{"package_id":"USCOURTS-cofc-1_17-vv-01388","decision_granule_id":"USCOURTS-cofc-1_17-vv-01388-1","petitioner_identifier":"Nichole Wagner","is_minor":0,"age_at_vaccination":30.45,"age_unit_raw":"years","vaccine_type":"influenza","vaccination_date":"2014-10-29","condition_raw":"Guillain-Barré syndrome (GBS) variant facial diplegia","condition_category":"GBS","autism_spectrum_adjacent":0,"outcome":"dismissed","award_amount_usd":null,"decision_date":"2019-07-23","extraction_version":"gemini-v2","extracted_at":"2026-04-30T05:03:24.267085+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":20,"theory_of_causation":"Nichole Wagner, age 30.45, received an influenza vaccine on October 29, 2014. She alleged that this vaccine caused Guillain-Barré syndrome (GBS) variant facial diplegia with residual effects lasting longer than six months. The Special Master, Brian H. Corcoran, dismissed the petition on July 23, 2019, finding that Petitioner failed to meet the statutory six-month severity requirement. Petitioner's GBS symptoms, characterized by facial diplegia, resolved within approximately three months of onset. While Petitioner reported intermittent numbness, tingling, and weakness in her extremities starting in January 2015, her treating neurologist, Dr. Sergiu Besliu, concluded these symptoms were likely due to vitamin B6 toxicity, not GBS sequelae. Dr. Besliu's opinion was given deference. Evidence from chiropractor Matthew Eiken, D.C., and Petitioner's husband, Jason Wagner, suggested ongoing symptoms, but lacked medical corroboration and explicit attribution to GBS. Medical literature submitted by Petitioner described GBS facial diplegia variants as typically not involving extremity symptoms, contradicting the theory that Petitioner's condition would progress to such symptoms. Petitioner's counsel was Ronald C. Homer, and Respondent's counsel was Debra Begley. No specific mechanism of causation was established, and the claim was dismissed for failure to prove the duration of injury.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-09-29","case_summary":"Nichole Wagner filed a petition on September 29, 2017, seeking compensation under the National Vaccine Injury Compensation Program, alleging that the influenza vaccine she received on October 29, 2014, caused her to develop Guillain-Barré syndrome (GBS). Respondent argued that Petitioner could not meet the requirements for a \"Table claim\" or make an evidentiary showing for a causation-in-fact claim, and crucially, that she could not satisfy the statutory prerequisite that her vaccine-related injury or its residual effects lasted for more than six months after vaccination. Petitioner was born on May 12, 1984. Her pre-vaccination medical history included vocal cord nodules, extraesophageal reflux, migraines, and gall bladder problems. She became pregnant in 2014 and tested positive for streptococcus bacteria and parvovirus. She received the flu vaccine on October 29, 2014, and gave birth two weeks later. On November 18, 2014, five days after giving birth, she presented to the emergency room with swelling in her lower back, jaw, and tongue, and was diagnosed with hypertension and postpartum facial swelling. She subsequently visited her obstetrician, complaining of facial paralysis, difficulty making facial expressions, worsening facial muscle weakness, and severe facial swelling. On November 21, 2014, neurologist Sandip Jain, M.D., suggested Petitioner might have GBS, possibly linked to the flu shot or an upper respiratory infection. An MRI of her brain was normal. Visits with Dr. Jain and neurologist Sergiu Besliu, M.D., on November 24 and 25, 2014, characterized her condition as \"possible GBS\" with facial diplegia. Dr. Besliu directed Petitioner to receive five days of intravenous immunoglobulin (IVIG) treatment, and discharged her on November 26, 2014, with a diagnosis of a mild form of GBS. A follow-up visit on December 8, 2014, again characterized her condition as \"Guillain-Barré syndrome variant facial diplegia,\" noting improvement but that she had not yet returned to her baseline. On January 30, 2015, Dr. Besliu noted Petitioner was \"stable\" with no facial diplegia and had \"almost fully recovered\" from her GBS/facial diplegia. However, he recorded her complaint of new-onset numbness and tingling in her extremities and theorized it could be due to a vitamin or hormonal imbalance, recommending tests for vitamin B6, vitamin B12, and thyroid stimulating hormone levels. On July 17, 2015, nearly eight months after onset, Dr. Besliu noted Petitioner complained of bilateral upper and lower extremity weakness and tingling, which had resolved by the time of the visit and for which his examination revealed no neurologic deficits. Crucially, Dr. Besliu stated that these symptoms had been diagnosed as related to B6 toxicity prior to this visit and had been addressed by discontinuing vitamin B6. He did not opine that these symptoms were sequelae of her GBS/facial diplegia. In February 2016, Petitioner again reported bilateral