VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00621
Package ID: USCOURTS-cofc-1_17-vv-00621
Petitioner: K.K.
Filed: 2017-05-09
Decided: 2025-04-29
Vaccine: influenza
Vaccination date: 2014-11-21
Condition: juvenile idiopathic arthritis
Outcome: compensated
Award amount USD: 45000

AI-assisted case summary:
On May 9, 2017, Russell Kilde, as parent and natural guardian for his minor son K.K., filed a petition for compensation under the National Vaccine Injury Compensation Program. The petition alleged that K.K. developed juvenile idiopathic arthritis (JIA) as a result of receiving an influenza vaccine on November 21, 2014. The respondent, the Secretary of Health and Human Services, denied that the immunization caused or significantly aggravated K.K.'s injury. The parties, represented by Amy A. Senerth, Esq., for the petitioner and Parisa Tabassian, Esq., for the respondent, reached a joint stipulation to settle the case. The respondent agreed to issue a payment of $45,000.00 to purchase an annuity contract, which represents compensation for all damages available under the program. Special Master Mindy Michaels Roth adopted the parties' stipulation and awarded compensation in the amount and on the terms set forth therein. The decision directed the clerk of the court to enter judgment in accordance with this decision. The public decision does not describe the specific onset of symptoms, medical tests, treatments, or the mechanism of causation.

Theory of causation field:
Petitioner K.K., a minor, received an influenza vaccine on November 21, 2014. The petition alleged that K.K. developed juvenile idiopathic arthritis (JIA) as a result of this vaccination. Respondent denied causation. The parties reached a joint stipulation to settle the case. The respondent agreed to pay $45,000.00 to purchase an annuity contract as compensation for all damages. Special Master Mindy Michaels Roth adopted the stipulation and awarded the compensation. The public decision does not detail the specific theory of causation, medical experts, or the mechanism by which the vaccine allegedly caused JIA.

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_17-vv-00621-1
Date issued/filed: 2023-03-10
Pages: 12
Docket text: PUBLIC RULING (Originally filed: 2/13/2023) regarding 74 Findings of Fact & Conclusions of Law. Signed by Special Master Mindy Michaels Roth. (dkj) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 1 of 12
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-621V
Filed: February 13, 2023
* * * * * * * * * * * * * * *
K.K. a minor, by and through his parent * Not For Publication
and natural guardian, RUSSELL KILDE, *
*
Petitioner, * Finding of Facts; Onset; Influenza (“Flu”)
v. * Vaccine; Guillain-Barré Syndrome
* (“GBS”) and Juvenile Idiopathic Arthritis
SECRETARY OF HEALTH * (“JIA”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * *
Amy Senerth, Esq., Muller Brazil, LLP, Dresher, PA, for petitioner.
Parisa Tabassian, Esq., U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ONSET1
Roth, Special Master:
On May 9, 2017, Russell Kilde (“Mr. Kilde,” or “petitioner”) filed a petition for
compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 et
seq.2 (“Vaccine Act” or “the Program”) on behalf of his minor child, K.K. Petitioner alleges that
K.K. developed Juvenile Idiopathic Arthritis (“JIA”) as a result of receiving an influenza
vaccination on November 21, 2014. Amended Petition (“Am. Pet.”), ECF No. 28.
1 Although this Ruling has been formally designated “unpublished,” it will nevertheless be posted on the
Court of Federal Claims’ website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347,
116 Stat. 2899, 2913 (codified as amended at 44 U.S.C. § 3501 note (2006)). This means the Ruling will
be available to anyone with access to the internet. However, the parties may object to the Decision’s
inclusion of certain kinds of confidential information. Specifically, under Vaccine Rule 18(b), each party
has fourteen days within which to request redaction “of any information furnished by that party: (1) that is
a trade secret or commercial or financial in substance and is privileged or confidential; or (2) that includes
medical files or similar files, the disclosure of which would constitute a clearly unwarranted invasion of
privacy.” Vaccine Rule 18(b). Otherwise, the whole Ruling will be available to the public. Id.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 2 of 12
This Ruling is focused only on onset. I find preponderant evidence to support that K.K.’s
limping and onset of his JIA began on November 24 or 25, 2014.
I. Procedural History
The petition was filed on May 9, 2017, along with petitioner’s vaccination and medical
records. See Petition; Petitioner’s Exhibits (“Pet. Ex.”) 1-7, ECF No. 1. Petitioner initially alleged
that K.K. developed Guillain-Barré Syndrome (“GBS”) as a result of the influenza vaccination.
Petition (“Pet.”), ECF No. 1.
Petitioner filed additional medical records on August 23, 2017; September 8, 2017; and
October 11, 2017. Pet. Ex. 8-11, ECF No. 11-12, 14. Respondent’s status report filed on December
19, 2017 indicated that he was satisfied that the record was complete and that he was not amenable
to settlement discussions. ECF No. 18.
On September 14, 2018, petitioner filed an amended petition, an expert report from Dr.
Morrison, and an expert report from Dr. Gershwin. Am. Pet., ECF No. 28; Pet. Ex. 12, ECF No.
29; Pet. Ex. 13, ECF No. 30. The Amended Petition clarified that petitioner was alleging Juvenile
Idiopathic Arthritis (“JIA”) as the injury resulting from his November 21, 2014 flu vaccination.
Am. Pet., ECF No. 28.
This matter was reassigned to the undersigned on September 18, 2018. ECF No. 32.
On March 25, 2019, respondent filed his Rule 4(c) Report and responsive expert reports by
Dr. Carlos Rose and Dr. S. Mark Tompkins. Respondent’s Report (“Resp. Rpt.”), ECF No. 42;
Respondent’s Exhibit (“Resp. Ex.”) A-D, ECF No. 43. Respondent recommended against
compensation in this matter. Resp. Rpt. at 2, ECF No. 42.
On May 30, 2019, during a Rule 5 status conference, the undersigned informed counsel
that a fact hearing to determine onset would be necessary. ECF No. 47. The parties agreed to April
23, 2020 for the Onset Hearing. Joint Status Report, ECF No. 48. On December 3, 2019, petitioner
filed the affidavit of Russell Kilde. Pet. Ex. 14, ECF No. 52. Two days before hearing, petitioner
filed the affidavit of Hisa Kilde. Pet. Ex. 15, ECF No. 58.
Due to the COVID-19 pandemic, the Onset Hearing was rescheduled for and held on
October 14, 2020. ECF No. 55.
After the hearing, petitioner was ordered to file additional medical records and videos or
photos of K.K., as well as social media data, between April 2014 through 2016. ECF No. 59.
Petitioner filed the requested records on December 21, 2020, Pet. Ex. 16, ECF No. 62; January 6,
2021, Pet. Ex. 17, ECF No. 63; and April 12, 2021, Pet. Ex. 18-28, ECF No. 68. The record was
then closed for the purposes of this Ruling. ECF No. 72.
The matter is now ripe for a Ruling on Onset.
2

