Julie Chen v. HHS - DPT, encephalopathy and significant aggravation of pre-existing neurological disorder (Rett syndrome) (1993)

Julie Chen, an 18-month-old infant, received her fourth DPT vaccination on July 30, 1981. Shortly after the vaccination, she developed a fever that lasted for three days and became irritable.

On the second day following the vaccination, she began crying inconsolably for approximately two weeks. Following this period, she became withdrawn and unresponsive for two to four months.

A subsequent medical evaluation at 22 months of age revealed a severe regression in language and motor development. Petitioners claimed that Julie suffered an encephalopathy caused by the vaccine, which either caused or significantly aggravated her pre-existing neurological disorder, Rett syndrome.

The Special Master denied the claim, finding that petitioners failed to establish an encephalopathy and that Julie's symptoms were characteristic of the natural progression of Rett syndrome, specifically Stage II. The court affirmed the Special Master's decision, agreeing that the evidence did not support a finding of vaccine-caused encephalopathy or significant aggravation.

The court noted that while inconsolable crying can be a sign of an encephalopathy, it is not conclusive on its own. Furthermore, diagnostic evidence of encephalopathy from an electroencephalogram performed six months post-vaccination was not probative of a vaccine-caused injury within the three-day window required for a "table" claim.

The court concluded that no presumption of vaccine-caused injury arose because there were no changes in the severity of Julie's underlying disorder within the three-day period following vaccination. The court emphasized that for a claim of significant aggravation, there must be evidence of a post-vaccinal disturbance recognized by medical science as a marker of an increase in the severity of an underlying neurological disorder, and this change must occur at the time of vaccination, not reflect future expected health.

The court found that petitioners failed to make a prima facie case for significant aggravation because there were no changes in the severity of Julie's underlying disorder within the three-day period following the DPT vaccination. Therefore, a presumption of vaccine-caused injury never arose.

The decision was affirmed.