Jason Lucas Anderson v. HHS - Hib, death; alleged hypotonic-hyporesponsive episode/shock collapse after DPT (1997)

On July 14, 1993, Danyelle Robinson and Mark Anderson filed a petition seeking compensation under the National Childhood Vaccine Injury Act for the death of their son, Jason Lucas Anderson, who was born on June 30, 1991. Petitioners alleged that Jason received his first Diphtheria-Pertussis-Tetanus (DPT), oral polio, and Haemophilus influenzae type b (Hib) vaccinations on August 30, 1991, at his two-month well-baby visit.

They contended that the DPT vaccine caused Jason to suffer a hypotonic-hyporesponsive episode (HHE), a condition listed in the Vaccine Injury Table, and that his death was a sequela of this Table injury. The respondent argued that the petitioners failed to prove the onset of an HHE or any other Table injury within the required timeframe and that DPT did not cause Jason's death.

According to the petitioners, Jason was unusually fussy after returning home from his vaccination appointment around 4:30 p.m. He did not nurse at his usual 6:00 p.m. feeding, cried continuously, and slept only briefly when put down.

His grandmother, Cleo Meckle, who babysat him that evening, described him as not his usual responsive self, appearing pale and bloated, and requiring coaxing to feed. Jason slept through being picked up around 2:30 a.m. and missed his usual 3:00 a.m. feeding.

The following day, August 31, he fed at 6:00 a.m. but then slept until mid-morning, after which he was fussy, wanted to be held, and slept only for short periods. He did not develop a fever.

Later that afternoon, Jason was left with a babysitter, Heather Ricks. Ms.

Ricks reported that Jason was fussy on and off, fed poorly, but responded to comfort and smiled during the evening. She testified that he did not appear swollen, febrile, limp, unconscious, or in respiratory distress.

Around 8:00 p.m., Ms. Ricks found Jason face-down on a waterbed, not breathing and appearing pale or white.

She initiated CPR and called 911. Paramedics attempted resuscitation but pronounced Jason dead at the hospital.

The death certificate listed sudden infant death syndrome (SIDS) as the cause of death. An autopsy performed by Dr.

George R. Lindholm considered SIDS but concluded the death was due to asphyxia from airway occlusion on the waterbed, noting petechiae consistent with asphyxiation.

Dr. Lindholm found no evidence of cerebral edema, hemorrhage, or inflammatory reaction that would support DPT involvement.

Dr. Michael A.

Donlan, Jason's pediatrician, signed the death certificate listing SIDS and testified that the findings were most compatible with SIDS, describing normal and rare serious reactions to DPT. Petitioners' expert, Dr.

Mark R. Geier, opined that Jason exhibited symptoms consistent with HHE, including decreased responsiveness, prolonged sleeping, difficulty arousing, lessened consciousness, loss of muscle tone, and cardiac and respiratory arrest, and that the DPT lot was highly reactogenic.

Respondent's expert, Dr. Mary Anne Guggenheim, concluded that Jason died from SIDS unrelated to vaccination, stating that the observed symptoms were not indicative of HHE or acute encephalopathy, as Jason continued to feed and respond to caretakers.

Special Master Elizabeth Wright denied compensation on January 31, 1997, finding Dr. Guggenheim's opinion more credible and concluding that petitioners had not proven an HHE occurred before Jason was found unconscious.

The Court of Federal Claims affirmed this decision. The court held that symptoms occurring during the dying process could not establish an HHE that then caused death, and that death following DPT vaccination was compensable as a Table claim only if a listed Table injury arose first and death followed as its sequela.

The court found that Jason's pre-death symptoms of fussiness, poor feeding, and disrupted sleep did not meet the criteria for HHE. The court also noted that the burden of proving an unrelated cause did not shift to the respondent because the petitioners failed to establish a Table injury.

Compensation was denied.