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 3 of 12
II. The Factual Record
A. K.K.’s Medical Records
a. Pre-Vaccine Medical History
K.K. was born on December 30, 2012. Pet. Ex. 1. In his first year of life, K.K. received
routine vaccinations without event. Id.; Pet. Ex. 2 at 75-76, 101-02. According to his well-child
visits, he was meeting all milestones expected for his age. Pet. Ex. 2 at 48, 70, 84, 105, 121, 136.
K.K. had his 9-month-old well child visit on October 9, 2013, where it was noted that he
had a fall. Pet. Ex. 2 at 121. He had blood tests that day, which showed that his hemoglobin3 was
low. Id. at 126-28, 134. His mother had his hemoglobin checked again while in Japan, and she
reported that his levels were normal. Id. at 136.
After his first birthday, in April of 2014, K.K. presented to pediatrician Dr. Ross with a
rash on his chest, abdomen, and upper arms. His mother also reported that K.K. had fallen down
the stairs. Pet. Ex. 2 at 147-48. Upon examination, Dr. Ross documented that his skin was “clear,
no rash or abnormal pigmentation.” Id. at 148. His hemoglobin was rechecked and noted to be
elevated. Id. at 153.
At a visit on July 2, 2014, K.K.’s mother reported a mass on K.K.’s neck. Dr. Ross
examined him and noted that his “neck is supple and thyroid is normal, no masses. Small posterior
cervical node high within chain.” Pet. Ex. 2 at 161-62. He was also noted to be walking normally
for his age. Id. at 162. His hemoglobin was checked again and was normal. Id. at 167.
On November 21, 2014, K.K. received an influenza vaccine in his left thigh. Pet. Ex. 1;
Pet. Ex. 8 at 1.
b. Post-Vaccine Medical History
K.K. presented to pediatrician Dr. Andersen on December 12, 2014 for a rash that began
the day prior and gait problems for the last three weeks after sleeping. The record includes,
“[d]ifficulty walking consistently occurs in mornings over the last couple weeks, without
worsening or resolving. Would rather crawl than walk, cries. Better later in day with gait normal.
Also noted to occur after waking up from naps.” Pet. Ex. 2 at 173-74. Further, K.K. was waking
and crying “4-5 times at night over last couple weeks, which is unusual for him.” Id. at 173. Upon
examination, Dr. Andersen noted that K.K. resisted “standing up when placed in seated position
on the floor . . . prefers to slide along the floor on his left hip pulling forward with left arm.” Id. at
174. He was diagnosed with rash, otitis media, and gait abnormality. Id. The pediatrician believed
his rash was due to a viral infection. The parents were advised to take a “[w]atchful waiting”
approach. Id.
3 Hemoglobin is the red oxygen-carrying pigment of erythrocytes, formed by developing erythrocytes in
bone marrow. Hemoglobin, Dorland’s Medical Dictionary Online,
https://www.dorlandsonline.com/dorland/definition?id=22033 (last visited Feb. 13, 2023).
3

