Jeffrey Hossack v. HHS - diphtheria-pertussis-tetanus (DPT), DPT Table HHE/shock collapse with death as sequela; death certificate listed SIDS (1995)

On October 21, 1991, John and Charlene Hossack filed a petition under the National Childhood Vaccine Injury Act on behalf of their son, Jeffrey Hossack, who was born on August 29, 1989. They alleged that Jeffrey suffered a hypotonic-hyporesponsive episode (HHE) or shock collapse and died within the three-day period following his diphtheria-pertussis-tetanus (DPT) vaccination on October 31, 1989.

Jeffrey was approximately sixty-three days old at the time of vaccination. The parents described Jeffrey as developing healthily in his first weeks, with excellent motor skills and high awareness.

After the DPT vaccination, his parents observed a significant change in his behavior. He became uncharacteristically lethargic and limp, showing a lack of interest in food or attention.

Later that evening, he cried intensely and inconsolably for two hours. He awoke again in the early morning hours, agitated and crying, and had difficulty settling back to sleep.

At approximately 3:00 a.m., he let out a painful shriek. His parents found him unresponsive in his crib at 8:00 a.m. on November 1, 1989, discolored and stiff.

Resuscitation efforts failed, and he was pronounced dead at the hospital at 8:40 a.m., approximately eighteen hours after the vaccination. The death certificate listed the cause of death as Sudden Infant Death Syndrome (SIDS).

Special Master E. LaVon French found the parents' testimony to be truthful, candid, cogent, and persuasive.

Petitioners presented Dr. Kevin C.

Geraghty, a pediatrician, immunologist, and allergist, who testified that Jeffrey sustained an unwitnessed HHE culminating in shock collapse, which caused his death. Dr.

Geraghty based his opinion on the constellation and severity of Jeffrey's symptoms. Respondent, the Department of Health and Human Services (HHS), disputed entitlement.

HHS presented Dr. Arnold Gale, a pediatrician and pediatric neurologist, who testified that Jeffrey's symptoms were within the normal range of reactions to DPT and not severe enough to indicate HHE/shock collapse.

HHS also presented Dr. Virginia Anderson, a pediatric pathologist, who found no abnormalities in Jeffrey's heart fiber cells, thymus, adrenal gland, brain neurons, or lungs.

However, Dr. Anderson acknowledged that a pathological examination might not detect evidence of an HHE/shock collapse if it lasted less than four to six hours.

Special Master French found that Jeffrey suffered an HHE/shock collapse within seventy-two hours of the DPT vaccination and that his death was a sequela of this vaccine-related Table injury. She noted that SIDS is an idiopathic diagnosis and could not serve as an unrelated factor rebutting the petitioners' case.

On August 18, 1994, Special Master French awarded compensation of $250,000. Respondent sought review, arguing that the Special Master applied an incorrect legal standard for proving a sequela.

Judge Robert J. Yock reviewed the case and agreed that a petitioner must prove a logical causal link between the Table injury and the sequela.

However, Judge Yock affirmed the Special Master's decision, finding that she had indeed performed the necessary causal analysis. The court found that the Special Master credited Dr.

Geraghty's testimony, rejected Dr. Gale's explanation of normal reactions, and found an uninterrupted progression from vaccination through HHE/shock collapse to death.

The court concluded that the Special Master found by a preponderance of the evidence that Jeffrey's death followed as a sequela of the vaccine-related HHE/shock collapse. The $250,000 award was affirmed.