Shakia Tany-ka Dickerson v. HHS - diphtheria-tetanus-pertussis (DTP), alleged DTP Table residual seizure disorder; afebrile seizure disorder; actual-causation seizure claim remanded (1996)
Case summary [AI summaries can sometimes make mistakes]
On January 29, 1991, Betty L. Dickerson filed a petition under the National Childhood Vaccine Injury Act on behalf of her daughter, Shakia Tany-ka Dickerson, who was born on October 31, 1984.
Shakia received her first diphtheria-tetanus-pertussis (DTP) vaccination on January 17, 1985, at approximately two and a half months of age. Ms.
Dickerson alleged that immediately after the vaccination, Shakia experienced a 40-minute episode of severe shaking, which was not contemporaneously documented in medical records. Four days later, on January 21, 1985, Shakia exhibited symptoms described as her eyes rolling back and an inability to hold her head steadily, followed by a seizure lasting about fifteen minutes.
She was taken to Saint Joseph Hospital, diagnosed with an afebrile seizure disorder, and prescribed Phenobarbital. Medical records noted jerking of extremities, increased blinking, and sensitivity to light.
Shakia was hospitalized again on March 7, 1985, for multiple jerking episodes, lethargy, and a fever of 101.2 degrees, and was discharged on March 11, 1985. She received another diphtheria-tetanus vaccine on March 18, 1985.
Subsequent medical records indicated that her seizure history coincided with DTP vaccinations and documented recurrent seizure episodes throughout her childhood, characterized by shaking, twitching, loss of head control, eyes rolling back, increased blinking, unresponsive staring, and prolonged screaming. An EEG on January 27, 1989, showed mild abnormalities with epileptiform discharges.
Shakia took anticonvulsant medication for approximately seven years, initially Phenobarbital and later Dilantin, but was not taking medication at the time of the decision. Ms.
Dickerson reported that Shakia, then eleven years old, had a short attention span, serious academic difficulties, performed below grade level, and required continuous tutoring, incurring approximately $3,413.36 in unreimbursed costs. Petitioner initially pursued a claim for residual seizure disorder (RSD) under the Vaccine Injury Table, alleging the first symptom occurred within three days of vaccination.
Alternatively, she argued that the DTP vaccine actually caused Shakia's seizure disorder. Special Master John F.
Edwards dismissed the case on November 22, 1995, without an evidentiary hearing. He found the Table claim lacked medical record or opinion support for the alleged January 17 post-vaccination episode and that Dr.
Michael Van Doren Johnston's declaration was insufficient for actual causation. Dr.
Johnston was a professor of neurology and pediatrics at Johns Hopkins University School of Medicine and the Kennedy Krieger Institute. On May 21, 1996, Judge James F.
Merow reviewed the dismissal. The court denied the challenge to the Table-injury ruling, finding the Special Master did not abuse his discretion by dismissing it without a hearing, as Petitioner had been instructed to develop the medical and factual basis for the Table theory but failed to submit medical support for the immediate post-vaccination episode.
However, the court set aside the dismissal of the actual-causation claim, holding that the Special Master had not adequately explained why Dr. Johnston's declaration was rejected, wrongly faulted it for lacking medical literature when none was specifically required, and had not given Petitioner a full and fair opportunity to elaborate on the expert's reasoning.
The case was remanded for further proceedings on actual causation. The public text does not contain a final post-remand entitlement ruling or compensation award.
Theory of causation
Petitioner Betty L. Dickerson filed a claim on behalf of her daughter Shakia Tany-ka Dickerson, alleging that a DTP vaccine administered on January 17, 1985, at approximately 2.5 months of age, caused residual seizure disorder (RSD) and/or was the actual cause of her seizure disorder. The claim was initially pursued under the Vaccine Injury Table (Table) for RSD, requiring the first symptom within three days of vaccination, and alternatively, for actual causation. Special Master John F. Edwards dismissed the Table claim due to lack of medical record or opinion support for the alleged immediate post-vaccination shaking episode on January 17, 1985, and dismissed the actual causation claim, finding the declaration of Dr. Michael Van Doren Johnston insufficient, citing a lack of medical literature and a "conclusive" statement. On review, Judge James F. Merow affirmed the dismissal of the Table claim, finding no abuse of discretion in denying a hearing as Petitioner failed to provide the required medical support for the January 17 episode despite ample opportunity. However, the court remanded the actual causation claim, ruling that the Special Master erred by rejecting Dr. Johnston's declaration without adequate explanation, faulting it for lacking medical literature not explicitly required, and failing to provide Petitioner a full opportunity to elaborate on the expert's reasoning. The court noted that Federal Rule of Evidence 705 allows experts to testify in terms of opinion without first testifying to underlying facts or data unless the court requires otherwise, and that the Vaccine Act requires medical records or opinion, not necessarily literature. The Special Master's dismissal of Dr. Johnston's opinion without specific findings or a thorough, rational explanation was deemed arbitrary and capricious. The case was remanded for further proceedings on actual causation. No final entitlement ruling or award is present in the staged public text. Attorneys involved were Petitioner's counsel and Respondent's counsel (Secretary of DHHS). Special Master was John F. Edwards; Judge was James F. Merow.
Source PDFs
USCOURTS-cofc-1_91-vv-00204