VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-01507
Package ID: USCOURTS-cofc-1_22-vv-01507
Petitioner: Adrian Williams
Filed: 2022-10-12
Decided: 2025-10-02
Vaccine: Tdap; influenza; pneumococcal
Vaccination date: 2017-09-09
Condition: septic shock, left arm cellulitis, and alleged post-sepsis syndrome
Outcome: dismissed
Award amount USD: 

AI-assisted case summary:
On October 12, 2022, Adrian Williams filed a new Vaccine Act petition after a prior petition had been dismissed for lack of jurisdiction while a civil action was pending. He alleged that Tdap, influenza, and pneumococcal vaccines administered at a Rite Aid in Louisiana on September 9, 2017, caused septic shock, left arm cellulitis, and later post-sepsis syndrome.

Two days after vaccination, Mr. Williams went to the emergency room with left arm soreness, fatigue, weakness, nausea, and vomiting. He was hospitalized for ten days, treated with IV fluids and antibiotics, and discharged on September 20, 2017. His primary hospital diagnosis was septic shock of unknown source, with left arm cellulitis also considered. The record also showed significant pre-vaccination medical history, including hypertension, a prior cardiopulmonary arrest and sepsis after gallbladder surgery, residual neurologic complaints, vertigo, and prior right arm and hand weakness.

Petitioner relied on Dr. Jerrold S. Dreyer, who opined that Mr. Williams developed post-sepsis syndrome and that later muscle cramping was a residual of vaccine-induced septic shock. Special Master Laura D. Millman Roth found that the evidence did not satisfy the Vaccine Act's six-month severity requirement. The post-discharge records did not document continuing vaccine-related sepsis or cellulitis symptoms for six months, did not show treating physicians diagnosing post-sepsis syndrome, and did not support petitioner's later explanation that he used over-the-counter magnesium for vaccine-related cramping.

Mr. Williams sought review. On October 2, 2025, Judge Zachary N. Somers Hadji denied review and sustained the dismissal, concluding that the Special Master had rationally evaluated the medical record and was not required to accept petitioner's expert over the absence of corroborating clinical evidence. No compensation was awarded. Mr. Williams was represented by Harry E. Forst.

Theory of causation field:
Tdap, influenza, and pneumococcal vaccines, September 9, 2017, adult exact age not stated, alleged septic shock/left arm cellulitis with residual post-sepsis syndrome. DISMISSED. Petitioner was hospitalized two days after vaccination with weakness, vomiting, fatigue, left arm soreness, septic shock of unknown source, and left arm cellulitis; expert Dr. Jerrold S. Dreyer attributed later cramping to post-sepsis syndrome. Special Master Roth found no medical records after discharge documenting vaccine-related residuals for six months and no treating diagnosis of post-sepsis syndrome. Judge Hadji denied review on October 2, 2025, holding the severity ruling was rational. Award: none. Attorney Harry E. Forst.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-01507-0
Date issued/filed: 2025-07-28
Pages: 15
Docket text: PUBLIC DECISION (Originally filed: 7/2/2025) regarding 36 DECISION of Special Master. Signed by Special Master Mindy Michaels Roth. (dkj) Service on parties made.
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Case 1:22-vv-01507-PSH Document 37 Filed 07/28/25 Page 1 of 15
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-1507V
Filed: July 2, 2025
* * * * * * * * * * * * * * *
ADRIAN WILLIAMS, *
*
Petitioner, *
v. *
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * *
Harry E. Forst, Esq., Harry E. Forst, Attorney at Law, New Orleans, LA, for petitioner.
Alec Saxe, Esq., U.S. Department of Justice, Washington, DC, for respondent.
FACT RULING AND DISMISSAL DECISION1
Roth, Special Master:
On October 12, 2022, Adrian Williams (“petitioner”) filed a petition for compensation
under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 et seq.2
(“Vaccine Act” or “the Program”). Petitioner alleges that she developed septic shock after
receiving the tetanus-diphtheria-acellular pertussis (“Tdap”) and influenza (“flu”) vaccines on
September 9, 2017. Petition, ECF No. 1.
The parties dispute whether petitioner satisfies the Vaccine Act’s severity requirement—
specifically, whether she experienced residual effects or complications of her alleged vaccine
injury for more than six months. § 11(c)(1)(D)(i).
1 Because this Decision contains a reasoned explanation for the action taken in this case, it must be made publicly
accessible and will be posted on the United States Court of Federal Claims' website, and/or at
https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government Act of 2002.
44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government Services). This means
the Decision will be available to anyone with access to the internet. In accordance with Vaccine Rule 18(b),
Petitioner has 14 days to identify and move to redact medical or other information, the disclosure of which would
constitute an unwarranted invasion of privacy. If, upon review, I agree that the identified material fits within this
definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease of citation,
all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa (2012).

Case 1:22-vv-01507-PSH Document 37 Filed 07/28/25 Page 2 of 15
For the reasons discussed below, and after reviewing the medical records, testimony, and
other evidence submitted, I find that petitioner has not established that she suffered any effects of
the alleged vaccine-related injury for more than six months.
I. Procedural History
Petitioner filed her original petition on March 31, 2020, at which time she had a civil action
pending against Rite Aid and the administering pharmacist for vaccine-related injuries. That
petition was dismissed on July 20, 2022, for lack of jurisdiction. Williams v. Sec'y of Health &
Human Servs., No. 20-367V, 2022 WL 3369717 (Fed. Cl. Spec. Mstr. July 20, 2022). Petitioner
then dismissed her civil action on August 11, 2022. ECF No. 1-2.
On October 12, 2022, petitioner started a new case by filing a petition accompanied by
medical records. ECF Nos. 1, 3. The matter was assigned to the undersigned on January 25, 2023,
following Pre-Assignment Review (“PAR”). ECF Nos. 12-13.
On July 10, 2023, respondent filed a Rule 4(c) Report, arguing that petitioner had not met
the Vaccine Act’s six-month severity requirement. ECF No. 21. Petitioner was subsequently
ordered to submit corroborating evidence in support of the six-month severity requirement, which
she filed on September 20, 2023. ECF Nos. 22, 25.
In a January 22, 2024 status report, after review of the additional evidence filed, respondent
submitted that he was not satisfied the requirement was met. ECF No. 29. Petitioner was ordered
to either file additional supporting evidence or confirm the record was complete on the issue of
severity. ECF No. 30. On February 5, 2024, petitioner filed a status report indicating that no further
evidence would be submitted. ECF No. 31.
On March 21, 2024, petitioner moved for a ruling on the record. Motion, ECF No. 33.
Respondent responded on April 22, 2024, maintaining his position that petitioner failed to
demonstrate residual effects or complications from her alleged vaccine injury lasting more than
six months. Response, ECF No. 34. Petitioner replied on April 25, 2024, stating simply that she
relied on the evidence previously submitted. Reply, ECF No. 35.
The matter is now ripe for ruling.
II. Legal Framework
A. Overall Fact-Finding Framework
Petitioner bears the burden of establishing her claims by a preponderance of the evidence.
§ 13(a)(1). A petitioner must offer evidence that leads the “trier of fact to believe that the existence
of a fact is more probable than its nonexistence before [he or she] may find in favor of the party
who has the burden to persuade the judge of the fact’s existence.” Moberly v. Sec’y of Health &
Human Servs., 592 F.3d 1315, 1322 n.2 (Fed. Cir. 2010) (citations omitted).
