{"package_id":"USCOURTS-cofc-1_17-vv-00662","decision_granule_id":"USCOURTS-cofc-1_17-vv-00662-0","petitioner_identifier":"Ethel Lynn Munn","is_minor":0,"age_at_vaccination":66.0,"age_unit_raw":"years","vaccine_type":"pneumococcal","vaccination_date":"2015-05-22","condition_raw":"bilateral hand pain and osteoarthritis alleged as vaccine-triggered inflammatory reaction","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2025-09-02","extraction_version":"manual-supplement-redo-2026-05-normal39","extracted_at":"2026-05-04 23:37:20","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":4,"theory_of_causation":"Pneumococcal vaccine, May 22, 2015, age 66, alleged to trigger bilateral hand pain, reactive/inflammatory arthritis, or a chronic osteoarthritis flare. DENIED. Petitioner relied primarily on treating internist Dr. Jennifer Ryal, who described a cytokine/innate immune reaction aggravating pre-existing osteoarthritis. Respondent relied on rheumatologist Dr. Lianne Gensler, who explained that osteoarthritis is degenerative, petitioner had substantial pre-vaccination osteoarthritis and hand findings, labs were not inflammatory, and the finger cyst/nail findings were consistent with osteoarthritis. Special Master Horner found no reliable vaccine-caused chronic osteoarthritis or reactive arthritis theory and no logical sequence proving the vaccine caused petitioner's chronic hand complaints. Attorney Ramon Rodriguez III.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-05-19","case_summary":"On May 19, 2017, Ethel Lynn Munn filed a petition alleging that a pneumococcal vaccination administered on May 22, 2015 caused bilateral hand pain, inflammatory or reactive arthritis, and a worsening of osteoarthritis. She was 66 years old at vaccination.\n\nThe medical record showed substantial pre-vaccination musculoskeletal disease. Ms. Munn had years of diffuse osteoarthritis involving her knees, feet, hip, shoulder, and hands, and records before vaccination described Heberden and Bouchard nodes. Four days after vaccination, a rheumatology visit documented hand symptoms, including left third finger tenderness and erythema, but assessed osteoarthritis. Over the next several weeks, Ms. Munn reported finger pain, swelling, a cyst or blister near the nail, and bilateral hand pain. Primary-care physician Dr. Jennifer Ryal viewed the episode as a likely vaccine reaction or reactive process superimposed on osteoarthritis, while later hand-surgery evaluation characterized the finger findings as consistent with osteoarthritis-related mucous cyst changes. Inflammatory labs were not supportive of rheumatoid arthritis or another systemic inflammatory disease.\n\nPetitioner relied on Dr. Ryal, who proposed that the pneumococcal vaccine triggered cytokine-mediated inflammation and aggravated pre-existing osteoarthritis. Respondent relied on rheumatologist Dr. Lianne Gensler, who explained that osteoarthritis is degenerative rather than immune-mediated, that the package-insert and literature evidence did not establish chronic arthritis caused by pneumococcal vaccine, and that the clinical picture fit Ms. Munn's underlying osteoarthritis better than a vaccine-caused chronic inflammatory injury.\n\nOn September 2, 2025, Special Master Thomas L. Gowen Horner denied compensation. He found that petitioner had not established a reliable medical theory connecting pneumococcal vaccination to chronic osteoarthritis or chronic hand arthritis, and that the case-specific record did not prove a logical sequence of cause and effect. No compensation was awarded. Ms. Munn was represented by Ramon Rodriguez III of Siri & Glimstad.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Daniel T. Horner","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Ramon Rodriguez, III","petitioner_attorney_firm":"Siri & Glimstad LLP","petitioner_attorney_location":"Richmond, VA","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|ramon-rodriguez|","firm_canonical_key":"siri-and-glimstad","package_title":"MUNN v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00662","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00662.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00662.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_17-vv-00662-0","title":"MUNN v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 9/2/2025) regarding 84 DECISION of Special Master. Signed by Special Master Daniel T. Horner. (ksb) Service on parties made.","date_issued":"2025-10-03","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-00662/granules/USCOURTS-cofc-1_17-vv-00662-0/pdf","pdf_bytes":421520,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'decision of special master'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_17-vv-00662/USCOURTS-cofc-1_17-vv-00662-0"}]}