Ronald Sturdevant v. HHS - Influenza, Bell's palsy (2024)
Case summary [AI summaries can sometimes make mistakes]
Ronald Sturdevant, a 51-year-old adult, filed a petition for compensation under the National Vaccine Injury Compensation Program on February 6, 2017, alleging that an influenza vaccine administered on November 3, 2015, caused him to develop Bell's palsy. Mr.
Sturdevant's medical history included obesity, diabetes mellitus type 2, hypertension, osteoarthritis, allergic rhinitis, and sleep apnea. He received the flu vaccine in his left arm.
The following day, he experienced right-sided facial numbness, and was diagnosed with Bell's palsy by his primary care physician, Dr. Christopher R.
Depner. Dr.
Depner prescribed prednisone and Famvir, and advised eye patching. Subsequent examinations showed continued facial nerve paresis, with improvement noted over time, though residual weakness persisted.
Petitioner's expert, Dr. M.
Eric Gershwin, opined that the flu vaccine caused Bell's palsy through an innate immune response, leading to inflammation and compression of the facial nerve. Respondent's experts, Dr.
Vinay Chaudhry and Dr. Neil Romberg, argued against this theory, suggesting alternative causes like herpes virus or ischemia, and questioning the anatomical and immunological plausibility of the vaccine-induced inflammatory response reaching the facial nerve.
The Special Master, Nora Beth Dorsey, issued a ruling on entitlement on July 19, 2022, finding that Mr. Sturdevant proved by a preponderance of the evidence that the flu vaccine caused his Bell's palsy, satisfying the three prongs of the Althen test for off-Table claims.
The Special Master denied petitioner's motion to strike Dr. Chaudhry's testimony.
The case then proceeded to damages. On February 12, 2024, Special Master Dorsey awarded Mr.
Sturdevant $100,000.00 for pain and suffering and $158.53 for past unreimbursable expenses, totaling $100,158.53. The award considered the duration and severity of the injury, including residual weakness, pain, and the petitioner's fear of losing his employment due to the condition.
Respondent sought review of the entitlement decision, which was denied by Senior Judge Charles F. Lettow on May 29, 2024, affirming the Special Master's findings.
Theory of causation
Petitioner Ronald Sturdevant, age 51, received an influenza vaccine on November 3, 2015, and developed right-sided Bell's palsy on November 4, 2015. Petitioner's expert, Dr. M. Eric Gershwin, proposed a theory that the flu vaccine triggered an innate immune response, involving the release of cytokines and inflammation in regional lymph nodes, which then trafficked mononuclear cells and inflammatory mediators to the facial nerve area, causing inflammation, compression, and paralysis. This mechanism was posited to be similar to that of viral-induced Bell's palsy. Respondent's experts, Drs. Vinay Chaudhry and Neil Romberg, argued against this theory, citing lack of anatomical plausibility for the immune response to reach the facial nerve from the injection site and questioning the rapid onset for an immune-mediated event. They proposed alternative causes such as herpes virus reactivation or ischemia. The Special Master, Nora Beth Dorsey, found Dr. Gershwin's theory to be sound and reliable, supported by medical literature and expert agreement on inflammation's role in Bell's palsy, and that the onset was consistent with an innate immune response. The Special Master found the evidence supported a logical sequence of cause and effect, rejecting respondent's alternative theories due to lack of evidence. The court affirmed the entitlement decision. Compensation was awarded for pain and suffering and unreimbursable expenses.