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The process for making determinations in Vaccine Program cases regarding factual issues
begins with analyzing the medical records, which are required to be filed with the petition. §
11(c)(2). Medical records created contemporaneously with the events they describe are generally
considered to be more trustworthy. Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525,
1528 (Fed. Cir. 1993); but see Kirby v. Sec’y of Health & Human Servs., 997 F.3d 1378, 1382-83
(Fed. Cir. 2021) (clarifying that Cucuras does not stand for proposition that medical records are
presumptively accurate and complete). While not presumed to be complete and accurate, medical
records made while seeking treatment are generally afforded more weight than statements made
by petitioner after-the-fact. See Gerami v. Sec'y of Health & Human Servs., No. 12-442V, 2013
WL 5998109, at *4 (Fed. Cl. Spec. Mstr. Oct. 11, 2013) (finding that contemporaneously
documented medical evidence was more persuasive than the letter prepared for litigation
purposes), mot. for rev. denied, 127 Fed. Cl. 299 (2014). Indeed, “where later testimony conflicts
with earlier contemporaneous documents, courts generally give the contemporaneous
documentation more weight.” Campbell ex rel. Campbell v. Sec’y of Health & Human Servs., 69
Fed. Cl. 775, 779 (2006); see United States v. U.S. Gypsum Co., 333 U.S. 364, 396 (1948).
B. Severity Requirement
The only question here is whether petitioner satisfied the severity requirement. The
Vaccine Act requires petitioner show by preponderant evidence that she “suffered the residual
effects or complications of such illness, disability, injury, or condition for more than 6 months
after the administration of the vaccine.” § 11(c)(1)(D)(i); see Song v. Sec'y of Dep't of Health &
Human Servs., 31 Fed. Cl. 61, 65-66 (1994), aff'd, 41 F.3d 1520 (Fed. Cir. 2014) (noting that a
petitioner must demonstrate the six-month severity requirement by a preponderance of the
evidence). A petitioner must offer evidence that leads the “trier of fact to believe that the existence
of a fact is more probable than its nonexistence.” Moberly v. Sec’y of Health & Human Servs., 592
F.3d 1315, 1322 n.2 (Fed. Cir. 2010) (citations omitted). Finding that petitioner has met the
severity requirement cannot be based on petitioner’s word alone, though a special master need not
base their finding on medical records. See § 13(a)(1); see Colon, 156 Fed. Cl. 541.
There are several cases addressing the sufficiency of evidence provided to satisfy the six-
month severity requirement. For example, in Kirby, the special master’s finding that Ms. Kirby’s
injury lasted for more than six months was upheld by the Circuit. Kirby, 997 F.3d at 1378. The
special master determined that the petitioner satisfied the severity requirement based on her
testimony, corroborating documentation, and expert testimony, despite medical records
documenting that the petitioner reported “feeling fine”. Id. at 1381. The Circuit distinguished the
petitioner’s case from Cucuras “where the petitioners said one thing to their physician and another
thing to the special master.” Id. at 1383 (citing 993 F.2d at 1527-28). The Circuit held that a
reasonable fact finder could find that petitioner’s testimony of ongoing pain did not conflict with
the records, as the records were also silent about the “nonexistence” of such symptoms, meaning
that the records did not specifically document the absence of certain symptoms. Kirby, 997 F.3d
at 1383. The petitioner’s testimony that her symptoms persisted for over a year was supported by
medical records showing discharge from in-person physical therapy with instruction to continue
with home exercises in addition to the home exercise instruction sheets that she produced at trial.
Id. at 1380-81.
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Special masters have found that continuing a course of medication that is actively treating
a condition for over six months can meet the severity requirement; however, taking medication
prophylactically to evade recurrence cannot. Prepejchal v. Sec'y of Health & Human Servs., No.
15-1302V, 2018 WL 5782865 at *16 (Fed. Cl. Spec. Mstr. Oct. 5, 2018); Watts v. Sec'y of Health
& Human Servs., No. 17-1494V, 2019 WL 4741748 at *7 (Fed. Cl. Aug. 13, 2019). There is a
distinction between taking medication without evidence of symptoms versus taking medication to
prevent symptoms and/or relapse, the latter of which can meet the severity requirement. See also
Faup v. Sec'y of Health & Human Servs., No. 12-87V, 2015 WL 443802 at *4 (finding that the
ongoing need for medication to prevent symptoms and/or relapse of the alleged vaccine-caused
illness constitutes a residual effect or complication of that illness). However, the severity
requirement may not be met merely by speculation that if a petitioner was not taking a medication,
they would experience further symptoms related to the vaccine injury. Toebe v. Sec'y of Health &
Human Servs., No. 91-1623V, 1992 WL 101638 at *3 (Fed. Cl. Spec. Mstr. Apr. 23, 1992).
The Federal Circuit addressed the six-month severity requirement in Wright v. Sec’y of
Health & Human Servs., 22 F.4th 999 (Fed. Cir. 2022). The Circuit held that petitioner failed to
satisfy the six-month requirement when her child’s platelet count normalized less than three
months post-ITP onset because “relatively non-invasive ongoing [platelet] monitoring” was not a
“residual effect” pursuant to § 11(c)(1)(D)(i). Id. at 1001, 1003, 1006–07. The Circuit noted that
the child experienced later bruising that was not related to his vaccine injury and that his ongoing
testing “did not reveal, constitute, or cause any somatic change”. Id. at 1001. Defining the language
in § 11(c)(1)(D)(i), the Federal Circuit determined that “[t]he term ‘residual effects[]’ . . . requires
a change within the patient that is caused by the vaccine injury.” Id. at 1004. It continued that
“‘[r]esidual’ suggests something remaining or left behind from a vaccine injury . . . . Because
vaccine injuries are somatic conditions defined by their signs and symptoms within the patient, . .
. their residues are similarly defined.” Id. at 1005–06. The Federal Circuit stated that the use of the
words “suffered” and “complication” in association with “residual effects” in § 11(c)(1)(D)(i)
“suggest[s] that Congress contemplated residual effects to be detrimental conditions within the
patient, such as lingering or recurring signs and symptoms.” Id. at 1006. It concluded that “[r]ead
together, ‘residual effects’ and ‘complications’ appear to both refer to conditions within the patient,
with ‘residual effects’ focused on lingering signs, symptoms, or sequelae characteristic of the
course of the original vaccine injury, and ‘complications’ encompassing conditions that may not
be ‘essential part[s] of the disease’ or may be outside the ordinary progression of the vaccine
injury.” Id.
The Federal Circuit in Wright noted that “it is sufficient that the vaccine injury be both a
but-for cause of the residual effect and a substantial factor in bringing about the residual effect,
even if it is not the predominant factor.” 22 F.4th at 1005 (citing Shyface v. Sec’y of Health &
Human Servs., 165 F.3d 1344, 1352 (Fed. Cir. 1999)). However, “even if legally caused by his
thrombocytopenic purpura, [the child’s] testing was not a ‘residual effect’”. 22 F.4th at 1005. This
is because the “[t]he tests revealed [that the child] had no lingering symptoms or recurrence of
thrombocytopenic purpura[;]” and because “there [was] no showing or argument that [the testing]
was detrimental to [the child’s] health such that it might qualify under § 300aa–11(c)(1)(D)(i) as
a ‘residual effect’ or a ‘complication’ of thrombocytopenic purpura.” Id. at 1006. The Federal
Circuit concluded that the ongoing monitoring was “neither an ‘ongoing disability’ nor indicative
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that he ‘suffered’ or was ‘seriously injured’ within Congress’s intended meaning of the severity
requirement.” Id. at 1007 (internal citations omitted).