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 4 of 12
K.K. had a follow up with Dr. Ross on January 8, 2015, where it was noted that he had
been limping for the past two months, which seemed to start after a viral illness. Pet. Ex. 2 at 183.
K.K. had presented about a month ago. Id. His limp had gotten worse and his left second toe
appeared swollen. K.K.’s pain was worse in the mornings and better with activity. Id. Dr. Ross
was “unable to completely extend [K.K.’s] knees bilaterally.” Id. at 184. X-rays were normal but
bloodwork revealed high ESR,4 suggestive of inflammation. Id. at 189-90, 202.
On January 15, 2015, K.K. was presented to a pediatric orthopedist. His parents reported
that K.K. had a viral illness in the middle of November 2014 and started limping shortly thereafter;
they stated that his limping started two months ago. Pet. Ex. 3 at 11-12; Pet. Ex. 5 at 42. His parents
reported that K.K. was a “normal, active 2 year old” prior to November 2014 and that he received
his flu vaccine after symptoms started. Pet. Ex. 3 at 11-12; Pet. Ex. 5 at 42. A pediatric neurologist
suspected that K.K. had GBS,5 so he was admitted and had an MRI and lumbar puncture and was
started on IVIG. Pet. Ex. 4 at 6-8; Pet. Ex. 5 at 35-37. K.K. had some benefit from the IVIG, but
then reverted to scooting and was again not climbing stairs. Pet. Ex. 4 at 25-26.
On January 17, 2015, K.K. was discharged. The discharge summary notes that K.K. had
been limping for two months and a week prior to his symptoms had an upper respiratory infection
with cough, congestion, and fever. Pet. Ex. 5 at 36.
On January 21, 2015, K.K. was seen by Dr. Ross for follow up of his hospitalization. Pet.
Ex. 2 at 213-14. His parents reported that they had not noticed any major improvements in his
symptoms, but he had not gotten worse. Id. at 214. Upon examination, Dr. Ross was “able to elicit
left knee reflex.” Id. at 213.
K.K. had a follow up on February 3, 2015. Pet. Ex. 4 at 26. He refused to bear weight and
resisted foot contact with the floor. Id. He also complained that a light touch of his right arm and
leg hurt. Id. The impression was a predominately sensory neuropathy. Id.
K.K. was presented to physical therapy on February 19, 2015. Pet. Ex. 10 at 348. Petitioner
reported that K.K. was walking, running, and jumping prior to November 2014. Id. Now, he was
unable to walk or climb stairs, unable to sit and stand independently, and unable to maintain
4 ESR refers to erythrocyte sedimentation rate. An increase in ESR is usually due to elevated levels of
plasma proteins, especially fibrinogen and immunoglobulins, which decrease the zeta potential on
erythrocytes by dielectric shielding and thus promote rouleau formation. It is increased in monoclonal
gammopathy, hypergammaglobulinemia due to inflammatory disease, hyperfibrinogenemia, active
inflammatory disease, and anemia. Erythrocyte Sedimentation Rate, Dorland’s Medical Dictionary
Online, https://www.dorlandsonline.com/dorland/definition?id=102146 (last visited Feb. 9, 2023).
5 GBS is a rapidly progressive ascending motor neuron paralysis of unknown etiology, frequently seen
after an enteric or respiratory infection. An autoimmune mechanism following viral infection has been
postulated. It begins with paresthesias of the feet, followed by flaccid paralysis of the entire lower limbs,
ascending to the trunk, upper limbs, and face; other characteristics include slight fever, bulbar palsy,
absent or lessened tendon reflexes, and increased protein in the cerebrospinal fluid without a
corresponding increase in cells. Guillain-Barré syndrome, Dorland’s Medical Dictionary Online,
https://www.dorlandsonline.com/dorland/definition?id=110689 (last visited Feb. 9, 2023).
4

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 5 of 12
“quadruped”. Id. K.K. was not bearing weight through his “RUE” and relied on his right forearm
to stabilize. Id. at 349. “Parents report that [K.K.] has just recently started performing this activity.”
Id. The onset date of his limping was listed as November 22, 2014, the day after he received the
flu vaccine. Id. at 348.
K.K. continued to be evaluated and treated throughout 2015 and into 2016 as having GBS
following vaccination. See Pet. Ex. 4 at 25, 102; Pet. Ex. 7 at 21, 24; Pet. Ex. 8 at 4. After consulting
a rheumatologist and neurologist on May 6, 2016, his diagnosis was changed to juvenile idiopathic
arthritis. Pet. Ex. 11-1 at 3-6; Pet. Ex. 7 at 48.
B. Affidavits and Testimony of the Witnesses
a. Petitioner Russell Kilde
Petitioner filed one affidavit and testified at the onset hearing. Pet. Ex. 14.
Petitioner stated that K.K. had a cold in early November, so he and his wife pushed his flu
vaccine off until he was well. Tr. 95-96, 115-16. Once K.K. recovered from his cold and “seemed
normal and healthy”, he received a flu vaccine on November 21, 2014. Pet. Ex. 14 at 1; Tr. 96.
“Within a couple of days” after receiving the vaccine, K.K. came down with another cold.
Pet. Ex. 14 at 1. Petitioner thought K.K.’s cold was related to the flu vaccine, because he had
similar symptoms following a flu vaccine in the past. Tr. 102. K.K. was not presented to a doctor
for his symptoms as they were not considered serious. Tr. 103. By Thanksgiving, or November
27, 2014, K.K. was slow getting out of bed and was experiencing pain in his legs. Tr. 99.
According to petitioner, K.K.’s leg pain started in his knees but only occurred in the
morning after sleeping. Pet. Ex. 14 at 1; Tr. 126. Petitioner estimated that the limping began at the
end of November, associating the leg pain with Thanksgiving that year. Tr. 91, 99, 128. He recalled
that K.K. did not have trouble walking in the fall of 2014, but he was certain that K.K. was
struggling to walk by the end of November that year. Tr. 95, 99, 117. “I don’t remember [K.K.]
limping before the vaccine.” Tr. 113.
Petitioner recalled K.K. presenting to the pediatrician on December 12, 2014 for a rash on
his torso that was “large” and “scary”. Tr. 88, 129, 134.
By mid-December of 2014, K.K. was limping all day and refusing to walk, so his parents
carried him everywhere. Tr. 93, 100, 125-26. Petitioner clarified that K.K. was still able to walk
but that he no longer wanted to and wanted to be carried everywhere. Tr. 125-26. Because of his
difficulty walking, K.K.’s mother bought him a stroller for either Christmas or his birthday on
December 30 in the hopes that he would use it like a walker to assist in ambulating. Tr. 121-23,
126. Petitioner confirmed that K.K. was limping constantly by his appointment on January 15,
2015. Tr. 93-95, 100.
Petitioner acknowledged the inconsistencies between his affidavit and the medical records
regarding the onset of K.K.’s limping. Pet. Ex. 14 at 2; Tr. 118, 126. He explained at hearing that
5

