W.M. v. HHS - DTaP, transverse myelitis (2023)
Case summary [AI summaries can sometimes make mistakes]
On June 22, 2016, Theodore and Sarah Martinez, as parents and natural guardians of their infant daughter W.M., filed a petition for compensation under the National Vaccine Injury Compensation Program. They alleged that the DTaP and rotavirus vaccines administered on June 26, 2013, caused W.M. to develop transverse myelitis (TM).
W.M. was approximately six months old at the time of vaccination. Petitioners claimed that shortly after vaccination, W.M. exhibited symptoms including lethargy, inability to move her legs, and fever, which progressed and led to a TM diagnosis after hospitalization and testing.
Petitioners presented expert testimony from Dr. Justin Willer and Dr.
Eric Gershwin, who proposed a causal link between the DTaP vaccine and TM, suggesting molecular mimicry as a mechanism and an onset date of June 30, 2013. Respondent contested entitlement, presenting expert testimony from Dr.
Timothy Lotze and Dr. James Moy.
Respondent's experts argued that TM is typically post-infectious or idiopathic, and the DTaP vaccine is not a known cause. They also contended that W.M.'s symptoms began too soon after vaccination for a causal link, suggesting an onset between June 26-27, 2013, which they deemed medically unreasonable for vaccine causation.
A two-day entitlement hearing was held on November 16-17, 2021. Chief Special Master Brian H.
Corcoran denied the claim, finding that Petitioners failed to establish a medically acceptable temporal relationship between the vaccination and the onset of TM, and that the evidence did not support a causal link. The Special Master gave greater weight to contemporaneous medical records, which indicated an earlier onset than Petitioners alleged, and found that an onset within 24 hours of vaccination was not medically acceptable for vaccine causation under the theory of molecular mimicry.
Petitioners sought review of this decision. On April 4, 2023, Judge Zachary N.
Somers of the U.S. Court of Federal Claims affirmed the Special Master's decision, finding that the Special Master's factual determination regarding the onset of symptoms was entitled to deference and that Petitioners had not met the burden to overturn it.
The Court found that the Special Master's weighing of the evidence, particularly the contemporaneous medical records indicating an earlier onset, was reasonable. Therefore, the petition was denied.
Theory of causation
Petitioners alleged that the DTaP and rotavirus vaccines administered on June 26, 2013, caused W.M., then approximately six months old, to develop transverse myelitis (TM). Petitioners' experts, Dr. Justin Willer and Dr. Eric Gershwin, proposed molecular mimicry as the causal mechanism, suggesting that vaccine antigens could resemble spinal cord proteins, leading to an autoimmune cross-reaction. They argued for an onset date of June 30, 2013, four days post-vaccination. Respondent's experts, Dr. Timothy Lotze and Dr. James Moy, contended that TM is typically post-infectious or idiopathic and not caused by the DTaP vaccine. They argued that W.M.'s symptoms began too soon after vaccination (within 24 hours) to be medically acceptable for vaccine causation, citing contemporaneous medical records that suggested an onset between June 26-27, 2013. Chief Special Master Brian H. Corcoran denied the petition, finding that Petitioners failed to establish a medically acceptable temporal relationship between the vaccination and the onset of TM, as the early onset was inconsistent with the proposed autoimmune mechanism requiring an adaptive immune response. The Court of Federal Claims affirmed, deferring to the Special Master's weighing of the evidence, particularly the contemporaneous medical records, which supported an earlier onset and thus precluded a finding of vaccine causation. The petition was denied.
Source PDFs
USCOURTS-cofc-1_16-vv-00738