The Federal Circuit further clarified that its decision in Wright “do[es] not disturb existing
case law holding that a course of treatment lasting longer than six months can be a ‘residual
effect.’” 22 F.4th 1007. The Circuit cited to H.S. v. Sec’y of Health & Human Servs., No. 14-
1057V, 2015 WL 1588366 (Fed. Cl. Spec. Mstr. Mar. 13, 2015), in which the special master
determined that restrictions on physical activity, including restrictions from participating in gym
class, recess, and sports, following a concussion constituted a “residual effect” because the
restriction was medically necessary to prevent aggravation of the injury. Id.; H.S., No. 14-1057V,
2015 WL 1588366, at *3. The Circuit also cited to Faup, wherein the special master held that the
petitioner fulfilled the six-month requirement because her child needed medication for her arthritis
for more than six months. Wright, 22 F.4th at 1007; Faup, 12-87V, 2015 WL 443802, at *4. The
Federal Circuit noted that “[d]uring a long course of treatment, the patient generally has some
lingering condition such that symptoms will likely recur if the treatment were stopped. Otherwise,
the long course of treatment would not be necessary.” Wright, 22 F.4th at 1007. The Circuit also
clarified that Wright “do[es] not decide [ ] whether a course of testing or monitoring that is part of
the management or treatment of a condition, necessary even in the absence of possible symptoms,
could be a ‘residual effect’” as monitoring may be considered an ongoing part of treatment if “the
patient’s somatic condition increases the risk of recurrence.” Id.
In sum, special masters may consider the whole record in evaluating whether there is
preponderant evidence for the severity requirement and may find the severity requirement satisfied
even if a petitioner’s medical records for the alleged injury are not continuous for the six months
following the injury. See Kirby, 997 F.3d 1378. However, there must be evidence beyond
petitioner’s word alone, such as other corroborating records or reports, to establish the severity
requirement by a preponderance of evidence. See Colon, 156 Fed. Cl. 534.
III. The Factual Record
A. Medical History
1. Pre-Vaccination Medical History
Petitioner’s medical history includes hypertension, cardiac arrest, sepsis, left knee pain,
chronic right-sided weakness, vertigo, and a severe latex allergy. See generally Pet. Ex. 3; Pet. Ex.
4. She became septic after gall bladder surgery in 2011 and coded with cardiopulmonary arrest.
She was hospitalized for an extended period and suffered complications with residual neck pain
and right arm and hand weakness. Pet. Ex. 3 at 30, 192, 240. She was later diagnosed with chronic
right hand pain, brachial neuritis, right radial nerve palsy, right wrist drop, and cervical spondylosis
for which she received extensive therapies. See generally Pet. Ex. 3 at 6-916.
2. Post-Vaccination Medical History
Petitioner received the subject vaccinations on September 9, 2017. Two days later, on
September 11, 2017, she presented to the emergency room with complaints of two days of fatigue,
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and three days of weakness and nausea which began after receiving flu, pneumonia and tetanus
immunizations. She felt weak all over. She denied pain and fever. Pet. Ex. 3 at 924. A history and
physical conducted by Dr. Chen noted that two days ago, petitioner began experiencing increasing
left arm soreness originating at the site of her vaccinations that was worse with exertion. She then
became weak, fatigued, with nausea and started vomiting. He also noted a history of chronic neck
and right arm pain described as numbness and weakness since a hospitalization in 2011. Pet. Ex.
3 at 932-38, 981-85. On examination, petitioner was afebrile but tachycardic. There was mild
erythema and a four-centimeter area of induration3 on the left deltoid that was warm to the touch.
She was started on IV antibiotics for a presumed infection. Id. at 933, 935, 937-38.
Petitioner’s treaters considered multiple potential sources of infection, including left arm
cellulitis, gastrointestinal infection, and a tubo-ovarian abscess. Pet. Ex. 3 at 921, 932, 937-38,
954, 976. At intake, Dr. Najul-Seda noted possible cellulitis due to flu shot. Id. at 921. Dr. Chen
documented “septic shock”, with the immunization site on petitioner’s left deltoid as a possible
source of cellulitis. Id. at 937. A CT of the abdomen did not show a clear bowel source of infection
but showed diverticulosis. It also showed a mass potentially consistent with a tubo-ovarian abscess,
but an ultrasound determined this was an ovarian cyst. Id. at 941, 971-73, 976
Petitioner improved and was discharged on September 20, 2017. The primary diagnosis
was septic shock, source unknown, that improved with IV Zosyn and vancomycin. Pet. Ex. 3 at
938-945, 1020-22. Oral medications to be started at discharge included Keflex, Lasix, Cozaar,
Imodium, and magnesium oxide. Id. at 943-45.
There are no medical records for further treatment of sepsis or cellulitis following
petitioner’s discharge. There are no medical records of any further complaints associated with her
left arm. Petitioner returned to her neurologist and resumed occupational therapy for her long-
standing right arm injury. Pet. Ex. 3 at 2425-2504. In medical visits subsequent to her
hospitalization, she denied any new complaints. Id. at 2385, 2502, 2522.
B. Testimony and Statements
1. Petitioner’s Affidavit
Petitioner submitted an affidavit dated March 19, 2020. Pet. Ex. 5 at 1. She affirmed receipt
of Tdap and flu vaccinations at a Rite Aid Pharmacy in Louisiana on September 9, 2017. She
developed soreness in her arm shortly after that was worse with exertion. Over the next few days,
she experienced fatigue, nausea, and vomiting. Id. She presented to Ochsner Medical Center on
September 11, 2017, was diagnosed with sepsis, and was hospitalized for ten days. Id. Petitioner
affirmed that she suffered complications from that hospitalization for more than six months. Id.
2. Petitioner’s Deposition Testimony
Petitioner was deposed on October 30, 2019, in her civil lawsuit against Rite Aid and the
pharmacist. Pet. Ex. 8. She testified to having chronic pain, vertigo, and right-sided nerve damage
3 Induration refers to an abnormally hard spot or place. Induration, DORLAND’S ILLUSTRATED MEDICAL DICTIONARY
921 (33rd ed. 2019) [hereinafter DORLAND’S].
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since 2011 following a gallbladder surgery and resulting sepsis. Pet. Ex. 8 at 16-17, 20, 39. She
had been receiving disability benefits since 2014. Id. at 18. In 2015, she suffered a knee injury
from a slip-and-fall incident and had an ongoing lawsuit associated with that fall. Id. at 26-28.
Petitioner testified that on the day of the subject vaccination, she only presented for the flu
and pneumonia vaccines but was offered a tetanus shot due to her recent exposure to a rusty nail.
Pet. Ex. 8 at 40-41. She stated that she received the Tdap and flu vaccines in her right arm and the
pneumococcal vaccine in her left arm. Id. at 42. The medical records document the Tdap vaccine
given in the right arm, and the flu and pneumococcal vaccines in the left. Pet. Ex. 6 at 3.