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 6 of 12
he was merely referring to the months and not considering the actual dates on which the events
transpired.6 Tr. 97, 114.
b. Petitioner’s Wife, Hisa Kilde
Petitioner’s wife filed an affidavit and testified at the onset hearing. Pet. Ex. 15. Notably,
English is not Mrs. Kilde’s first language.
Mrs. Kilde affirmed that K.K. had a cold prior to receiving the subject vaccine in late
October of 2014, which led her and husband to postpone K.K.’s flu vaccine. Tr. 14, 24-25. Mrs.
Kilde did not remember anything in particular about November 21, 2014, the day K.K received
the flu vaccine, other than bringing K.K. and her other son to the doctor that day for K.K.’s flu
shot. Tr. 13-14, 20. At the time of the appointment, his limping and leg pain had not yet begun. Tr.
15. In fact, he was running. Tr. 26. She testified that she had never noticed any difficulty with his
walking or limping prior to November of 2014. Tr. 22.
“A few days after the shot,” K.K.’s leg began hurting. Pet. Ex. 15 at 1; Tr. 52. She noticed
that “[h]e couldn’t take one step from the bed. He say (sic) ‘owie, owie.’ He cried.” Tr. 15, 54.
Mrs. Kilde stated that her older son was not at home when K.K. awoke the first time crying; her
older son was at school. Tr 33. She could not recall the exact date that K.K.’s symptoms began,
but she estimated that it was two or three days after the flu shot—around November 24 or 25,
2014. Tr. 20-21, 33, 53.
Mrs. Kilde said K.K.’s pain would start in the morning and then subside within a short
period of 10-30 minutes. Tr. 18. When he first started having symptoms, K.K. was still walking
and running around in the late afternoon. Tr. 18, 33.
By Thanksgiving Day, K.K. was having “pain in the morning when he woke up.” Tr. 19.
Mrs. Kilde recalled telling her mother-in-law about his symptoms on Thanksgiving. Tr. 19. But
when the family was together later in the day, K.K. was fine, running around and walking like
normal. Tr. 55-56.
Mrs. Kilde took him to the pediatrician on December 12, 2014, because he had a large rash.
Tr. 16, 23. She also reported at that visit that he had been limping for three weeks. Tr. 23. She later
clarified that three weeks was an estimate. Tr. 26, 27, 65-66.
Mrs. Kilde noted that around Christmas 2014, K.K.’s symptoms had gotten worse. Tr. 42.
At that time, he was mostly sitting and did not want to move. Tr. 42. For either Christmas or his
birthday that year, Mrs. Kilde got K.K. a baby stroller so he would have some assistance while
walking. Tr. 42-43, 59, 61-62.
Mrs. Kilde affirmed that at the end of December 2014 or beginning of January 2015, K.K.
was no longer able to walk and was scooting instead. Tr. 75. She acknowledged the January 8,
2015 appointment, but stated that the notes indicating K.K. had been limping for two months were
6 Petitioner also noted that his rough estimations of when K.K.’s limping began could have influenced
what his wife reported to doctor, as English is her second language. Tr. 127.
6

