William ('Billy') Skinner v. HHS - DPT, vaccine-caused encephalopathy (1994)

William "Billy" Skinner, born December 20, 1983, received a diphtheria-pertussis-tetanus (DPT) vaccination on February 23, 1984. Prior to this vaccination, Billy experienced five seizure episodes between January 17 and 19, 1984, characterized by rigidity of his arms and legs, arching of his head and neck, and eyes rolling back.

Both parties' experts agreed these January episodes were seizures. Following the DPT vaccination, the next two days were uneventful.

On February 25, 1984, Billy experienced screaming, stiffening of his arms and legs, and violent shaking, with his mother observing three such episodes lasting a few seconds each. He was hospitalized, but neurological examinations during this admission were normal, and he was discharged two days later.

After a brief period, seizures recurred on March 2, 1984, and increased significantly, exceeding one hundred in a single day during April 1984. The cause of these recurrent seizures remained unknown.

Billy was hospitalized multiple times, his health deteriorated rapidly, and he died on April 15, 1985. The petitioner's claim was based on a theory of significant aggravation, arguing the DPT vaccination worsened Billy's pre-existing seizure disorder, leading to his death.

Petitioner's expert testified that the February 25 seizures were significantly worse than the January seizures. Respondent's expert disputed this, attributing the February seizures to the natural progression of Billy's pre-existing neurological condition.

The Special Master granted compensation on May 31, 1994, not on the significant aggravation theory, but on the basis that Billy suffered a vaccine-caused Table encephalopathy, as seizures occurred within three days of vaccination, relying on the Federal Circuit's decision in Whitecotton. Respondent appealed, arguing the Special Master misinterpreted Whitecotton.

Judge Robert J. Wiese of the Court of Federal Claims agreed, holding that Whitecotton did not permit a diagnosis of encephalopathy based solely on seizures when medical evidence did not support it.

The court noted that no medical testimony supported the conclusion that Billy's post-vaccination seizures indicated an encephalopathy, and petitioner's own expert conceded he could not state to a reasonable medical certainty that an encephalopathy had occurred within the Table period. The Court of Federal Claims vacated the Special Master's decision and remanded the case for the Special Master to decide the theory actually tried: whether the DPT vaccination significantly aggravated Billy's pre-existing seizure disorder.

The public decision does not state a final compensation award or the outcome after remand.