Petitioner stated that she developed soreness within hours of the vaccinations. She rested,
but her symptoms worsened the next day, and neighbors drove her to the hospital. Pet. Ex. 8 at 70-
73. She reported arm pain, fever, and vomiting at the hospital. Id. at 75-76. She stated that she was
admitted to the ICU and diagnosed with cellulitis of the left arm. Id. at 76-78. IV antibiotics were
administered, her condition improved, and she was discharged home ten days later. Id. at 78, 81-
82.
Petitioner stated that after discharge from the hospital, she had left arm soreness for about
a week and persistent left arm cramping about three to four times per week that lasted between
five and twenty minutes. Pet. Ex. 8 at 83-85, 87. She stated that she never reported left arm
cramping to any provider, but claimed an unnamed physician recommended she take over-the-
counter magnesium supplements for the cramping, which she currently takes. Pet. Ex. at 85-88;
Pet. Ex. 10.
Petitioner had preexisting right hand weakness that is unrelated to her alleged vaccine
injuries. As a result, she has difficulties with lifting, with hygiene, and driving and requires
assistance with some tasks. Pet. Ex. 8 at 89-91. She confirmed that all treatment for her alleged
vaccine-related injury occurred during her initial hospitalization. Id. at 92-93.
C. Other Evidence
a. Report of Jerrold S. Dreyer, M.D., F.A.C.P., F.I.D.S.A.
Petitioner filed an expert report4 from Dr. Jerrold S. Dreyer, an infectious disease specialist,
that described the events following petitioner’s receipt of the vaccines on September 9, 2017. Pet.
Ex. 7.
Dr. Dreyer wrote that petitioner presented to the ER two days after her vaccinations with
nausea, vomiting, hypotension, and left arm pain at the injection site. Pet. Ex. 7 at 2. Her heart rate
was 120-130 beats per minute, her white blood cell count was 18,000, her BUN/creatinine level
was 26/4.0, her procalcitonin level was 35.6, and her lactic acid level was 5.0. Dr. Dreyer opined
that her procalcitonin level was indicative of infection, and her lactic acid level was consistent
4 Dr. Dreyer did not reference any medical records or literature in support of his opinions. He relied on petitioner’s
deposition testimony in her civil action as the basis for his opinion that she suffered left arm cramping in excess of six
months. Pet. Ex. 7 at 2
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with septic shock. Id. There was a 4-centimeter area of induration on her left deltoid, and she was
diagnosed with left upper extremity cellulitis. Id.
Dr. Dreyer opined that petitioner was hospitalized for ten days due to septic shock caused
by the vaccinations she received. Pet. Ex. 7 at 2. He further opined that petitioner suffers from
post-sepsis syndrome (“PSS”), which affects up to 50% of sepsis survivors and can include long-
term effects such as disabling muscle and joint pain. Id. He opined that petitioner’s reported
cramping was more likely a residual effect or complication of her PSS than a direct result of the
vaccine itself, stating: “[i]t is not likely that [she] would have developed cramping but for the
sepsis secondary to the vaccine injury.” Id.
b. Medical Literature
Petitioner filed three pieces of literature in support of her claim. Pet. Ex. 19; Pet. Ex. 20;
Pet. Ex. 24.
The first article is titled “Post-Sepsis Syndrome” and is from the Sepsis Alliance website.
Pet. Ex. 19. It defines PSS as a condition affecting up to 50% of sepsis survivors that is associated
with both physical and psychological symptoms, including but not limited to fatigue, muscle and
joint pain, swelling of the limbs, difficulty sleeping, depression, loss of self-esteem, memory loss,
and post-traumatic stress disorder. Id. at 1-2. The article does not include cramping as a symptom
of PSS, nor does it identify magnesium as a treatment. Pet. Ex. 19. There is no discussion of
symptoms limited to a single limb. Id.
The second article is from the UK Sepsis Trust, addresses PSS, and states that around 40%
of sepsis survivors report physical, cognitive, or psychological after-effects. Pet. Ex. 20 at 2.
Symptoms include lethargy, muscle weakness, joint and muscle pain, insomnia, shortness of
breath, hair loss, changes in sensation in limbs, anxiety and depression, and memory impairment.
Id. at 3. Like the first article, muscle cramping is not included as a symptom.
Petitioner also filed an article from the Journal of Musculoskeletal and Neuronal
Interactions that discusses magnesium in the treatment of muscle cramps. Pet. Ex. 24 at 1. The
article describes muscle cramps as sudden, painful, and sustained contractions of the skeletal
muscle fibers that may be idiopathic or disease-related and can stem from neurologic, renal, or
metabolic conditions. Id. The intervention studied was oral, intramuscular, and IV supplementation
“with magnesium salts at any dose.” Id. at 2. Magnesium was described as one of the minerals
required by the body for nerve transmission and muscle contraction. Id. at 1. The authors found
insufficient evidence to support the use of magnesium for treating idiopathic muscle cramps. Id.
at 3. Petitioner highlighted portions of the article that align with her claim; however, the authors
concluded that magnesium supplementation “probably makes little to no difference” in reducing
the frequency or severity of muscle cramps, particularly in older adults. Id. at 4.
IV. Discussion
There is no dispute that petitioner received three vaccinations on September 9, 2017: Tdap
in her right arm, and flu and pneumococcal vaccines in her left arm. Pet. Ex. 6. There is no dispute
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that she was hospitalized from September 11 to September 20, 2017, and diagnosed with sepsis as
well as left arm cellulitis. Pet. Ex. 3 at 917-2370. The cause of the sepsis, however, was noted to
be unclear. Id. at 976, 990, 994.
Petitioner testified that, following her discharge from the hospital on September 20, 2017,
the only ongoing symptoms she experienced were left arm soreness which resolved within a week
of her discharge and left arm cramping. Pet. Ex. 8 at 83-84. She claimed that the left arm cramping
continued to occur three to four times per week, lasting five to twenty minutes each time, and is
worse with cold weather. Id. at 85-88. She stated that a doctor at Ochsner told her before she left
the hospital to take an over-the-counter magnesium supplement for the cramping, but she could
not remember which doctor. Id. at 86. She continues to take the magnesium supplement. She did
not believe she would see any physician again for her injuries because the magnesium “works.”
Id. at 83, 86-88.
A. The Parties’ Arguments
1. Petitioner’s Submissions
Petitioner filed a motion for ruling on the six-months severity requirement, stating that the
issue was thoroughly briefed in a previous submission and was also addressed in petitioner’s
original case. However, that case was dismissed for lack of jurisdiction and closed. Motion, ECF
No. 33; ECF No. 25; Williams v. Sec'y of Health & Human Servs., No. 20-367V, 2022 WL
3369717 (Fed. Cl. Spec. Mstr. July 20, 2022).5
Petitioner then referenced her September 20, 2023 filing, which was submitted in response
to the Court’s order directing petitioner to file corroborating evidence in support of the six-month
severity requirement. ECF Nos. 22, 25. In that submission, she argued that the medical records,
her sworn testimony, and the expert opinion of Dr. Jerrold Dreyer demonstrate that she meets the
severity requirement because she continues to suffer the residual effects of her vaccine injury
which caused her ten-day hospitalization for septic shock. ECF No. 25 at 1.