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 7 of 12
incorrect. Tr. 22-24, 70-71. The reason the notes may have indicated symptoms starting two
months ago was because his limping started in the month of November; she did not account for
the exact date. Tr. 22, 71.
In discussing the next appointment on January 15, 2015, Mrs. Kilde confirmed that she had
estimated the onset as being roughly two months prior. Tr. 31. However, she did not provide an
exact date, so two months exactly—or sixty days—was incorrect. Tr. 31, 70-71. She explained
that her use of “two months” prior was similar to her estimate at the prior appointment of “three
weeks.” It was a rough estimate. Tr. 71.
When asked about the visit notes from January 15, 2015 that stated K.K. received the flu
vaccine “after symptoms started”, Mrs. Kilde claimed that the notation was incorrect. Tr. 34-36;
see also Pet. Ex. 5 at 42. Mrs. Kilde insisted that K.K.’s symptoms began two to three days after
the subject vaccine. Tr. 36.
C. Video Footage
After the hearing, petitioner was ordered to file any photos or video footage of K.K. taken
by his parents, grandparents, relatives, or family friends between April 2014 through the end of
2016. ECF No. 59. Petitioner filed several videos on April 12, 2021. Pet. Ex. 18-28, ECF No. 68.
a. Pre-Vaccination Videos
Petitioner filed a video dated October 31, 2014, showing K.K. walking around, standing,
and squatting while his father carved pumpkins. Pet. Ex. 19. The video dated November 7, 2014
showed K.K. picking up and carrying a cat. Pet. Ex. 28.
There are two videos from November 13, 2014. One showed K.K. running across the room,
jumping onto a recliner, and playfully kicking his legs; the other showed K.K. leaning across a
coffee table while walking to grab a book. Pet. Ex. 21-22.
b. Post-Vaccination Videos
A video dated November 22, 2014, one day after K.K. received the flu vaccine shows K.K.
playing outside with his brother, picking up and throwing snow. Pet. Ex. 20. A video dated
November 27, 2014, Thanksgiving, shows K.K. putting decorations on a Christmas tree taking
only a few small steps around the tree. Pet. Ex. 25.
A video dated December 1, 2014, shows K.K. playing with toys on the coffee table. Pet.
Ex. 24. A video dated December 19, 2014 shows K.K. running across the room and playing with
petitioner. Pet. Ex. 23.
A video dated December 24, 2014, Christmas Eve, shows K.K. standing in one place,
taking only a few steps throughout the video, and sitting in his father’s lap. Pet. Ex. 18. In a
7

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 8 of 12
December 25, 2014 video, petitioner is carrying K.K. to the Christmas tree, setting him down, and
bringing toys to him. Pet. Ex. 27. K.K. does not stand or walk in the video.
The last video filed was dated December 30, 2014, K.K.’s 2nd birthday. Pet. Ex. 26. In the
video he is sitting on the ground, opening a present (a pink stroller). He does not stand up or walk.
III. Legal Standards Regarding Fact Finding
Petitioner bears the burden of establishing his claims by a preponderance of the evidence.
§ 13(a)(1). A petitioner must offer evidence that leads the “trier of fact to believe that the existence
of a fact is more probable than its nonexistence before [he or she] may find in favor of the party
who has the burden to persuade the judge of the fact’s existence.” Moberly v. Sec’y of Health &
Human Servs., 592 F.3d 1315, 1322 n.2 (Fed. Cir. 2010) (citations omitted).
The process for making determinations in Vaccine Program cases regarding factual issues,
such as the timing of onset of petitioner’s alleged injury, begins with analyzing the medical
records, which are required to be filed with the petition. § 11(c)(2). Medical records created
contemporaneously with the events they describe are generally considered to be trustworthy.
Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed. Cir. 1993); but see Kirby
v. Sec’y of Health & Human Servs., 993 F.3d 1378, 1382-83 (Fed. Cir. 2021) (clarifying
that Cucuras does not stand for proposition that medical records are presumptively accurate and
complete). This presumption is based on the linked proposition that (i) sick people visit medical
professionals; (ii) sick people honestly report their health problems to those professionals; and (iii)
medical professionals record what they are told or observe when examining their patients in an
accurate manner, so that they are aware of enough relevant facts to make appropriate treatment
decisions. Sanchez v. Sec’y of Health & Human Servs., No. 11-685V, 2013 WL 1880825, at *2
(Fed. Cl. Spec. Mstr. Apr. 10, 2013), vacated on other grounds, Sanchez by & through Sanchez v.
Sec’y of Health & Human Servs., No. 2019-1753, 2020 WL 1685554 (Fed. Cir. Apr. 7, 2020),
review denied, Sanchez by & through Sanchez v. Sec'y of Health & Hum. Servs., 152 Fed. Cl. 782
(2021); Cucuras v. Sec’y of Health & Human Servs., 26 Cl. Ct. 537, 543 (1992), aff’d, 993 F. 2d.
1525 (Fed. Cir. 1993) (“[i]t strains reason to conclude that petitioners would fail to accurately
report the onset of their daughter’s symptoms. It is equally unlikely that pediatric neurologists,
who are trained in taking medical histories concerning the onset of neurologically significant
symptoms, would consistently but erroneously report the onset of seizures a week after they in fact
occurred”). In making contemporaneous reports, “accuracy has an extra premium” given that the
“proper treatment hang[s] in the balance.” Id. A patient’s motivation for providing an accurate
recount of symptoms is more immediate, as opposed to testimony offered after the events in
question, which is considered inherently less reliable. Reusser v. Sec’y of Health & Human Servs.,
28 Fed. Cl. 516, 523 (1993); see Murphy v. Sec’y of Health & Human Servs., 23 Cl. Ct. 726, 733
(1991), aff'd, 968 F.2d 1226 (Fed. Cir. 1992) (citing United States v. U.S. Gypsum Co., 333 U.S.
364, 396 (1948)). Contemporaneous medical records that are clear, consistent, and complete
warrant substantial weight “as trustworthy evidence.” Cucuras, 993 F.2d at 1528. Indeed, “where
later testimony conflicts with earlier contemporaneous documents, courts generally give the
contemporaneous documentation more weight.” Id.
8

