{"package_id":"USCOURTS-cofc-1_18-vv-00198","decision_granule_id":"USCOURTS-cofc-1_18-vv-00198-1","petitioner_identifier":"Frank Crawford","is_minor":0,"age_at_vaccination":84.0,"age_unit_raw":"years","vaccine_type":"influenza","vaccination_date":"2016-09-06","condition_raw":"nausea and vomiting leading to vasovagal event, fall, head injury, shoulder injury, hip injury, fractured pelvis, compressed L1 vertebrae, shoulder replacement","condition_category":"syncope","autism_spectrum_adjacent":0,"outcome":"compensated","award_amount_usd":145180,"decision_date":"2023-08-03","extraction_version":"gemini-v2","extracted_at":"2026-04-30T00:55:59.650894+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":0,"theory_of_causation":"Petitioner Frank Crawford, an 84-year-old man, received a high-dose influenza vaccine on September 6, 2016. He alleged that the vaccine caused severe nausea and vomiting, beginning within hours of vaccination and continuing for two days, which led to a vasovagal event, a fall, and subsequent injuries including a head laceration, fractured left shoulder requiring replacement, fractured pelvis, and compressed L1 vertebrae. The case was litigated as an off-Table claim. Petitioner's expert, Dr. Vera Byers, proposed a theory that the high-dose influenza vaccine induced a dysregulated cytokine release, a process involving inflammatory cytokines like TNF-α and IL-6, and a delayed response of suppressor cytokines like IL-10, which caused the petitioner's nausea, vomiting, and malaise. This prolonged inflammatory state, supported by elevated monocyte levels observed in the petitioner's medical records two days post-vaccination and cited medical literature (Mohanty, Chatziandreou, Weiner), ultimately led to the vasovagal event. Respondent's expert, Dr. You-Wen He, countered that the symptoms were likely due to pre-existing gastrointestinal issues or a neuroreaction occurring within an hour of vaccination, not an immune-mediated response. He argued that while vaccines can cause nausea, the timing and mechanism proposed by Dr. Byers were not supported by evidence, and that elevated monocytes represented a normal immune response. Special Master Thomas L. Gowen found Dr. Byers's theory to be a sound and reliable explanation, supported by the vaccine package insert and CDC fact sheet listing common systemic adverse events like nausea and malaise, and by medical literature suggesting prolonged cytokine activity post-vaccination. The Special Master found a logical sequence of cause and effect and a medically acceptable temporal relationship, concluding that the vaccine was the cause-in-fact of the petitioner's injuries. The decision awarded $145,000.00 for pain and suffering and $180.00 for unreimbursable expenses, totaling $145,180.00. Petitioner was represented by Richard Gage, P.C., and respondent by Emilie Williams, U.S. Dept. of Justice.","is_death":0,"date_of_death":null,"petition_filed_date":"2018-02-08","case_summary":"On February 8, 2018, Frank Crawford filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that the influenza vaccine he received on September 6, 2016, caused him to suffer nausea and vomiting, leading to a vasovagal event, a fall, and subsequent injuries including a head laceration, a fractured left shoulder requiring replacement surgery, a fractured pelvis, and a compressed L1 vertebrae. The respondent, the Secretary of Health and Human Services, initially recommended against compensation, stating that the petitioner had not provided a medical theory causally connecting the vaccine to his symptoms. The case proceeded as an off-Table claim, requiring the petitioner to prove actual causation. Petitioner's expert, Dr. Vera Byers, opined that the high-dose influenza vaccine triggered a dysregulated cytokine release, leading to nausea, vomiting, and ultimately the vasovagal event. Respondent's expert, Dr. You-Wen He, argued that the petitioner's symptoms were likely due to pre-existing gastrointestinal issues or a neuroreaction, not an immune response to the vaccine. Special Master Thomas L. Gowen, in a ruling on entitlement dated July 27, 2023, found that the petitioner had established by preponderant evidence that the high-dose influenza vaccine caused his nausea, vomiting, and subsequent vasovagal event and injuries. The Special Master accepted Dr. Byers's theory, supported by medical literature and the vaccine's package insert, that the vaccine could induce cytokine production leading to the observed symptoms and event. The Special Master found a logical sequence of cause and effect and a proximate temporal relationship between the vaccination and the injuries. A separate ruling on damages was issued on August 3, 2023. Special Master Gowen awarded Mr. Crawford $145,000.00 for pain and suffering and $180.00 for unreimbursable out-of-pocket expenses, totaling $145,180.00. Petitioner was represented by Richard Gage of Richard Gage, P.C., and respondent was represented by Emilie Williams of the U.S. Dept. of Justice.","is_minor_inferred":0,"is_pediatric_broad":0,"special_master":"Thomas L. Gowen","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Richard Gage","petitioner_attorney_firm":"Richard Gage, P.C.","petitioner_attorney_location":"Cheyenne, WY","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|richard-gage|","firm_canonical_key":"richard-gage","package_title":"CRAWFORD v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00198","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00198.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-00198.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_18-vv-00198-0","title":"CRAWFORD v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC ORDER/RULING (Originally filed: 07/27/2023) regarding 104 Ruling on Entitlement. Signed by Special Master Thomas L. Gowen. (hs) Service on parties made.","date_issued":"2023-09-08","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_18-vv-00198/granules/USCOURTS-cofc-1_18-vv-00198-0/pdf","pdf_bytes":426695,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'ruling on entitlement'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_18-vv-00198/USCOURTS-cofc-1_18-vv-00198-0"},{"granule_id":"USCOURTS-cofc-1_18-vv-00198-1","title":"CRAWFORD v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 08/03/2023) regarding 105 DECISION of Special Master Signed by Special Master Thomas L. Gowen. (slw) Service on parties made.","date_issued":"2023-09-08","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_18-vv-00198/granules/USCOURTS-cofc-1_18-vv-00198-1/pdf","pdf_bytes":341427,"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_18-vv-00198/USCOURTS-cofc-1_18-vv-00198-1"},{"granule_id":"USCOURTS-cofc-1_18-vv-00198-2","title":"CRAWFORD v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 05/29/2024 ) regarding 111 DECISION of Special Master - Fees. Signed by Special Master Thomas L. Gowen. (kp) Service on parties made.","date_issued":"2024-09-04","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}