Brent Langley v. HHS - tetanus, encephalopathy (2022)

Brent Langley, a 56-year-old adult, alleged that a tetanus vaccine administered on August 1, 2014, caused him to suffer an encephalopathy. He received the tetanus vaccine along with a rabies vaccine and immunoglobulin after a cat bite.

Following the vaccination, Mr. Langley reported experiencing a range of symptoms including headaches, fatigue, anxiety, difficulty concentrating, memory loss, tremors, and confusion.

He sought treatment from numerous physicians, including his PCP, an ER physician, a neurologist, an infectious disease specialist, a psychiatrist, a hematologist/oncologist, and a neuropsychologist. Some treating physicians, such as Dr.

Annibali and Dr. Williams, diagnosed him with encephalopathy, while others, like Dr.

Uniacke, Dr. Laza, and Dr.

Tkatch, diagnosed him with adjustment disorder, anxiety, or attributed his symptoms to the rabies vaccine. Neuropsychological testing by Dr.

Flaherty-Craig suggested recovering encephalopathy, though her later assessments indicated largely resolved symptoms with residual declines in attention and executive functioning. The respondent, the Secretary of Health and Human Services, argued that Mr.

Langley failed to establish a diagnosis of encephalopathy and that even if he had, the tetanus vaccine was not the cause-in-fact. The court reviewed expert reports from both sides, noting that while some treating physicians and Mr.

Langley's retained experts (Dr. Steinman, Dr.

Marks) supported the encephalopathy diagnosis, the respondent's experts (Dr. LaRusso, Dr.

Naismith) disagreed, citing normal objective tests and the unreliability of SPECT scans for diagnosing encephalopathy. The court found that Mr.

Langley failed to establish by a preponderance of the evidence that he suffered from an encephalopathy, citing the normal results of objective tests, the lack of diagnosis from treating physicians close in time to the vaccination, and the questionable basis for the opinions of Dr. Annibali and Dr.

Williams. Furthermore, the court found that Mr.

Langley did not establish causation-in-fact, as the medical theory presented was not sufficiently supported, and treating physicians often attributed symptoms to multiple vaccines or specifically the rabies vaccine, not the tetanus vaccine. Therefore, the petition was denied.