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 9 of 12
However, there are situations in which compelling oral testimony may be more persuasive
than written records, such as in cases where records are deemed to be incomplete or inaccurate.
See Campbell ex rel. Campbell v. Sec’y of Health & Human Servs., 69 Fed. Cl. 775, 779 (2006)
(“[L]ike any norm based upon common sense and experience, this rule should not be treated as an
absolute and must yield where the factual predicates for its application are weak or lacking.”). The
Court of Federal Claims has listed four possible explanations for inconsistencies between
contemporaneously created medical records and later testimony: (1) a person’s failure to recount
to the medical professional everything that happened during the relevant time period; (2) the
medical professional’s failure to document everything reported to her or him; (3) a person’s faulty
recollection of the events when presenting testimony; or (4) a person’s purposeful recounting of
symptoms that did not exist. La Londe v. Sec’y of Health & Human Servs., 110 Fed. Cl. 184, 203-
04 (2013), aff’d, 746 F.3d 1334 (Fed. Cir. 2014). Ultimately, a determination regarding a witness’s
credibility is needed when determining the weight that such testimony should be given. Andreu v.
Sec’y of Health & Human Servs., 569 F.3d 1367, 1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health
& Human Servs., 991 F.2d 1570, 1575 (Fed. Cir. 1993).
When witness testimony is used to overcome the presumption of accuracy given to
contemporaneous medical records, such testimony must be “consistent, clear, cogent and
compelling.” Sanchez v. Sec’y of Health & Human Servs., No. 11-685V, 2013 WL 1880825, at *3
(Fed. Cl. Spec. Mstr. Apr. 10, 2013) (quoting Blutstein v. Sec’y of Health & Human Servs., No.
90-2808V, 1998 WL 408611, at *85 (Fed. Cl. Spec. Mstr. June 30, 1998)); see, e.g., Stevenson ex
rel. Stevenson v. Sec’y of Health & Human Servs., No. 90-2127V, 1994 WL 808592, at *7 (Fed.
Cl. Spec. Mstr. June 27, 1994) (crediting the testimony of a fact witness whose “memory was
sound” and “recollections were consistent with the other factual evidence”). Moreover, despite the
weight afforded medical records, special masters are not bound rigidly by those records in
determining onset of a petitioner’s symptoms. Vallenzuela v. Sec’y of Health & Human Servs., No.
90-1002V, 1991 WL 182241, at *3 (Fed. Cl. Spec. Mstr. Aug. 30, 1991); see also Eng v. Sec’y of
Health & Human Servs., No. 90-175V, 1994 WL 67704, at *3 (Fed. Cl. Spec. Mstr. Feb 18, 1994)
(explaining that § 13(b)(2) “must be construed so as to give effect to § 13(b)(1) which directs the
special master or court to consider the medical record...but does not require the special master or
court to be bound by them”). In short, “the record as a whole” must be considered. § 13(a).
IV. Discussion and Findings of Fact
Petitioner alleges that K.K. developed JIA as a result of the flu vaccine he received on
November 21, 2014. Am. Pet. The focus of this Ruling is only the onset of K.K.’s leg pain and
limping. Viewing the record as a whole, preponderant evidence exists to support the onset of
K.K.’s symptoms as on or about November 24 or 25, 2014.
K.K.’s medical records show that he was developing normally and meeting all milestones
for his age throughout his first almost two years of life. Pet. Ex. 2 at 48, 70, 84, 105, 121, 136. His
records show, and petitioner and Mrs. Kilde confirm, that K.K. was walking and running normally
in the fall of 2014, before the November 21, 2014 flu vaccine. Pet. Ex. 2 at 162; Pet. Ex. 3 at 11-
12; Tr. 15, 22, 26, 95, 99, 113, 117; Pet. Ex. 19; Pet. Ex. 28. A video dated November 13, 2014
shows K.K. playing with petitioner, running around, and playfully kicking his legs. Pet. Ex. 21.
This video was taken approximately eight days before K.K. received the subject flu vaccine.
9