Petitioner submitted that Dr. Dreyer opined that she suffers from PSS, a condition that can
include long-term physical effects like disabling joint and muscle pain. ECF No. 25 at 2; Pet. Ex.
7. According to Dr. Dreyer, petitioner’s ongoing left arm cramping is a residual effect or
complication of sepsis that she would not have developed but for the vaccine-induced sepsis
hospitalization. Id.
Petitioner pointed to the literature on PSS filed in support of her argument and explained
that her symptoms for which she continues to take magnesium align with those described in the
literature. ECF No. 25 at 3; Pet. Ex. 19; Pet. Ex. 20. Petitioner emphasized that Dr. Dreyer noted
her cramping, that magnesium was initiated during her hospitalization and was continued post-
discharge. She argued that the literature and the “open-ended” prescription for magnesium satisfies
5 Petitioner’s previous dismissed case is not part of the record in the instant matter, and any materials filed as part of
that docket will not be reviewed herein.
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the six-month requirement, even though evidence supporting the efficacy of magnesium for
cramping is limited. ECF No. 25 at 3, 5-6; Pet. Ex. 24.
Petitioner argued that she was not taking magnesium upon admission to the hospital but
was prescribed it during her stay. Her magnesium blood levels were monitored, and she was
prescribed magnesium oxide upon discharge. ECF No. 25 at 4; Pet. Ex. 11; Pet. Ex. 21; Pet. Ex.
22. Petitioner cited to medical records to support her claim that she was instructed to take 400 mg
once daily and that the recommendation was indefinite. ECF No. 25 at 4; Pet. Ex. 12; Pet. Ex. 21;
Pet. Ex. 22; Pet. Ex. 23 at 1, 3, 5-6, 8.
Petitioner conceded that one record notes the magnesium prescription was to be taken for
ten days but asserted that other records contradict that entry because they do not contain a stop
date. She conceded that the discharge summary listed the medication as “new,” with “no refills,”
but argued this did not explicitly instruct her to stop. ECF No. 25 at 6-7; Pet. Ex. 12; Pet. Ex. 23.
She added that a later pharmacy record included instructions for refill and pickup with no end date.
Id. Petitioner argued that the record is supportive of the understanding that magnesium was to be
taken as needed, which she continues to do. ECF No. 25 at 7.
Petitioner argued that she is not required to prove causation with certainty, she “only has
to prove more likely than not her injury and residuals came from the vaccine.” ECF No. 25 at 8.
She noted that based on the medical records, the treating physician considered left arm cellulitis,
tubo-ovarian abscess, and GI infection as the likely causes of her sepsis but ultimately concluded
that cellulitis was likely the cause after ruling out the others. Id. at 9.
Finally, petitioner referenced the Centers for Disease Control and Prevention (“CDC”)
definition of cellulitis as a common bacterial skin infection that can result in redness, swelling, and
pain, arguing that the most probable source of her cellulitis was the injection site of a vaccine. Dr.
Dreyer agreed that the vaccines caused sepsis and PSS requiring continued magnesium use. ECF
No. 25 at 9.
2. Respondent’s Submissions
Respondent maintained the position set forth in his Rule 4(c) Report and January 22, 2024
status report that petitioner has not provided preponderant evidence of residual effects or
complications lasting more than six months. Response at 1, ECF No. 34. Accordingly, respondent
argued that the petition should be dismissed for failure to meet the severity requirement, relying
on the record as it stands because petitioner’s motion did not present new arguments or evidence.
Id.
In his Rule 4(c) Report, respondent summarized petitioner’s report of the flu, Tdap, and
pneumococcal vaccines on September 9, 2017, and her ER visit two days later for left arm pain,
weakness, and nausea. Respondent’s Report (“Resp. Report”) at 2, ECF No. 21. She was diagnosed
with septic shock and acute renal failure, and she had a four-centimeter area of induration on
examination. Id. The possible sources of infection considered included left arm cellulitis, GI
infection, or a tubo-ovarian abscess. Petitioner’s condition improved with treatment, and she was
10

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discharged on September 20, 2017. At the time of discharge, the source of her sepsis was uncertain.
Id.; Pet. Ex. 3 at 992, 1020.
Respondent added that the only treatment petitioner sought post-discharge was for her
preexisting and ongoing right arm brachial plexus injury. There was no mention of sequelae from
her hospitalization, her sepsis, or further discussion of her allegedly causal vaccinations contained
in those treatment records. Resp. Report at 3.
Respondent argued that, under the Vaccine Act, petitioner bears the burden of proving by
preponderant evidence that she suffered residual effects or complications of her alleged vaccine
injury for more than six months, or that her injury resulted in inpatient hospitalization and surgical
intervention. Resp. Report at 3. Because petitioner did not undergo surgery during her
hospitalization, she must show ongoing residual effects or complications of her allegedly injury
through at least March 11, 2018. Respondent asserted that no such evidence exists, and petitioner’s
medical records are “devoid of any complaints or treatment related to her sepsis diagnosis
following her nine-day hospitalization.” Id. at 4. Further, petitioner relied on a report from Dr.
Dreyer, who diagnosed petitioner with PSS based on her deposition testimony, or her own word,
rather than the medical records, and a finding may not be made based upon the claims of petitioner
alone. Id.
In his January 22, 2024 status report, respondent stated that the “newly filed evidence,”
including articles and medical records, were duplicative of prior submissions and similarly lacked
preponderant support for any residual effects lasting more than six months. Resp. Status Report at
1-2, ECF No. 29.
Respondent disagreed with petitioner’s argument that the magnesium prescription she
received at discharge was “open-ended” and asserted that the records also do not contain evidence
that she continued to take the medication for six months after her hospitalization. Resp. Status
Report at 4. He cited to the medical and pharmacy records to demonstrate that magnesium was
prescribed at a dosage of 400 mg once daily, with a defined 10-day course beginning September
20, 2017, and no refills. Id.; see Pet. Ex. 21; Pet. Ex. 22; Pet. Ex. 23 at 4-7. This limited duration
and the fact that no refills were prescribed contradict petitioner’s claim of long-term use for
residual effects. Resp. Status Report at 4-5. Further, a progress note from an October 11, 2017
neurology visit does not list magnesium oxide among petitioner’s active medications. Id. at 5; Pet.
Ex. 3 at 2382-83, 2388-89.
Respondent disagreed that the literature petitioner filed supported her case. Resp. Status
Report at 6. He submitted that while the articles reference disabling muscle and joint pain as a
long-term effect of PSS, she has not submitted any medical records to corroborate that she has PSS
or the long-term effects thereof. Id. He further noted that the article petitioner filed on magnesium
for muscle cramps concluded that the effectiveness of magnesium supplementation remains
unclear, and petitioner conceded that it did not include muscle cramps as a result of a systemic
disease like sepsis. Id. Even if the literature supported a connection between magnesium and post-
sepsis cramping, it would still be insufficient to meet the statutory burden without corroborating
medical documentation that petitioner suffered from muscle cramps related to her alleged vaccine-
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related injury for more than six months and treated those with magnesium supplementation for
more than six months following her alleged injury. Id.
B. Weighing Petitioner’s Evidence
Following review of the evidence and arguments, I find that petitioner has not established
by a preponderance of the evidence that she suffered a vaccine-related injury that satisfies the six-
month severity requirement. Petitioner claims that she suffered from ongoing left arm cramping
from vaccine-induced sepsis. However, there is nothing in the record to corroborate prolonged or
recurring symptoms consistent with that assertion or that petitioner was prescribed magnesium to
treat left arm cramping.
