{"package_id":"USCOURTS-cofc-1_99-vv-00524","decision_granule_id":"USCOURTS-cofc-1_99-vv-00524-cl6662523","petitioner_identifier":"Thomas Ricci","is_minor":1,"age_at_vaccination":0.252,"age_unit_raw":"years (born July 8, 1992; vaccinated October 8, 1992)","vaccine_type":"Hepatitis B","vaccination_date":"1992-10-08","condition_raw":"encephalopathy and/or encephalitis and/or meningoencephalitis, resulting in a seizure disorder impairing cognitive and physical development","condition_category":"seizure_disorder","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2011-10-26","extraction_version":"gemini-v2","extracted_at":"2026-04-30T14:31:31.492511+00:00","number_of_concurrent_vaccines":1,"dose_number":1,"time_to_onset_days":5,"theory_of_causation":"Off-Table claim for Thomas Ricci, born July 8, 1992, alleging injury from Hepatitis B vaccine administered October 8, 1992. Petition filed July 28, 1999. Alleged injury: encephalopathy/encephalitis/meningoencephalitis resulting in a seizure disorder with severe cognitive and physical impairment. Clinical timeline: symptoms (arm jerks) began October 13, 1992; hospitalized October 15-21, 1992, with inconclusive tests for inflammation; further seizures and hospitalization November 6, 1992, with continued inconclusive testing. Petitioners' expert Dr. Lawrence Steinman proposed an autoimmune \"molecular mimicry\" theory, positing the vaccine triggered an immune response attacking neural tissue, evidenced by alleged inflammation indicated by cerebrospinal fluid results and an MRI showing a thin corpus callosum. Respondent's expert Dr. Max Wiznitzer testified against inflammation, stating CSF levels were normal for an infant, the thin corpus callosum finding was not consistently observed, and no evidence supported encephalopathy with meningoencephalitis. Special Master Christian J. Moran denied compensation on May 16, 2011, finding no preponderant evidence of inflammation at seizure onset, which was a necessary predicate for Dr. Steinman's theory. Judge Wheeler affirmed the denial on October 26, 2011, deferring to the special master's reliance on contemporaneous medical records and Dr. Wiznitzer's testimony over Dr. Steinman's ex-post facto interpretation. Petitioners' counsel and respondent's counsel are not named in the provided text. No award was made.","is_death":0,"date_of_death":null,"petition_filed_date":"1999-07-28","case_summary":"On July 28, 1999, Daniel and Eva Ricci filed a petition under the National Childhood Vaccine Injury Act on behalf of their son, Thomas Ricci. They alleged that a Hepatitis B vaccination administered on October 8, 1992, had caused an encephalopathy, encephalitis, or meningoencephalitis, resulting in a seizure disorder that impaired his cognitive and physical development. Thomas was born on July 8, 1992, and was developing normally prior to vaccination. Five days after receiving the vaccine, on October 13, 1992, his mother noticed arm jerks. His pediatrician, Dr. Ofelia B. Ayuste, witnessed another arm jerk on October 15, 1992, and immediately sent Thomas to Adventist Hinsdale Hospital. He was hospitalized from October 15 to October 21, 1992, during which time he underwent cerebrospinal fluid testing, genetic testing, a CT scan with contrast, an MRI, and an EEG. No cause, such as inflammation, was identified. He was discharged with a diagnosis of infantile seizure disorder of undetermined etiology and prescribed Phenobarbital. Thomas continued to experience seizures despite further treatment and testing, including another hospitalization at Loyola University Medical Center on November 6, 1992. By the time of the proceedings, his parents reported that his cognitive and physical development had effectively stopped at approximately three months of age. The Hepatitis B vaccine is on the Vaccine Injury Table, but Thomas's alleged injury was not listed. Therefore, the case proceeded as an \"off-Table\" causation claim, requiring petitioners to prove causation-in-fact. Petitioners' expert, Dr. Lawrence Steinman, a professor at Stanford University, proposed a theory of \"molecular mimicry,\" suggesting the vaccine triggered an autoimmune process where the body's immune response mistakenly attacked Thomas's neural tissue, causing meningoencephalitis and neurological damage. This theory required the presence of inflammation at the onset of seizures. Dr. Steinman interpreted Thomas's cerebrospinal fluid results and an MRI showing a thin corpus callosum as evidence of inflammation and early brain injury. Respondent's expert, Dr. Max Wiznitzer, a pediatric neurologist from Case Western Reserve University, testified that there was no evidence of encephalopathy with associated meningoencephalitis at the time of Thomas's hospital admission. He stated that the cerebrospinal fluid white blood cell and protein levels were within normal limits for an infant, that the MRI finding of a thin corpus callosum was not supported by later imaging, and that the case showed only a temporal association between the vaccine and the seizures, not a medically demonstrated inflammatory process. Special Master Christian J. Moran denied compensation on May 16, 2011, finding that the preponderant evidence did not show meningoencephalitis or other central nervous system inflammation when Thomas's seizures began, thus breaking the causal chain required for Dr. Steinman's theory. Judge Wheeler affirmed this decision on October 26, 2011, holding that the lack of proven inflammation at seizure onset was dispositive. The court found that contemporaneous medical records and Dr. Wiznitzer's testimony carried more weight than Dr. Steinman's present testimony and ex-post facto interpretations. The court affirmed the denial of compensation.","is_minor_inferred":0,"is_pediatric_broad":1,"special_master":"Christian J. Moran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":null,"petitioner_attorney_firm":null,"petitioner_attorney_location":null,"adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":null,"firm_canonical_key":null,"package_title":"Ricci v. Secretary of Health & Human Services","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_99-vv-00524","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_99-vv-00524.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_99-vv-00524.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_99-vv-00524-cl6662523","title":"Ricci v. Secretary of Health & Human Services","docket_text":"lead-opinion","date_issued":"2011-10-26","pdf_url":"https://www.courtlistener.com/opinion/6778921/ricci-v-secretary-of-health-human-services/","pdf_bytes":null,"triage_decision":"keep","triage_reason":"recovered via CL opinion 6662523 (html_with_citations)","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_99-vv-00524/USCOURTS-cofc-1_99-vv-00524-cl6662523"}]}