{"package_id":"USCOURTS-cofc-1_17-vv-01362","decision_granule_id":"USCOURTS-cofc-1_17-vv-01362-0","petitioner_identifier":"A.J.K.","is_minor":1,"age_at_vaccination":1.02,"age_unit_raw":"years","vaccine_type":"MMR","vaccination_date":"2014-09-29","condition_raw":"posterior reversible leukoencephalopathy or stroke, seizure disorder and their sequelae","condition_category":"encephalitis_encephalopathy","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2023-12-22","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:53:01.892375+00:00","number_of_concurrent_vaccines":4,"dose_number":1,"time_to_onset_days":2,"theory_of_causation":"Petitioners alleged that A.J.K., a minor aged approximately 1 year and 3 days, received MMR, Hep A, varicella, and flu vaccinations on September 29, 2014, and subsequently developed posterior reversible leukoencephalopathy syndrome (PRES) and seizure disorder. Petitioners' experts, Dr. Huq and Dr. Gershwin, theorized that the vaccinations, acting synergistically with a resolving HFMD infection, caused an inflammatory cytokine response that disrupted the blood-brain barrier, leading to PRES. Respondent's experts, Dr. Forsthuber and Dr. Bingham, contended that vaccines do not cause PRES, that cytokine levels from vaccination are insufficient to disrupt the blood-brain barrier, and that A.J.K.'s condition was more likely a stroke due to hypertension or HFMD. Special Master Daniel T. Horner found that while PRES can be theorized as cytokine-mediated, petitioners failed to prove by preponderant evidence that vaccines can cause PRES or that the vaccines caused A.J.K.'s specific condition. The case was dismissed. Petitioner counsel: Edward Kraus. Respondent counsel: Colleen Hartley. Decision Date: December 22, 2023.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-11-27","case_summary":"On September 28, 2017, Andrew Kaltenmark and Danielle Kaltenmark, parents of A.J.K., a minor, filed a petition alleging that A.J.K.'s Measles, Mumps, and Rubella (MMR), varicella, and Influenza (flu) vaccinations administered on September 29, 2014, caused posterior reversible leukoencephalopathy syndrome (PRES), seizure disorder, and their sequelae. An amended petition later included Hepatitis A (Hep A) vaccine and alleged aggravation of an underlying seizure condition. The case proceeded as an off-Table claim, requiring petitioners to prove causation-in-fact. Petitioners' experts, pediatric neurologist AHM Mahbubul Huq and immunologist M. Eric Gershwin, theorized that the vaccinations, in combination with a resolving hand, foot, and mouth disease (HFMD) infection, triggered an inflammatory cytokine response that disrupted the blood-brain barrier, leading to PRES. Respondent's experts, immunologist Thomas G. Forsthuber and pediatric neurologist Peter M. Bingham, argued that the medical literature does not support vaccines causing PRES, that the cytokine levels expected from vaccination are too low to disrupt the blood-brain barrier, and that A.J.K.'s condition was more likely a stroke caused by hypertension or her prior HFMD infection. The Special Master, Daniel T. Horner, found that while PRES is a recognized condition and can be theorized as cytokine-mediated, petitioners failed to present preponderant evidence that vaccines can cause PRES or that A.J.K.'s specific condition was vaccine-caused. The Special Master noted that the timing of A.J.K.'s symptoms (approximately two days post-vaccination) was consistent with an innate immune response, but the lack of clinical evidence of inflammation and the insufficient scientific support for the vaccine-cytokine-PRES pathway led to the denial of entitlement. The petition was dismissed. Petitioner counsel was Edward Kraus. Respondent counsel was Colleen Hartley.","is_minor_inferred":null,"is_pediatric_broad":1,"special_master":"Daniel T. Horner","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Edward Kraus","petitioner_attorney_firm":"Kraus Law Group, LLC","petitioner_attorney_location":"Chicago, IL","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|edward-kraus|","firm_canonical_key":"kraus-law-group","package_title":"KALTENMARK v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01362","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01362.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01362.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_17-vv-01362-0","title":"KALTENMARK v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 11/27/2023) regarding 147 DECISION of Special Master. Signed by Special Master Daniel T. Horner. (ksb) Service on parties made.","date_issued":"2023-12-22","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-01362/granules/USCOURTS-cofc-1_17-vv-01362-0/pdf","pdf_bytes":656063,"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-01362/USCOURTS-cofc-1_17-vv-01362-0"},{"granule_id":"USCOURTS-cofc-1_17-vv-01362-1","title":"KALTENMARK v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/23/2024) regarding 154 DECISION of Special Master - Fees. Signed by Special Master Daniel T. Horner. (sh). Service on parties made.","date_issued":"2024-11-18","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_17-vv-01362-cl-extra-10742567","title":"Kaltenmark v. Secretary of Health and Human Services","docket_text":"Supplementary opinion from CourtListener cluster 10275977","date_issued":"2024-11-18","pdf_url":null,"pdf_bytes":null,"triage_decision":"keep","triage_reason":"CL supplement: Kaltenmark v. Secretary of Health and Human Services","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_17-vv-01362/USCOURTS-cofc-1_17-vv-01362-cl-extra-10742567"}]}