primary care physician on November 29, 2014, and prescribed prednisone and albuterol. On December 1, 2014, she presented to the emergency department with shortness of breath, which had progressively worsened since a presumed upper respiratory infection that started several weeks prior. She was found to be hypoxic with diminished lung sounds and diffuse expiratory wheezing. Testing for various viruses was negative. She was admitted to the hospital and discharged on December 5, 2014, with resolved hospital problems including acute bronchospasm, viral illness, hypoxia, and wheezing. She was instructed to continue oral steroids and started on Advair, duo-nebulizers, and Albuterol. \n\nHer condition continued to worsen, and she was seen by a pulmonologist, Dr. Simonelli, on December 17, 2014. He noted worsening wheezing, chest tightness, and dyspnea following the flu vaccination. Spirometry revealed severe airflow obstruction. He suspected bronchiolitis and recommended continued treatment with prednisone and other medications. Petitioner was admitted to the hospital again on December 22, 2014, due to worsening breathing. She was discharged on December 24, 2014, with a higher dose of prednisone. Her condition did not improve, and further testing, including a lung biopsy on February 4, 2015, revealed evidence of acute and chronic bronchiolitis with peribronchiolar aggregates of foamy histiocytes, rare poorly formed granuloma, peribronchiolar metaplasia, and patchy mild interstitial fibrosis. On February 18, 2015, Dr. Simonelli diagnosed her with constrictive bronchiolitis, noting that while the cause was unknown, the temporal relationship to the flu vaccine was provocative. \n\nPetitioner was evaluated at the University of Pennsylvania in March 2015, where she was assessed with advanced obstructive lung disease secondary to constrictive bronchiolitis, likely related to a recent respiratory viral infection. She was evaluated for lung transplantation. Her condition continued to deteriorate, leading to hospitalizations and further diagnostic procedures. On May 27, 2015, her discharge summary from the University of Pennsylvania Hospital noted biopsy-proven bronchiolitis obliterans, suspected to have an underlying autoimmune etiology (response to flu immunization, +ANA). She was considered a candidate for lung transplantation. Further evaluations revealed necrotizing granulomatous inflammation compatible with mycobacterial infection, and she was diagnosed with Mycobacterium avium complex infection. \n\nPetitioner's pulmonologist, Dr. Mehta, described her condition as very severe but stable in November 2018. In January 2019, Petitioner related that she had a flu vaccination in 2014 which led to pulmonary mycobacterium avium infection which has caused permanent damage to her lungs. She stated she uses oxygen daily. In April 2019, the influenza vaccine was listed as an allergy that caused lung damage in her records. \n\nPetitioner testified that she was in good health prior to her vaccination and noticed a slight wheeze the day after, followed by a dry cough and shortness of breath. She stated that Dr. Simonelli told her the most likely cause for her lung disease was a reaction to the flu shot and that her only option was a double lung transplant. \n\nPetitioner's expert, Dr. Eric Gershwin, opined that Petitioner had an underlying viral infection that, combined with the flu vaccine, triggered bystander activation and further inflammation, leading to bronchiolitis obliterans. He stated the vaccination was the but-for cause of her condition. Respondent's experts, Dr. Derek Byers and Dr. Emil Bardana, opined that the flu vaccine was irrelevant to Petitioner's lung disease, attributing her condition to a viral infection or other inhaled injury. They found no medical literature supporting a link between influenza vaccination and bronchiolitis obliterans. \n\nOn March 23, 2022, Special Master Katherine E. Oler issued a Ruling on Entitlement, finding that Petitioner met her burden of proof for an off-Table claim, establishing a medical theory and a logical sequence of cause and effect linking the vaccine to her injury. On September 29, 2023, a proffer on the award of compensation was filed. The parties agreed to a total award of $1,078,449.55. This amount included a lump sum of $20,242.42 for first-year life care expenses, $798,691.91 for lost earnings, $250,000.00 for pain and suffering, and $9,515.22 for past unreimbursable expenses. The remainder of the award was to be paid via an annuity contract for future life care needs, with specific criteria for the annuity provider and growth rates for medical and non-medical items. The decision was issued by Special Master Katherine E. Oler on November 2, 2023.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Katherine E. Oler","petitioner_identifier_original":null,"caption_petitioner_name":"Lisa Antalosky","petitioner_attorney_name":"Edward M. Kraus","petitioner_attorney_firm":"Law Offices of Chicago Kent; Kraus Law Group, LLC","petitioner_attorney_location":"Chicago, IL","adjudicator_name":null,"caption_people_backfilled_at":"2026-05-05 23:44:13","attorney_canonical_keys":"|edward-kraus|","firm_canonical_key":"law-offices-of-chicago-kent","package_title":"ANTALOSKY v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00701","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00701.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00701.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_16-vv-00701-0","title":"ANTALOSKY v. 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