{"package_id":"USCOURTS-cofc-1_17-vv-00936","decision_granule_id":"USCOURTS-cofc-1_17-vv-00936-1","petitioner_identifier":"Mary Orloski","is_minor":0,"age_at_vaccination":58.0,"age_unit_raw":"years","vaccine_type":"influenza","vaccination_date":"2014-10-23","condition_raw":"acute disseminated encephalomyelitis","condition_category":"encephalitis_encephalopathy","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2020-04-27","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:51:13.966550+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":0,"theory_of_causation":"Mary Orloski, age 58, filed a claim alleging that her influenza vaccine on October 23, 2014, and/or her Tdap vaccine on November 18, 2015, caused acute disseminated encephalomyelitis (ADEM). Petitioner's treating neurologist, Dr. Alexandra Degenhardt, diagnosed ADEM, citing a temporal relationship between the vaccinations and symptoms including visual disturbances and extremity tingling/numbness. However, other physicians, Dr. David Preston and Dr. Haatem Reda, questioned this diagnosis, suggesting anxiety or MS. Respondent's expert, Dr. Subramaniam Sriram, opined that Petitioner did not meet ADEM criteria, citing her age, lack of encephalopathy, and symptom timeline, and found MRIs inconsistent with demyelinating disease. The Special Master denied the claim, finding Petitioner failed to establish Althen Prong 1 (medical theory of causation), Prong 2 (logical sequence of cause and effect), and Prong 3 (proximate temporal relationship). Deficiencies in Dr. Degenhardt's reports regarding causation mechanism, temporal aspects, qualifications, and supporting literature were noted. Medical literature submitted by Petitioner was deemed insufficient to establish causation, and immediate symptom onset was found inconsistent with typical ADEM timelines. The Court of Federal Claims affirmed the Special Master's decision, finding Petitioner did not meet her burden of proof under the Althen prongs. The claim was dismissed for insufficient proof.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-07-13","case_summary":"Mary Orloski filed a petition on July 13, 2017, alleging that the influenza vaccine she received on October 23, 2014, and the tetanus-diphtheria-acellular-pertussis (Tdap) vaccine she received on November 18, 2015, caused her to develop acute disseminated encephalomyelitis (ADEM). Petitioner, a 58-year-old woman, reported experiencing visual disturbances shortly after the flu vaccine and later developed tingling and numbness in her extremities after both vaccinations. Her treating neurologist, Dr. Alexandra Degenhardt, diagnosed her with ADEM, citing a temporal relationship between the vaccinations and her symptoms. However, other treating physicians, Dr. David Preston and Dr. Haatem Reda, offered alternative diagnoses or questioned the ADEM diagnosis. Dr. Preston attributed many of Petitioner's symptoms to anxiety and panic disorder, while Dr. Reda suggested Multiple Sclerosis (MS) was more likely based on neuroimaging. Respondent's expert, Dr. Subramaniam Sriram, opined that Petitioner did not meet the criteria for ADEM, citing her age, lack of encephalopathy, and the timeline of her symptoms. Dr. Sriram also concluded that Petitioner's MRI images were inconsistent with a CNS demyelinating disease and more likely represented patterns seen in chronic migraines. The Special Master denied the claim, finding that Petitioner failed to establish a medical theory of causation (Althen Prong 1), a logical sequence of cause and effect (Althen Prong 2), and a proximate temporal relationship (Althen Prong 3). The Special Master noted deficiencies in Dr. Degenhardt's reports, including a lack of specific causation mechanisms, temporal considerations, and supporting medical literature, as well as inadequate demonstration of her qualifications. The medical literature submitted by Petitioner was also found insufficient to establish causation. The Special Master found that Petitioner's immediate symptom onset was inconsistent with typical timelines for vaccine-induced ADEM and that her diagnosis of ADEM was not definitively supported by the record, especially given the conflicting opinions from other physicians and the lack of mandatory encephalopathy. The United States Court of Federal Claims reviewed the Special Master's decision. The Court denied Petitioner's motion for review and sustained the Special Master's decision, agreeing that Petitioner failed to meet her burden of proof under the three prongs of the Althen test. The Court found that the Special Master appropriately considered the evidence, including Dr. Degenhardt's opinions, and did not abuse her discretion in declining to hold an evidentiary hearing. The claim was dismissed for insufficient proof.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Herbrina Sanders Young","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Verne E. Paradie, Jr.","petitioner_attorney_firm":"Paradie, Sherman, et al.","petitioner_attorney_location":"Lewiston, ME","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|verne-paradie|","firm_canonical_key":"paradie-sherman-et-al","package_title":"ORLOSKI v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00936","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00936.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00936.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_17-vv-00936-0","title":"ORLOSKI v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/31/2019) regarding 47 DECISION of Special Master. Signed by Special Master Herbrina Sanders. (rs) Service on parties made.","date_issued":"2020-01-13","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-00936/granules/USCOURTS-cofc-1_17-vv-00936-0/pdf","pdf_bytes":363583,"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-00936/USCOURTS-cofc-1_17-vv-00936-0"},{"granule_id":"USCOURTS-cofc-1_17-vv-00936-1","title":"ORLOSKI v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"**RE-DOCKETED 57 TO CORRECT FILING ERROR** JUDGE VACCINE REPORTED OPINION on Motion for Review. Signed by Judge Lydia Kay Griggsby. (jt1) Service on parties made. Modified on 4/27/2020 - corrected document error(jt1).","date_issued":"2020-04-27","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-00936/granules/USCOURTS-cofc-1_17-vv-00936-1/pdf","pdf_bytes":364899,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_17-vv-00936/USCOURTS-cofc-1_17-vv-00936-1"},{"granule_id":"USCOURTS-cofc-1_17-vv-00936-2","title":"ORLOSKI v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/22/2021) regarding 69 DECISION of Special Master - Fees Signed by Special Master Herbrina Sanders. (kp) Service on parties made.","date_issued":"2021-11-19","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}