Jay Nussman v. HHS - Hepatitis B, confusion of unknown etiology, possible partial seizure, seizure disorder (2008)

Petitioner Jay Nussman, born in August 1978, filed a petition for compensation on July 26, 1999, alleging injuries resulting from two hepatitis B vaccinations. The first vaccination was administered on December 10, 1992.

Forty-one days later, on January 20, 1993, petitioner experienced an episode of confusion and memory loss. He was diagnosed with confusion of unknown etiology, with a neurologist suggesting it could be a partial seizure or psychogenic.

An EEG showed mild abnormalities, and an MRI was normal. Petitioner received a second hepatitis B vaccination on April 1, 1993.

Within three days of this vaccination, he experienced a second episode, which his mother described as a seizure. He was prescribed the anticonvulsant Tegretol.

Subsequent MRIs and EEGs showed normal or non-specific abnormalities. A Child Study Team classified him as "perceptually impaired" and developed an Individualized Education Program.

His treating neurologist, Dr. Arnold P.

Gold, did not believe the vaccinations caused his episodes, noting the timing was atypical for vaccinal encephalopathy. Petitioner's father suggested a causal link between the vaccinations and the episodes, which Dr.

Gold noted as highly atypical. Petitioner's counsel was Jay Nussman.

Respondent's counsel is not named in the provided text. The Special Master denied entitlement on January 31, 2008, finding that while a medical theory of causation (delayed hypersensitivity) was established, petitioner failed to prove a logical sequence of cause and effect or a proximate temporal relationship between the vaccinations and his episodes, particularly regarding the challenge-rechallenge paradigm.

The court, in an opinion dated January 31, 2008, affirmed the Special Master's decision, agreeing that petitioner did not meet the burden of proof for causation. The court found no error in the Special Master's conclusion that petitioner failed to establish the second and third prongs of the Althen analysis: a logical sequence of cause and effect and a proximate temporal relationship.

The court noted that the Special Master's discussion of sequelae was dicta and did not affect the entitlement decision. Petitioner's motion for review was denied.