1. Relevant Medical Records
Petitioner argues that the magnesium prescribed in the hospital and at discharge to treat her
left arm cramping. However, the medical record indicates she was prescribed magnesium oxide—
a formulation generally used as a short-term laxative or to manage magnesium deficiency, not
muscular symptoms.6 Pet. Ex. 3 at 938-44, 2369. During her hospitalization, metabolic panels
performed daily showed that petitioner’s magnesium levels were abnormally low, and IV
magnesium oxide was ordered and administered over the course of her inpatient care. Id. at 1043,
1071, 1155. A metabolic panel performed on the day of discharge showed her magnesium levels
to be “abnormal” and low. She was prescribed oral magnesium oxide for ten days. Id. at 1073,
1088; Pet. Ex. 13 at 1. The discharge summary did not reference cramping or that the magnesium
oxide was prescribed for muscle-related issues. Id. at 938-44, 2367. Further, the discharge
summary lists all the medications to be started, those to be continued that have changed, those to
be continued that have not change, and those to stop, with each entry noting the dosage and whether
refills were ordered. Id. at 943-45. Magnesium oxide 400 mg tablets were to be taken once daily.
Refills were noted as “0”. Id. at 944.
There are no medical records filed following petitioner’s discharge from the hospital that
mention a diagnosis, treatment or complaints of PSS, left-arm cramping, or any related conditions.
Petitioner resumed care only for her chronic right-sided neuritis and wrist-drop, which predated
the vaccinations. Pet. Ex. 3 at 2425-2504. Petitioner attended multiple neurology and occupational
therapy visits between October 2017 and May 2018, and did not report any left arm complaints.
See Pet. Ex. 3 at 2374, 2385, 2425-27, 2450-55, 2502, 2522. While her discharge record reflects
that magnesium oxide was prescribed for ten days, magnesium oxide or magnesium in any form
was not listed on her medications in her medical records subsequent to her discharge from the
hospital. See id. at 2382-84, 2389, 2397-99, 2403-04, 2411-12, 2415-16, 2419-20, 2428-29, 2434-
36, 2443, 2448, 2460, 2487, 2493.
Petitioner filed a photo of the magnesium supplement bottle she alleges to take to treat her
left arm cramping. It is not a prescription bottle, and only reflects “Magnesium” not “Magnesium
Oxide” as prescribed. Pet. Ex. 10. As the medical records reflect, petitioner was administered
magnesium oxide by IV for low magnesium levels during her hospitalization and prescribed oral
6 Magnesium oxide is used “as an oral antacid and laxative, and as a preventative for hypomagnesemia.” Magnesium
oxide, DORLAND’S 1080.
12

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magnesium oxide for ten days at discharge due to continued low levels of magnesium shown on
discharge lab work. The record does not include any reference to magnesium oxide being
prescribed to treat left arm cramping or that she was diagnosed with or suffered from PSS.
2. Petitioner’s Testimony
Petitioner stated that she has experienced cramping in her left arm three to four times a
week for five to 20 minutes at a time since her hospitalization, managed with over-the-counter
magnesium which she claims “works”. Pet. Ex. 8 at 83-88. Petitioner did not report or seek any
medical treatment for left arm cramping after her discharge from the hospital. She could not
identify the physician who she claimed recommended she take magnesium for left arm cramping.
She offered no corroborating documentation to show that she was directed to take the magnesium
supplement beyond the 10 days prescribed, or that her continued use of magnesium is medically
required and/or supervised. She did not mention taking magnesium or having continued left arm
cramping at any medical visits subsequent to her hospitalization. Petitioner’s word alone is
insufficient to satisfy her burden in proving that her symptoms lasted for more than six months. §
13(a)(1).
3. Dr. Dreyer’s Opinion
Petitioner’s expert, Dr. Dreyer, opines that she suffers from PSS with muscle cramping as
a residual effect of vaccine-induced septic shock. Pet. Ex. 7 at 2. However, expert opinions are
usually more persuasive when they rest on more than the expert’s own assertions. Prokopeas v.
Sec'y of Health & Human Servs., No. 04-1717V, 2019 WL 2509626, at *19 (Fed. Cl. Spec. Mstr.
May 24, 2019). Further, conclusory expert statements lacking reliable support are routinely
rejected. See Kreizenbeck v. Sec'y of Health & Human Servs., No. 08-209V, 2018 WL 3679843,
at *31 (Fed. Cl. Spec. Mstr. June 22, 2018), review denied, decision aff’d, 141 Fed. Cl. 138 (2018),
aff'd, 945 F.3d 1362 (Fed. Cir. 2020); see also Burns, 3 F.3d at 417 (holding that special master
properly rejected the petitioner’s medical expert testimony where the expert based his opinion on
facts not substantiated by the record).
Dr. Dreyer’s opinion lacks support from any medical documentation. Although Dr. Dreyer
stated that petitioner suffers from PSS, which includes “long term physical effects like disabling
muscle pain and joint pain,” he offered no basis for how he diagnosed her with PSS or any literature
that supports his assertion that muscle and joint pain are symptoms associated with PSS. Pet. Ex.
7 at 2. This is particularly problematic because none of petitioner’s treating physicians diagnosed
her with or even mentioned PSS or left arm cramping. Dr. Dreyer’s report does not cite to any
medical record in support of his opinions and appears to rely on petitioner’s uncorroborated
statements given at deposition in her civil case. The weight of his opinion is therefore significantly
diminished.
4. Medical Literature
Petitioner submitted three articles discussing PSS and the related complications, as well as
the role of magnesium in treating muscle cramping. Pet. Ex. 19; Pet. Ex. 20; Pet. Ex. 24. None of
the literature establishes a causal relationship between vaccination and long-term cramping, nor
13

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does it support the persistence of PSS symptoms beyond six months in the absence of clinical
confirmation. Pet. Ex. 19; Pet. Ex. 20. Further, the authors of the article on magnesium concluded
that magnesium supplementation “probably makes little to no difference” in reducing the
frequency or severity of muscle cramps, particularly in older adults. Pet. Ex. 24 at 4. As such, the
medical literature does not support petitioner’s claim.
C. Analysis
Petitioner’s claim rests on her personal account, unsupported by medical records. Her
deposition testimony includes various beliefs associated with the vaccinations she received
including that the vaccines caused sepsis, the injections were mishandled by the pharmacist, and
that she should not have been given another pneumonia vaccine. Pet. Ex. 5 at 1; Pet Ex. 8 at 44-
67, 95-100. None of her treating physicians persuasively linked her illness to the vaccines. There
is no evidence to substantiate that magnesium was prescribed for left arm cramping or that it was
to be continued beyond the prescribed ten-day window after discharge. Even if it was accepted
that her left arm cellulitis was vaccine-related, it resolved with IV antibiotics and a ten-day course
of oral medications following her discharge from the hospital with no further treatment required
and no mention of any sequela in the medical records thereafter.