hand and feet numbness, which she stated began in September 2015 and had fluctuated. Dr. Besliu did not attribute these symptoms to GBS, suggesting a possible sensory polyneuropathy and proposing further testing. No other subsequent neurologic records were filed. Petitioner also submitted a letter from chiropractor Matthew Eiken, D.C., dated October 18, 2017, stating he treated her for spasms and tingling around April 2015, approximately six months after her flu shot, and that she reported a history of GBS. However, Dr. Eiken did not opine whether her paresthesia symptoms were part of her GBS or an unrelated condition, and his letter lacked contemporaneous record corroboration. Petitioner's husband, Jason Wagner, provided an affidavit stating she experienced pain and twitching in her face and legs for months after leaving the hospital, and weakness and tingling in her hands persisted for over a year. He also noted her B12 levels were off. Petitioner submitted her own statement detailing ongoing weakness, facial twitching, hypersensitivity to cold, anxiety, and panic attacks, and noted she did not return to work as a teacher. She also submitted Facebook records from October 2017 stating she still had problems with spasms in her face, weakness in her hands, and toe pain. Respondent argued that Petitioner's paresthesia-type symptoms were inconsistent with the monophasic nature of GBS, especially since her facial paralysis largely resolved within two months, and her extremity symptoms began months later and fluctuated. Respondent emphasized that no treating physician characterized her post-diplegia tingling, weakness, or numbness as GBS sequelae, pointing to Dr. Besliu's explicit conclusion that these symptoms were likely due to B6 toxicity. The Special Master found that Petitioner failed to satisfy the six-month severity requirement. The medical records indicated that while Petitioner reported intermittent numbness, tingling, and weakness in her extremities since January 2015, the records did not preponderantly support the contention that these symptoms were GBS sequelae. Dr. Besliu, Petitioner's primary neurologic treater, concluded that her GBS/facial diplegia had almost fully recovered by January 30, 2015, approximately three months post-vaccination. His later opinion was that her extremity symptoms were the result of vitamin B6 toxicity, not GBS. The Special Master found Dr. Besliu's opinion entitled to deference. While Dr. Eiken's letter had some probative value in establishing the existence of symptoms, it did not expressly attribute them to GBS and lacked contemporaneous record support. Furthermore, the medical literature submitted by Petitioner described GBS facial diplegia variants as presenting without extremity symptoms, undermining the contention that her condition would progress to such symptoms. The Special Master concluded that Petitioner's facial diplegia resolved within less than three months of onset, and she failed to demonstrate that her ongoing symptoms were attributable to GBS and lasted longer than six months. Therefore, her claim was dismissed. Ronald C. Homer, Esq. represented Petitioner, and Debra Begley, Esq. represented Respondent. Special Master Brian H. Corcoran issued the decision on July 23, 2019.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Brian H. Corcoran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Ronald C. Homer","petitioner_attorney_firm":"Conway, Homer, P.C.","petitioner_attorney_location":"Boston, MA","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|ronald-homer|","firm_canonical_key":"conway-homer","package_title":"WAGNER v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01388","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01388.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01388.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_17-vv-01388-0","title":"WAGNER v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 6/4/2019) regarding 50 Order on Motion for Reconsideration. Signed by Special Master Brian H. Corcoran. (mml) Service on parties made.","date_issued":"2019-07-02","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"docketText matches skip keyword 'motion'","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_17-vv-01388-1","title":"WAGNER v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 5/8/2019) regarding 48 DECISION of Special Master Signed by Special Master Brian H. Corcoran. (mml) Service on parties made.","date_issued":"2019-07-23","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-01388/granules/USCOURTS-cofc-1_17-vv-01388-1/pdf","pdf_bytes":369401,"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-01388/USCOURTS-cofc-1_17-vv-01388-1"},{"granule_id":"USCOURTS-cofc-1_17-vv-01388-2","title":"WAGNER v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/29/2019) regarding 61 DECISION of Special Master - Fees Signed by Special Master Nora Beth Dorsey. (nh) Service on parties made.","date_issued":"2019-12-06","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}