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 10 of 12
Petitioner and Mrs. Kilde recalled that K.K. had a cold prior to his receipt of the flu vaccine,
which caused them to delay his flu vaccination. Tr. 14, 24-25, 95-96, 115-16; Pet. Ex. 14 at 1.
After he recovered from the cold, K.K. was presented to his pediatrician’s office on November 21,
2014 to receive flu vaccine. Tr. 14, 24-25, 96. A video dated November 22, 2014, the following
day, shows K.K. running and playing in the snow with his brother. Pet. Ex. 20. K.K. repeatedly
squats to pick up snow, throws it, and runs to a different spot to grab more, all without any apparent
pain. Id.
Petitioner testified that K.K. appeared to have another cold a few days after his receipt of
the flu vaccine, but he didn’t think much of it because he had experienced similar symptoms
himself following a flu vaccine in the past. Tr. 102; Pet. Ex. 14 at 1. K.K. was not seen by a doctor
because his symptoms were not serious. Tr. 103.
Mrs. Kilde estimated that K.K.’s legs began hurting two to three days after his shot or
around November 24 or November 25, 2014. Mrs. Kilde recalled K.K. crying in the morning,
saying “owie”, and having a difficult time bearing weight. She further recalled her older son being
at school that day, so it was either Monday or Tuesday, November 24 or 25 because school was
likely closed Wednesday and Thursday for the Thanksgiving holiday. Pet. Ex. 15 at 1; Tr. 15, 33,
52, 54. This is consistent with Mrs. Kilde’s reporting onset as being a few days after the flu vaccine
and before Thanksgiving. Tr. 20-21, 33, 53. Both petitioner and Mrs. Kilde remembered that
K.K.’s symptoms had already begun by Thanksgiving, or November 27, 2014. Tr. 19, 55-56, 91,
99, 128.
Further, petitioner and Mrs. Kilde both explained that they provided estimates of the onset
of K.K.’s pain and limping to his medical providers, not exact dates. Pet. Ex. 14 at 2; Tr. 22-24,
26, 27, 31, 36, 65-66, 70-71, 118, 126. Mrs. Kilde explained that her estimate of his limping and
leg pain was three weeks prior to the December 2014 appointment, because she knew it was more
than two weeks ago when she took K.K. to the doctor. Tr. 26, 27, 66. Similarly, when questioned
about their reporting onset as two months prior when presenting K.K. on January 8 and 15, 2015,
they both explained that they were referring to the general month of onset and not the actual date
his symptoms began. Tr. 97, 114. Petitioner believed that Mrs. Kilde may have relied on his rough
estimations because English is not her first language. Tr. 127. Notably, petitioner and Mrs. Kilde
were sequestered during their testimony.
The preponderant evidence supports that petitioner and Mrs. Kilde provided estimates to
medical providers regarding the relevant timeframe within which K.K.’s limping and leg pain
began rather than exact dates. They reported onset three weeks prior to a December 12, 2014
medical visit, which would have placed onset on the day of the flu vaccine. However, a video
showed K.K. running and playing the next day with no apparent pain or limping. Pet. Ex. 20. At
medical visits on both January 8, 2015 and January 15, 2015, they reported onset as two months
ago. If taken literally, that would place onset prior to K.K.’s receipt of his flu vaccination on
November 21, 2014. However, videos show on October 31, 2014, K.K. was walking around,
standing, and squatting while his father carved pumpkins. Pet. Ex. 19; on November 7, 2014, K.K.
was picking up and carrying a cat. Pet. Ex. 28; on November 13, 2014, one video showed K.K.
running across the room, jumping onto a recliner, and playfully kicking his legs; and the other
showed K.K. leaning across a coffee table while walking to grab a book. Pet. Ex. 21-22. A video
10

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 11 of 12
a day after the flu vaccine shows K.K. playing outside with his brother, picking up and throwing
snow. Pet. Ex. 20.
In the weeks that followed his vaccination, however, the videos filed show a less active
child. On November 27, 2014, Thanksgiving, a video shows K.K. putting decorations on a
Christmas tree taking only a few small steps around the tree. Pet. Ex. 25. On December 1, 2014, a
video shows K.K. playing with toys on the coffee table. Pet. Ex. 24. A video dated December 19,
2014 shows K.K. running across the room and playing with petitioner. Pet. Ex. 23. This is
consistent with the parents’ testimony that when the symptoms first started, K.K. was still walking
and running around in the late afternoon. Tr. 18, 33. Both parents testified that by Thanksgiving,
K.K. was having “pain in the morning when he woke up” but was still running and walking
normally in the afternoon. Tr. 19, 55-56. A video dated December 24, 2014, Christmas Eve, shows
K.K. standing in one place, taking only a few steps throughout the video, and sitting in his father’s
lap. Pet. Ex. 18. On Christmas day, a video shows petitioner carrying K.K. to the Christmas tree,
setting him down, and bringing toys to him. Pet. Ex. 27. K.K. does not stand or walk in the video.
In a December 30, 2014 video, K.K.’s 2nd birthday, he is sitting on the ground, opening a present
(a pink stroller). He does not stand up or walk. Pet. Ex. 26. The corroborating evidence supports
petitioner and Mrs. Kilde’s references to the onset of K.K.’s limping and leg pain being estimates
rather than exact dates. Pet. Ex. 2 at 183; Pet. Ex. 5 at 42.
This is the type of scenario the Court of Federal Claims contemplated when purported
inconsistencies exist between the contemporaneously created medical records and later testimony.
See La Londe, 110 Fed. Cl. at 203-04. Though the onset of symptoms here was reported as three
weeks before the December 12, 2014 appointment and two months before the January 8 and 15,
2015 appointments, all placed onset in the month of November 2014. Thus, the medical records
do not contradict the parents’ memory of when K.K.’s leg pain and limping began, which was just
before Thanksgiving. Further, both parents recalled K.K.’s symptoms being present during
Thanksgiving 2014. Petitioner recalled having to carry K.K. and Mrs. Kilde discussed K.K.’s leg
pain and limping with her mother-in-law. Tr. 19, 93, 100, 125-26.
Succinctly, the medical records show that petitioner and Mrs. Kilde provided estimates for
the onset of K.K.’s leg pain and limping. Neither parent noticed any symptoms prior to the flu
vaccine. Tr. 15, 113. Mrs. Kilde stated that K.K.’s leg pain and limping began two to three days
after he received the flu vaccine on November 21, 2014. Tr. 20-21, 33, 53. Both parents were
adamant that his symptoms were present by Thanksgiving, or November 27, that year. Tr. 19, 55-
56, 91, 99, 128. Corroborating evidence by way of videos supports both parents’ testimony. The
videos filed in this matter show K.K. running and playing both before and the day after his flu
vaccine. Pet. Ex. 19-22, 28. However, thereafter, the videos show a less active child, taking only
a few steps, sitting, or being carried. Pet. Ex. 18, 23-27. By either December 25 (Christmas) or
December 30 (K.K.’s birthday) he was given a stroller in hopes that he would walk holding on to
something. Tr. 42-43, 59, 61-62, 121-23, 126. In the video showing K.K. opening this present, he
is sitting on the ground and tearing wrapping paper with the help of his brother. K.K. does not
stand up or walk at any point in the video. Pet. Ex. 26.
This Ruling is a determination only as to onset of K.K.’s leg pain and limping. Viewing
the record as a whole and for the reasons set forth above, I find preponderant evidence to support
11