Moreover, petitioner’s claim that magnesium was prescribed for cramping lacks clinical
support. The specific formulation, magnesium oxide, is not standard for muscle cramps and is
more commonly used as a laxative, antacid or for magnesium deficiency.7 See Pet. Ex. 3 at 943-
45. In fact, the medical records corroborate that petitioner was prescribed magnesium by IV due
to low levels of magnesium, not cramping, during her hospitalization. Pet. Ex. 3 at 1043, 1071,
1073, 1155. A metabolic panel performed on the date of discharge showed that her magnesium
levels were still low, and she was prescribed ten days of oral magnesium oxide. Id. at 1073, 1088;
Pet. Ex. 13 at 1.
The Vaccine Act requires reliable, corroborative evidence of an injury lasting in excess of
six months, and the word of petitioner alone is insufficient to satisfy her burden in proving that her
symptoms lasted for more than six months. § 13(a)(1). Neither the medical records, expert report,
or medical literature filed by petitioner provide any corroborating evidence that she continued to
suffer any injury resulting from her vaccinations, that she was prescribed magnesium oxide for left
arm cramping resulting from her vaccine injury, that the prescription for magnesium oxide was
indefinite and to exceed the ten days following her discharge from the hospital on September 20,
2017, that she actually took magnesium oxide for longer than ten days, or that she continued to
suffer any sequela from her vaccinations. Accordingly, petitioner has failed to satisfy the six-
month severity requirement.
V. Conclusion
Upon careful review of the record and after assigning all evidence its appropriate weight,
petitioner has failed to satisfy the severity requirement by preponderant evidence. Therefore,
petitioner may not receive compensation under the Vaccine Act. The Clerk of Court shall enter
judgment accordingly.
7 Supra n.6.
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Case 1:22-vv-01507-PSH Document 37 Filed 07/28/25 Page 15 of 15
IT IS SO ORDERED.
s/Mindy Michaels Roth
Mindy Michaels Roth
Special Master
15

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_22-vv-01507-1
Date issued/filed: 2025-10-20
Pages: 5
Docket text: JUDGE VACCINE REPORTED OPINION (PUBLIC VERSION) reissuing 41 Judge Vaccine Order/Opinion denying Motion for Review. Signed by Judge Philip S. Hadji. (lrf) Service on parties made.
--------------------------------------------------------------------------------
Case 1:22-vv-01507-PSH Document 43 Filed 10/20/25 Page 1 of 5
In the United States Court of Federal Claims
ADRIAN WILLIAMS,
Petitioner,
No. 22-1507
v.
(Originally Filed: October 2, 2025)
Reissued Publicly: October 17, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Harry E. Forst, Harry E. Forst, Attorney at Law, New Orleans, Louisiana, for Petitioner.
Alec Saxe, Trial Attorney, Lara A. Englund, Assistant Director, Heather L. Pearlman,
Deputy Director, C. Salvatore D’Alessio, Director, Torts Branch, Brett A. Shumate,
Assistant Attorney General, Civil Division, United States Department of Justice,
Washington, D.C., for Respondent.
OPINION AND ORDER1
HADJI, Judge.
Petitioner seeks review of a decision dismissing her petition for compensation under
the National Vaccine Injury Compensation Program. For the reasons stated below,
Petitioner’s Motion for Review (ECF 38) is DENIED, and the Special Master’s Decision
(ECF 36) is SUSTAINED.
BACKGROUND
I. Petitioner’s Medical History
The Special Master’s Decision contains a thorough discussion of the evidence of
record. ECF 36 at 5-8. As the underlying facts set forth in Petitioner’s medical records are
not in dispute, the Court adopts such facts as set forth in the Decision and briefly
summarizes them here. See ECF 36 at 5-8; ECF 38; ECF 40 at 6.
1 This Opinion was issued under seal on October 2, 2025. The parties were directed to propose redactions
within fourteen days of issuance of the Opinion. No proposed redactions were received. The Court hereby
publicly releases the Opinion in full.

Case 1:22-vv-01507-PSH Document 43 Filed 10/20/25 Page 2 of 5
On September 9, 2017, Petitioner received tetanus-diphtheria-acellular pertussis
(Tdap), influenza (flu), and pneumococcal vaccines at a Rite Aid in Louisiana. ECF 36 at
5-6. Two days later, she presented to the emergency room complaining of left arm soreness,
fatigue, weakness, nausea, and vomiting. Id. Petitioner’s medical team considered multiple
potential sources of infection, including cellulitis. Id. at 6. Ultimately, Petitioner was
admitted to the hospital and received a primary diagnosis of septic shock, source unknown.
Id. She was treated with IV fluids and antibiotics and discharged on September 20, 2017.
Id.
There are no medical records documenting further complaints related to Petitioner’s
left arm following her discharge from the hospital. Id. Nor are there any medical records
reflecting further treatment of sepsis or cellulitis. Id. Instead, Petitioner’s post-discharge
medical records reflect that she resumed treatment for a preexisting right arm injury. Id.
II. The Petition and Procedural History
In October 2022, Petitioner filed a petition seeking compensation under the National
Vaccine Injury Compensation Program, 42 U.S.C. §§ 300aa-10 et seq.,2 alleging that her
September 2017 vaccines caused septic shock and sequelae. ECF 1 at 1-2. In support of
her claim, Petitioner submitted medical records, affidavits, and the report of Dr. Jerrold S.
Dreyer, an infectious disease specialist who opined that Petitioner suffers from post-sepsis
syndrome with muscle cramping as a residual effect of vaccine-induced septic shock. See
ECF 3 at 1-2; Pet. Ex. 7 at 2. Petitioner also submitted deposition testimony and civil
litigation documents arising from a dismissed suit against Rite Aid and the pharmacist who
administered the vaccines. See ECF 3 at 1-2.
Respondent’s Rule 4(c) Report challenged Petitioner’s claim on the basis that she
had not met the Vaccine Act’s six-month severity requirement. ECF 21 at 3-7. The Special
Master ordered Petitioner to submit any corroborating evidence to support her claim that
her injury, pain, or disability continued in excess of six months. ECF 22 at 3. In September
2023, Petitioner filed additional medical records as well as three pieces of medical
literature in support of her claim. ECF 25. Unsatisfied that the six-month severity
requirement was met, Respondent again sought dismissal. ECF 29 at 1. The Special Master
ordered Petitioner to either file additional supporting evidence or confirm the record was
complete on the issue of severity. ECF 30 at 2. In February 2024, Petitioner filed a status
report averring that she “has no additional evidence to submit on the six-month severity
issue….” ECF 31 at 1.
In March 2024, Petitioner moved for a ruling on the record on the six-month severity
requirement. ECF 33. On July 2, 2025, the Special Master found that Petitioner failed to
satisfy the severity requirement by preponderant evidence and concluded that Petitioner
2 The National Vaccine Injury Compensation Program was established by the National Childhood Vaccine
Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755 (the Vaccine Act).
2

Case 1:22-vv-01507-PSH Document 43 Filed 10/20/25 Page 3 of 5
may not receive compensation under the Vaccine Act. ECF 36 at 14. Petitioner now seeks
review of the Special Master’s Decision. ECF 38.
STANDARD OF REVIEW
Under the Vaccine Act, this Court has jurisdiction to review a special master’s
decision. 42 U.S.C. § 300aa-12(e)(2). In reviewing a special master’s decision, this Court
may:
(A) uphold the findings of fact and conclusions of law of the
special master and sustain the special master’s decision, (B) set
aside any of the findings of fact or conclusion of law of the
special master found to be arbitrary, capricious, an abuse of
discretion, or otherwise not in accordance with law and issue
its own findings of fact and conclusions of law, or (C) remand
the petition to the special master for further action in
accordance with the court’s direction.
