Neil Silver v. HHS - Influenza, Guillain-Barré syndrome (GBS) (2023)

Neil Silver, a 62-year-old adult, filed a petition for compensation under the National Vaccine Injury Compensation Program on February 10, 2020. He alleged that approximately three to four weeks after receiving an influenza vaccine on January 8, 2019, he began experiencing numbness, tingling, and pain in his legs, which he believed to be the initial manifestation of Guillain-Barré syndrome (GBS).

The Secretary of Health and Human Services disagreed, arguing that Mr. Silver's GBS symptoms did not manifest until early June 2019, approximately five months after vaccination, which would be outside the Vaccine Injury Table's time frame.

A fact-finding hearing was held on November 16, 2021, to determine the precise onset date of Mr. Silver's symptoms.

The public decision does not describe Mr. Silver's prior medical history beyond a 2013 diagnosis of Parsonage Turner Syndrome (PTS), which affected his upper extremities.

Mr. Silver testified that his PTS did not involve his lower extremities.

He also stated that prior to January 2019, he was generally healthy and active, participating in weekly basketball games, walking with his wife, and taking adventurous vacations. His wife, Robyn Cohen, and friend, Richard Baumer, corroborated his active lifestyle.

Mr. Silver received the influenza vaccine on January 8, 2019, during a cardiology follow-up.

He stated this was his first flu vaccine. Mr.

Silver, Ms. Cohen, and Mr.

Baumer asserted that Mr. Silver began exhibiting health problems soon after the vaccination.

Mr. Silver's affidavit claimed he began experiencing left lower extremity pain shooting down his leg and weakness in his left leg periodically in late January/early February 2019, describing these issues as pain and weakness in his legs, hot shooting pains down the outside of his legs, tingling sensations in his feet and legs, and heavy legs with chronic muscle pain.

Ms. Cohen testified that she noticed a "huge decline" in Mr.

Silver's energy and that he complained of pain and discomfort in his back, legs, and feet around the end of January 2019, and began struggling to walk up stairs. Mr.

Baumer testified that Mr. Silver's energy declined to the point where he started sitting out of basketball games and eventually stopped playing completely, reporting that Mr.

Silver told him his legs were hurting and felt like they had sharp, fire-like shooting pains. The public decision notes a lack of contemporaneous medical records documenting leg symptoms in January or February 2019.

Medical records from April 25, 2019, and June 4, 2019, did not mention leg pain, numbness, or tingling. Mr.

Silver explained he did not mention his leg symptoms to his physician on June 4, 2019, because they were "a few months back" and he was focused on arm and shoulder pain. Contemporaneous gym records showed Mr.

Silver visited the gym seven times in January 2019, with the last visit on January 29, and did not return in February 2019. Mr.

Silver traveled to Zurich, Switzerland, on June 4, 2019, and was admitted to Zurich University Hospital on June 6, 2019, with flaccid tetraparesis and areflexia. An EMG/NCS test on June 7 showed demyelinating disease consistent with Guillain Barré Syndrome.

He was diagnosed with GBS, Miller-Fisher subtype, and later developed respiratory failure requiring ventilation and a tracheotomy. He was medevacked back to the United States on June 18, 2019.

Medical records from New York Presbyterian, taken on June 18, 2019, stated his symptoms started prior to travel on June 3 with new weakness and pain in the shoulder and arms, progressing to weakness in the legs on June 5, 2019, with this information reportedly provided by his wife. On October 19, 2019, Mr.

Silver told his pulmonary doctor, Claudia M. Felberg, that he began having "shooting pains" "a few weeks after[] [his] Flu shot." The Special Master, Christian J.

Moran, found Mr. Silver's testimony, corroborated by his wife and friend, along with the gym records showing a decline in activity, to be credible.

The Special Master determined that Mr. Silver experienced the onset of leg pain, numbness, and tingling during the last week of January 2019.

This ruling establishes the onset date for the purpose of further proceedings, such as expert testimony on causation and potential damages, but does not constitute a diagnosis of GBS itself. The case is ongoing, with entitlement granted pending further decisions on damages.

Petitioner's counsel was Ira M. Newman, and respondent's counsel was Nina Ren.

The decision was issued on April 27, 2023.