{"package_id":"USCOURTS-cofc-1_19-vv-00238","decision_granule_id":"USCOURTS-cofc-1_19-vv-00238-1","petitioner_identifier":"WCF","is_minor":1,"age_at_vaccination":0.75,"age_unit_raw":"years","vaccine_type":"hepatitis A","vaccination_date":"2016-02-17","condition_raw":"anti-NMDAR encephalitis","condition_category":"encephalitis_encephalopathy","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2025-05-14","extraction_version":"gemini-v2","extracted_at":"2026-04-30T01:04:29.455628+00:00","number_of_concurrent_vaccines":2,"dose_number":2,"time_to_onset_days":4,"theory_of_causation":"Petitioner Amy Faulkenberry alleged that WCF, a minor vaccinated with hepatitis A and flu vaccines on February 17, 2016, developed anti-NMDAR encephalitis. Petitioner's expert, Dr. Lydia Marcus, proposed molecular mimicry as a plausible mechanism, suggesting homology between vaccine antigens and the NMDA receptor. Respondent's expert, Dr. Eric Lancaster, disputed this, citing the lack of specificity and the unlikelihood of a vaccine protein mimicking the required receptor epitope, and pointed to WCF's history of infections as a more probable cause. The Special Master denied compensation, finding Petitioner failed to establish a medical theory causally connecting the vaccines to the injury by a preponderance of the evidence, as required by the first prong of the Althen test. The Special Master found the presented epidemiologic evidence and case reports unpersuasive and Dr. Marcus's theories too general and lacking specific empirical support. Judge David A. Tapp affirmed, agreeing that Petitioner did not meet the burden of proof for Althen prong one, as the evidence did not establish a persuasive medical theory of causation, and that the Special Master correctly applied the preponderance of the evidence standard. Petitioner's counsel was M. Clay Ragsdale, IV. Respondent's counsel included Emily Manoso and Catherine Stolar before the Special Master, and Madelyn E. Weeks, Alexis B. Babcock, Heather L. Pearlman, C. Salvatore D’Alessio, and Brian M. Boynton before the Judge. Special Master was Christian J. Moran, and the reviewing Judge was David A. Tapp. Decision date was May 14, 2025.","is_death":0,"date_of_death":null,"petition_filed_date":"2019-02-12","case_summary":"On February 12, 2019, Amy Faulkenberry, on behalf of her minor son WCF, filed a petition for compensation under the National Childhood Vaccine Injury Act of 1986. WCF, born in July 2014, received a hepatitis A vaccine and an influenza (flu) vaccine on February 17, 2016. Four days later, WCF began experiencing vomiting, and on March 6, 2016, he had convulsions. Ms. Faulkenberry alleged that these vaccines caused WCF's diagnosed condition of anti-NMDAR encephalitis, which is a rare neurologic condition associated with antibodies against N-methyl-D-aspartate receptors. The respondent, the Secretary of Health and Human Services, disputed the claim. Both parties retained experts: Ms. Faulkenberry presented Dr. Lydia Marcus, a pediatric neurologist, and the Secretary presented Dr. Eric Lancaster, a neurologist specializing in antibody-mediated neurologic disorders. Both experts agreed on WCF's diagnosis of anti-NMDAR encephalitis but disagreed on vaccine causation. Dr. Marcus proposed molecular mimicry as a plausible mechanism by which vaccines could induce autoimmune encephalitis, citing studies suggesting molecular homology between influenza antigens and the NMDA receptor. Dr. Lancaster disputed this theory, stating it was highly unlikely that a denatured vaccine protein would resemble the specific 3-dimensional epitope on the GluN1 receptor subunit required for the disease. He also noted deficiencies in Dr. Marcus's theory, such as the lack of specificity regarding the vaccine components and mechanism, and highlighted the possibility of infection as an alternative cause, citing WCF's history of respiratory infections and a diagnosis of maxillary sinusitis preceding the encephalitis symptoms. Dr. Marcus countered that even if an infection was present, the vaccinations could still be considered a necessary and substantial cause, and that the relationship between environmental triggers and autoimmune encephalitis is generally accepted without requiring an exact mechanistic explanation. The Special Master, Christian J. Moran, denied compensation on November 1, 2024. The Special Master found that Ms. Faulkenberry failed to establish by a preponderance of the evidence a medical theory causally connecting the hepatitis A or flu vaccine to WCF's anti-NMDAR encephalitis. The decision focused on the first prong of the Althen test, requiring a medical theory connecting the vaccination and the injury. The Special Master found that the epidemiologic evidence (Jedidi abstract) and case reports presented by Ms. Faulkenberry were not persuasive or reliable. He also found Dr. Marcus's proposed theories, particularly molecular mimicry, to be too general and lacking specific evidence to establish a causal link between the specific vaccines and anti-NMDAR encephalitis. The Special Master concluded that Ms. Faulkenberry's evidence did not meet the required standard of proof. On review, Judge David A. Tapp affirmed the Special Master's decision on May 14, 2025, finding that the Special Master applied the correct legal standards and did not impermissibly elevate the burden of proof. The court agreed that Ms. Faulkenberry failed to present a persuasive medical theory of causation, noting the lack of specific evidence linking the vaccines to the creation of antibodies against the specific protein causing anti-NMDAR encephalitis. The court found the Special Master's analysis to be well-reasoned and thorough, and therefore denied Ms. Faulkenberry's motion for review.","is_minor_inferred":1,"is_pediatric_broad":1,"special_master":"Christian J. Moran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Milton Clay Ragsdale, IV","petitioner_attorney_firm":"Ragsdale LLC","petitioner_attorney_location":"Birmingham, AL","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|milton-ragsdale|","firm_canonical_key":"ragsdale","package_title":"FAULKENBERRY v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00238","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00238.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-00238.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_19-vv-00238-0","title":"FAULKENBERRY v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 11/01/2024) regarding 95 DECISION of Special Master. Signed by Special Master Christian J. Moran. (jjb) Service on parties made.","date_issued":"2024-11-26","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_19-vv-00238/granules/USCOURTS-cofc-1_19-vv-00238-0/pdf","pdf_bytes":440152,"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_19-vv-00238/USCOURTS-cofc-1_19-vv-00238-0"},{"granule_id":"USCOURTS-cofc-1_19-vv-00238-1","title":"FAULKENBERRY v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"JUDGE VACCINE REPORTED OPINION (PUBLIC VERSION) re: 101 Order on Motion for Review, Judge Vaccine Order/Opinion. Signed by Judge David A. Tapp. (jjg) Service on parties made.","date_issued":"2025-05-14","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_19-vv-00238/granules/USCOURTS-cofc-1_19-vv-00238-1/pdf","pdf_bytes":398426,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'opinion'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_19-vv-00238/USCOURTS-cofc-1_19-vv-00238-1"},{"granule_id":"USCOURTS-cofc-1_19-vv-00238-2","title":"FAULKENBERRY v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 01/05/2026) regarding 108 DECISION of Special Master - Fees. Signed by Special Master Christian J. Moran. (jjb) Service on parties made.","date_issued":"2026-01-29","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}