Marjorie Madan v. HHS - Influenza, brachial neuritis (Parsonage-Turner Syndrome) (2023)

Marjorie Madan, a 48-year-old adult, received an influenza vaccine on September 27, 2017. She later developed brachial neuritis, also known as Parsonage-Turner Syndrome.

The parties stipulated that she did not have this condition before vaccination and that she underwent anterior cervical discectomy with fusion (ACDF) surgery on November 22, 2017. The core dispute was the onset of her brachial neuritis and whether the flu vaccine caused it.

Petitioner argued her symptoms began around October 23, 2017 (26 days post-vaccination), while Respondent contended onset was around November 26, 2017 (60 days post-vaccination). The court found no objective evidence of weakness or scapular winging, key symptoms of brachial neuritis, in the six weeks following vaccination and prior to her surgery.

Objective signs of brachial neuritis, specifically scapular winging, were first documented after her surgery, leading the court to conclude the onset was either November 26, 2017, or December 1, 2017. This timing was considered too remote from the vaccination for causation and more consistent with post-surgical brachial neuritis, which is a recognized, though not fully understood, condition.

Petitioner's treating physicians did not opine that the vaccine caused her condition, and her expert's opinion linking the vaccine to the injury was found to be speculative and unsupported by the medical records. The court ultimately found Petitioner failed to prove by a preponderance of the evidence that the flu vaccine caused her brachial neuritis, and therefore, her petition was denied.

The case was an off-Table claim, meaning Petitioner had to prove causation-in-fact.