{"package_id":"USCOURTS-cofc-1_20-vv-00583","decision_granule_id":"USCOURTS-cofc-1_20-vv-00583-0","petitioner_identifier":"T.R.","is_minor":1,"age_at_vaccination":0.16438,"age_unit_raw":"years","vaccine_type":"Rotavirus","vaccination_date":"2017-10-19","condition_raw":"intussusception","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2024-07-03","extraction_version":"gemini-v2","extracted_at":"2026-04-30T01:14:36.847172+00:00","number_of_concurrent_vaccines":null,"dose_number":null,"time_to_onset_days":null,"theory_of_causation":"Petitioners alleged that T.R., born August 17, 2017, received a Rotavirus vaccine on October 19, 2017, and subsequently developed intussusception. Petitioners' expert, Dr. Hillel Janai, opined that the Rotavirus vaccine caused T.R.'s intussusception through vaccine-induced lymph node hyperplasia leading to a 'lead point' and bowel telescoping. Petitioners argued this met the Althen prongs, including a medically acceptable temporal relationship, citing witness statements alleging symptoms from November 5, 2017. Respondent's expert, Dr. Christopher Liacouras, contended that current Rotavirus vaccines have a weak link to intussusception, the proposed mechanism was speculative, and T.R.'s symptoms were more consistent with infection. Dr. Liacouras emphasized that contemporaneous medical records indicated symptom onset closer to the November 18, 2017 hospitalization. The Special Master found that the petitioners failed to establish a medically acceptable timeframe for vaccine causation, as the contemporaneous medical records indicated an onset of symptoms within two days of hospitalization, which is consistent with the rapid-onset nature of intussusception but too late for a Table claim. The Special Master also found no support in the literature for a progressive, intermittent form of intussusception preceding an acute event over several weeks. The claim was denied. Attorneys for Petitioner were Michael Firestone, Marvin Firestone, MD, JD and Associates. Attorney for Respondent was Bridget Corridon. Chief Special Master Brian H. Corcoran issued the decision on July 3, 2024.","is_death":0,"date_of_death":null,"petition_filed_date":"2020-06-03","case_summary":"On May 11, 2020, Roderick and Kelly Ramos filed a petition on behalf of their infant son, T.R., alleging that he developed intussusception after receiving a Rotavirus vaccine on October 19, 2017. T.R. was born on August 17, 2017. Initially, the petition stated that T.R. began experiencing symptoms around November 17, 2017, leading to hospitalization on November 18, 2017, where he was diagnosed with intussusception and underwent surgery. However, the parents later provided declarations alleging earlier symptoms starting as early as November 5, 2017, and continuing intermittently. Petitioners' expert, Dr. Hillel Janai, opined that the Rotavirus vaccine caused T.R.'s intussusception, suggesting a mechanism of vaccine-induced lymph node hyperplasia leading to a 'lead point' and subsequent bowel telescoping. Dr. Janai's reports addressed the alleged earlier symptoms, the plausibility of the vaccine-induced mechanism, and disputed alternative explanations. Respondent's expert, Dr. Christopher Liacouras, a pediatric gastroenterologist, disagreed, stating that current Rotavirus vaccines are not strongly linked to intussusception, that the proposed mechanism was speculative, and that T.R.'s symptoms were more consistent with an infection. Dr. Liacouras also noted that the medical records indicated an onset closer to the hospitalization date, not the earlier dates alleged in the witness statements. Dr. Steven Lee, the surgeon who operated on T.R., provided a letter opining that T.R. exhibited symptoms of intermittent intussusception for 13 days prior to surgery, based on the parents' declarations. The court considered the arguments from both parties, including the weight given to contemporaneous medical records versus later witness statements, and the application of the Althen factors for causation. The Special Master found that the petitioners failed to establish a medically acceptable timeframe for vaccine causation. The contemporaneous medical records indicated an onset of symptoms within two days of hospitalization, which is consistent with the rapid-onset nature of intussusception but too late for a Table claim. Even if the earlier alleged symptoms were accepted, the court found no support in the literature for a progressive, intermittent form of intussusception that would precede an acute event over several weeks. Therefore, the court denied entitlement and dismissed the claim.","is_minor_inferred":1,"is_pediatric_broad":1,"special_master":"Brian H. Corcoran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Michael Firestone","petitioner_attorney_firm":"Marvin Firestone, MD, JD and Associates","petitioner_attorney_location":"San Mateo, CA","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|michael-firestone|","firm_canonical_key":"marvin-firestone-and-associates","package_title":"RAMOS et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00583","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00583.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00583.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_20-vv-00583-0","title":"RAMOS et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 6/3/2024) regarding 45 DECISION of Special Master. Signed by Chief Special Master Brian H. Corcoran. (ag) Service on parties made.","date_issued":"2024-07-03","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_20-vv-00583/granules/USCOURTS-cofc-1_20-vv-00583-0/pdf","pdf_bytes":484450,"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_20-vv-00583/USCOURTS-cofc-1_20-vv-00583-0"},{"granule_id":"USCOURTS-cofc-1_20-vv-00583-1","title":"RAMOS et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 12/12/2024) regarding 53 DECISION of Special Master - Fees. Signed by Chief Special Master Brian H. Corcoran. (af) Service on parties made.","date_issued":"2025-01-08","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}