Case 1:17-vv-00621-UNJ Document 75 Filed 03/10/23 Page 12 of 12
that the onset of K.K.’s leg pain and limping began a few days after receipt of his flu vaccine on
November 21, 2014 or on or about November 24 or 25, 2014.
V. Conclusion
Upon detailed review of the record in its entirety, I find that petitioner’s symptoms began
on or about November 24 or 25, 2014.
To continue pursuing his claim, petitioner must file an expert report which relies on the
facts as found in this Ruling. Should petitioner’s expert base their opinion on facts not substantiated
by this Ruling, the expert’s report will be disregarded. See Burns by Burns v. Sec’y of Health &
Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993).
Accordingly, the following is ORDERED:
By Thursday, March 30, 2023, petitioner shall file either an expert report that is
based on the onset as found herein, or a status report indicating how he intends to
proceed. Petitioner shall provide a copy of this Onset Ruling to each of his expert
witnesses, and his expert(s) shall rely on the timing of onset as I have found it in this
Ruling. If petitioner is unable to secure reports from his expert(s) based on the timing of
onset as I have found it, he shall file either a motion to dismiss, a joint stipulation for
dismissal, or a motion for a ruling on the record, all of which will result in the dismissal
of his claim.
IT IS SO ORDERED.
s/Mindy Michaels Roth
Mindy Michaels Roth
Special Master
12

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_17-vv-00621-2
Date issued/filed: 2025-05-27
Pages: 9
Docket text: PUBLIC DECISION (Originally filed: 4/29/2025) regarding 110 DECISION Stipulation. Signed by Special Master Mindy Michaels Roth. (msg) Service on parties made.
--------------------------------------------------------------------------------
Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 1 of 9
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-621V
Filed: April 29, 2025
* * * * * * * * * * * * *
K.K., a minor, by and through his parent *
and natural guardian, *
RUSSELL KILDE, *
*
Petitioner, *
*
*
v. *
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
* * * * * * * * * * * * *
Amy A. Senerth, Esq., Muller Brazil, LLP, Dresher, PA, for petitioner.
Parisa Tabassian, Esq., US Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Roth, Special Master:
On May 9, 2017, Russell Kilde (“petitioner”) filed a petition for compensation under the
National Vaccine Injury Compensation Program2 on behalf of his minor son K.K., alleging that
K.K. developed juvenile idiopathic arthritis (“JIA”) as a result of the influenza (“flu”) vaccine he
received on November 21, 2014. Petition, ECF No. 1; Stipulation, filed April 29, 2025, at ¶¶ 1-4.
Respondent denies that the aforementioned immunization caused or significantly aggravated
K.K.’s injury. Stipulation at ¶ 6.
1 Because this Decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the Decision will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2018).
1

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 2 of 9
Nevertheless, the parties have agreed to settle the case. On April 29, 2025, the parties filed
a joint stipulation agreeing to settle this case and describing the settlement terms.3
Respondent agrees to issue the following payment:
An amount of $45,000.00 to purchase the annuity contract described in paragraph 10
of the stipulation, paid to the life insurance company from which the annuity will be
purchased.
This amount represents compensation for all damages that would be available under § 300aa-15(a).
I adopt the parties’ stipulation attached hereto, and award compensation in the amount and
on the terms set forth therein. The clerk of the court is directed to enter judgment in accordance
with this decision.4
IT IS SO ORDERED.
s/ Mindy Michaels Roth
Mindy Michaels Roth
Special Master
3 The stipulation was filed with petitioner’s signature completed via Vinesign (electronic verification). To
avoid the unnecessary disclosure of petitioner’s personal information, the Vinesign form has been omitted
from this decision.
4 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party filing a notice
renouncing the right to seek review.
2

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 3 of 9

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 4 of 9

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 5 of 9

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 6 of 9

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 7 of 9

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 8 of 9

Case 1:17-vv-00621-UNJ Document 114 Filed 05/27/25 Page 9 of 9