{"package_id":"USCOURTS-cofc-1_90-vv-01335","decision_granule_id":"USCOURTS-cofc-1_90-vv-01335-cl6649070","petitioner_identifier":"Trevor Hulbert","is_minor":1,"age_at_vaccination":0.23,"age_unit_raw":"years (84 days)","vaccine_type":"diphtheria-pertussis-tetanus (DPT)","vaccination_date":"1985-09-26","condition_raw":"alleged DPT Table seizure onset/residual seizure disorder and significant aggravation of congenital tuberous sclerosis; mental retardation, developmental delay, autistic features","condition_category":"seizure_disorder","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2001-02-20","extraction_version":"gemini-v2","extracted_at":"2026-04-30T14:08:55.293926+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":3,"theory_of_causation":"DPT vaccine administered September 26, 1985, at 84 days old (born July 4, 1985) allegedly significantly aggravated congenital tuberous sclerosis (TS) and caused seizure onset/residual seizure disorder, mental retardation, developmental delay, and autistic features. DENIED. Initial Vaccine Table theory succeeded in 1994 when Special Master Laura D. Millman found seizure onset within three days post-vaccination, coupled with localized redness, swelling, low fever, and fussiness, creating a rebuttable DPT Table presumption. Respondent later reopened TS cases based on new evidence from Dr. Manuel Gomez, who changed his view and no longer believed DPT caused or triggered seizure onset in TS children, attributing it instead to cortical tubers. In a subsequent case-specific hearing on January 28, 2000, petitioner's expert Dr. Marcel Kinsbourne testified against respondent's expert Dr. Max Wiznitzer, a clinical pediatric neurologist and TS clinician. The Special Master credited Dr. Wiznitzer, finding that TS was more likely the cause of Trevor's seizures and current condition, and that the vaccine-site reactions, low fever, and fussiness were transient and unrelated to the seizures. The denial decision was issued on February 20, 2001, and affirmed on review by Judge Eric G. Bruggink. No award was made.","is_death":0,"date_of_death":null,"petition_filed_date":"1990-09-25","case_summary":"On September 25, 1990, a petition was filed on behalf of Trevor Hulbert, born July 4, 1985, for injuries allegedly sustained as a result of receiving the diphtheria-pertussis-tetanus (DPT) vaccine on September 26, 1985. Trevor had tuberous sclerosis (TS) from birth, a genetic disorder involving cortical lesions on the brain. Petitioners alleged that the DPT vaccine significantly aggravated Trevor's TS and caused the onset of his seizures. Trevor later continued to have seizures and was described as mentally retarded, significantly delayed, and having autistic features. \n\nInitially, the case proceeded as a Vaccine Table claim. Special Master Laura D. Millman found that within three days after the DPT vaccination, Trevor suffered a seizure, along with localized redness, heat, and swelling at the vaccination site, a low fever, and fussiness. Based on testimony from Dr. Manuel Gomez of the Mayo Clinic, who stated that the vaccine likely precipitated or triggered the seizures if onset occurred within three days, the special master found in an unpublished December 28, 1994 decision that Trevor's seizure onset was \"on-Table,\" creating a rebuttable presumption of causation. Petitioners were deemed entitled to compensation, though no final judgment was entered as damages were not yet determined.\n\nIn March 1995, the respondent presented new evidence in pending TS cases, including a new article co-authored by Dr. Gomez and a letter from him stating that some of his prior testimony was \"confusing or meaningless, if not erroneous.\" Special Master Millman reopened the TS cases, consolidated them for omnibus proceedings, and heard additional expert testimony. During the June 1997 omnibus trial, Dr. Gomez testified that he had reconsidered his earlier views and no longer believed that DPT caused or triggered seizure onset in children with TS, attributing seizure onset and outcome to the cortical tubers instead.\n\nFollowing the omnibus decision, Special Master Millman revisited Trevor's case. She noted that Trevor had experienced more than afebrile seizures within three days of the DPT vaccination but required case-specific expert testimony to determine if his localized vaccine-site reaction, low fever, and fussiness were part of a broader vaccine reaction or merely transient post-vaccination symptoms unrelated to the seizures. An evidentiary hearing was held on January 28, 2000, for this purpose. Dr. Gomez did not testify at this hearing. Petitioners relied on Dr. Marcel Kinsbourne, and respondent relied on Dr. Max Wiznitzer.\n\nOn February 20, 2001, Special Master Millman denied compensation. She found that the respondent had rebutted the Table presumption by proving, more likely than not, that Trevor's TS caused both the onset of his seizures and his later condition. She credited the testimony of Dr. Wiznitzer, a clinical pediatric neurologist specializing in autism and treating patients with TS, and gave less weight to Dr. Kinsbourne, who had not practiced clinical medicine for many years and taught non-medical subjects. The special master also concluded that Trevor's localized vaccine-site reaction, low fever, and fussiness were benign transient symptoms and did not demonstrate that DPT significantly aggravated his TS. \n\nPetitioners sought review, arguing that the special master had improperly shifted the burden of proof, wrongly refused to strike Dr. Gomez's adverse later testimony, and relied on speculative testimony from Dr. Wiznitzer. Judge Eric G. Bruggink affirmed the denial, holding that the special master correctly recognized the Table presumption and allowed the respondent to rebut it with preponderant evidence of an unrelated factor. The court further held that the special master's final causation ruling was based on the January 28, 2000, evidence, particularly Dr. Wiznitzer's testimony, and not on Dr. Gomez's omnibus testimony. As credibility determinations are within the special master's purview and her reliance on Dr. Wiznitzer was not arbitrary or capricious, the petitioners' motion for review was denied. No compensation was awarded.","is_minor_inferred":0,"is_pediatric_broad":1,"special_master":"Laura D. Millman","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":null,"petitioner_attorney_firm":null,"petitioner_attorney_location":null,"adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":null,"firm_canonical_key":null,"package_title":"Hulbert v. Secretary of Health & Human Services","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_90-vv-01335","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_90-vv-01335.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_90-vv-01335.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_90-vv-01335-cl6649070","title":"Hulbert v. Secretary of Health & Human Services","docket_text":"lead-opinion","date_issued":"2001-05-11","pdf_url":"https://www.courtlistener.com/opinion/6766293/hulbert-v-secretary-of-health-human-services/","pdf_bytes":null,"triage_decision":"keep","triage_reason":"recovered via CL opinion 6649070 (html_with_citations)","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_90-vv-01335/USCOURTS-cofc-1_90-vv-01335-cl6649070"}]}