D.C. v. HHS - Influenza, autoimmune epilepsy, plus a number of secondary symptoms (anxiety and post-traumatic stress in particular) (2021)
Case summary [AI summaries can sometimes make mistakes]
Luke and Jamielee Caredio, on behalf of their minor daughter D.C., filed a claim on July 30, 2017, seeking compensation under the National Vaccine Injury Compensation Program. They alleged that an influenza vaccine administered to D.C. on January 22, 2014, when she was a little over two years old, caused her to develop epilepsia partialis continua (EPC), anxiety disorders, and post-traumatic stress disorder.
D.C. experienced shaking and a fever on the same day as vaccination, initially diagnosed as a likely viral infection. Approximately three months later, D.C. began experiencing eye twitching and other seizure-like episodes, leading to a diagnosis of epilepsy, likely EPC.
Over several years, D.C. received extensive medical treatment and testing, including EEGs, MRIs, steroids, anti-epileptic medications, and IVIG therapy. Despite these efforts, the specific etiology of D.C.'s EPC remained unclear, though treaters suspected an autoimmune process.
The petitioners' expert, Dr. Lawrence Steinman, proposed a theory that the flu vaccine could cause autoimmune epilepsy through molecular mimicry.
This theory was contested by respondent's experts, Drs. Christine McCusker and Jenny Linnoila.
The Special Master denied entitlement, finding that the petitioners failed to establish causation by a preponderance of the evidence under the Althen standard. Specifically, the Special Master found Dr.
Steinman's reliance on molecular mimicry and homology insufficient and that the medical records did not support a causal link between the vaccine and D.C.'s EPC. The Special Master gave more weight to Dr.
McCusker's testimony than Dr. Steinman's.
The Court of Federal Claims affirmed the Special Master's decision on review, finding no abuse of discretion or legal error. The petitioners' motion for review was denied.
Theory of causation
Petitioners alleged that the January 22, 2014 influenza vaccine caused D.C. to develop epilepsia partialis continua (EPC), anxiety, and PTSD. Petitioners' expert, Dr. Lawrence Steinman, proposed a theory that the flu vaccine could cause autoimmune epilepsy through molecular mimicry, citing homology between vaccine components and neuronal receptors. Respondent's experts, Drs. Christine McCusker and Jenny Linnoila, contested this theory, arguing that homology alone is insufficient and that the flu vaccine is unlikely to stimulate the relevant T cells. The Special Master found Dr. Steinman's theory speculative, over-reliant on homology, and lacking sufficient links to establish causation. The Special Master also found that the medical records did not support a logical sequence of cause and effect between the vaccine and D.C.'s EPC, noting that Dr. Steinman did not connect D.C.'s initial febrile seizure to her later EPC. The Special Master denied entitlement, finding that petitioners failed to establish causation by a preponderance of the evidence under the Althen standard. The Court of Federal Claims affirmed the Special Master's decision.
Source PDFs
USCOURTS-cofc-1_17-vv-00079