42 U.S.C. § 300aa-12(e)(2)(A)-(C). The standards set forth in 42 U.S.C. § 300aa-
12(e)(2)(B) “vary in application as well as degree of deference” as each “standard applies
to a different aspect of the judgment.” Munn v. Sec'y of Health & Hum. Servs., 970 F.2d
863, 870 n.10 (Fed. Cir. 1992). Findings of fact receive deferential review under the
“arbitrary and capricious” standard; legal conclusions are reviewed de novo under the “not
in accordance with law” standard; and discretionary rulings are reviewed for “abuse of
discretion.” Turner v. Sec’y of Health & Hum. Servs., 268 F.3d 1334, 1337 (Fed. Cir. 2001).
With respect to the arbitrary and capricious standard, “no uniform definition … has
emerged,” but it is “a highly deferential standard of review” such that “[i]f the special
master has considered the relevant evidence of record, drawn plausible inferences and
articulated a rational basis for the decision, reversible error will be extremely difficult to
demonstrate.” Hines v. Sec’y of Health & Hum. Servs., 940 F.2d 1518, 1527-28 (Fed. Cir.
1991); see also Motor Vehicle Mfrs. Ass’n of U.S., Inc. v. State Farm Mut. Auto Ins. Co.,
463 U.S. 29, 43 (1983) (a decision is arbitrary and capricious only if it is “so implausible
that it could not be ascribed to a difference in view”). Accordingly, if a special master’s
finding of fact is “based on evidence in the record that [is] not wholly implausible,” this
Court is “compelled to uphold that finding as not being arbitrary or capricious.” Lampe v.
Sec’y of Health & Hum. Servs., 219 F.3d 1357, 1363 (Fed. Cir. 2000).
DISCUSSION
To obtain compensation under the Vaccine Act, a petitioner must demonstrate, by a
preponderance of evidence, all matters required under 42 U.S.C. § 300aa-11(c)(1),
including the elements required to establish entitlement to compensation. 42 U.S.C. §
300aa-13(a)(1)(A). As relevant here, this burden includes a showing that the petitioner
3

Case 1:22-vv-01507-PSH Document 43 Filed 10/20/25 Page 4 of 5
suffered the residual effects or complications of a vaccine injury for more than six months.3
42 U.S.C. § 300aa-11(c)(1)(D)(i). In determining whether compensation should be
awarded, the special master or court must review the record as a whole, and may not find
that a petitioner met his or her burden “based on the claims of a petitioner alone,
unsubstantiated by medical records or by medical opinion.” 42 U.S.C. § 300aa-13(a)(1).
The sole issue before the Court is whether the Special Master arbitrarily or
capriciously found that Petitioner did not meet the Vaccine Act’s six-month severity
requirement. Here, Petitioner effectively asks the Court to reweigh the evidence and find
that Petitioner met that requirement. See ECF 38 at 1-2. But “[t]he statute makes clear that,
on review, [this Court] is not to second guess the Special Master[’]s fact-intensive
conclusions.” Hodges v. Sec’y of Health & Hum. Servs., 9 F.3d 958, 961 (Fed. Cir. 1993).
It is not for this Court to “reweigh the factual evidence, assess whether the special master
correctly evaluated the evidence, or examine the probative value of the evidence or the
credibility of the witnesses—these are all matters within the purview of the fact finder.”
Porter v. Sec’y of Health & Hum. Servs., 663 F.3d 1242, 1249 (Fed. Cir. 2011).
Accordingly, the Court cannot “substitute its judgment for that of the special master merely
because it might have reached a different conclusion.” Snyder v. Sec’y of Health & Hum.
Servs., 88 Fed. Cl. 706, 718 (2009).
In the instant case, the Special Master undertook a thorough and careful evaluation
of the evidence before concluding that “[P]etitioner has not established by a preponderance
of the evidence that she suffered a vaccine-related injury that satisfies the six-month
severity requirement.” ECF 36 at 12. The Special Master reviewed Petitioner’s medical
records and testimony, Dr. Dreyer’s expert report, and medical literature. See id. at 5-8, 12-
14. After doing so, she found that “there is nothing in the record to corroborate” Petitioner’s
claims that she suffered from sequelae for more than six months. Id. at 12.
This finding was not arbitrary and capricious. Though Petitioner argues that she
“presented overwhelming evidence that her injury lasted more than six months,” ECF 38
at 1, the Special Master addressed each piece of evidence and articulated her rationale for
finding each unpersuasive. With respect to Dr. Dreyer’s expert report, she explained that
his opinion lacked support from any medical documentation and noted that his opinions
rely on Petitioner’s uncorroborated statements. ECF 36 at 13. Regarding the medical
literature Petitioner presented, the Special Master noted that none of the articles established
a causal relationship between vaccination and long-term cramping or supported the
persistence of post-sepsis syndrome symptoms beyond six months. Id. at 13-14. Finally,
she explained that, in accordance with the evidentiary standard set forth in the Vaccine Act,
3 Alternatively, a petitioner may prove death or that her injury resulted in inpatient hospitalization and
surgical intervention. 42 U.S.C. § 300aa-11(c)(1)(D)(i). Here, there is no dispute that Petitioner is alive and
that she did not undergo surgery during her hospitalization.
4

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Petitioner’s testimony alone is insufficient to satisfy her burden.4 Id. at 13. Because the
Special Master “considered the relevant evidence of record, dr[ew] plausible inferences
and articulated a rational basis for the decision,” Hines, 940 F.2d at 1528, the Court
declines to disturb the Special Master’s finding.
Though Petitioner argues that public policy considerations warrant a different result,
the Court disagrees. In Petitioner’s view, the Special Master’s Decision is “contrary to the
very spirit of the Vaccine Injury Fund’s very existence.” ECF 38 at 3. However, though
the goal of the Vaccine Act is to “lessen the number of lawsuits against manufacturers and
… satisfy petitioners in a fair, expeditious, and generous manner,” Cloer v. Sec’y of Health
& Hum. Servs., 654 F.3d 1322, 1326 (Fed. Cir. 2011), the Vaccine Act nonetheless sets
forth strict evidentiary standards that must be met in order to obtain compensation. Because
Petitioner did not meet that burden here, the Special Master’s denial of compensation is
consistent with both the letter and spirit of the Vaccine Act.
CONCLUSION
Because the Special Master thoroughly evaluated the evidence of record and
articulated a rational basis for finding that Petitioner did not meet her burden in meeting
the six-month severity requirement, Petitioner’s Motion for Review (ECF 38) is DENIED
and the Special Master’s Decision (ECF 36) is SUSTAINED. The Clerk of the Court is
directed to enter judgment accordingly.
IT IS SO ORDERED.
PHILIP S. HADJI
Judge
4 Petitioner suggests that the Special Master discredited her testimony based on an improper credibility
determination and argues that Petitioner “should be believed” absent “a history of being a liar or a cheater.”
ECF 38 at 2. This argument fails because: (1) no adverse credibility determination was made; and (2) special
masters have broad discretion in determining credibility. Bradley v. Sec’y of Health & Hum. Servs., 991
F.2d 1570, 1575 (Fed. Cir. 1993).
5