B. v. Secretary of Health and Human Services

United States Court of Federal Claims·Decided September 14, 2020·No. 18-1634·Unpublished

Opinion

In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 18-1634V UNPUBLISHED

W.B., Chief Special Master Corcoran

Petitioner, Filed: August 7, 2020 v. Special Processing Unit (SPU); SECRETARY OF HEALTH AND Decision Awarding Damages; Pain HUMAN SERVICES, and Suffering; Influenza (Flu) Vaccine; Guillain-Barre Syndrome Respondent. (GBS)

Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for petitioner.

Adriana Ruth Teitel, U.S. Department of Justice, Washington, DC, for respondent.

DECISION AWARDING DAMAGES1

On October 23, 2018, W.B. filed a petition for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the “Vaccine Act”). Petitioner alleges that he suffered Guillain Barré syndrome (“GBS”) as a result of receiving the influenza (“flu”) vaccination on September 12, 2016. Petition at 1. The case was assigned to the Special Processing Unit of the Office of Special Masters.

For the reasons set forth below, and after hearing argument from the parties, I find that Petitioner is entitled to compensation in the amount $172,104.02, representing compensation in the amount of $155,000.00 for actual pain and suffering, $7,304.02 for past unreimbursed medical expenses, and $9,800.00 for lost wages.

1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am required to post it on the United States Court of Federal Claims' website in accordance with the E-Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government Services). This means the decision will be available to anyone with access to the internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that the identified material fits within this definition, I will redact such material from public access.

2National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa (2012). I. Relevant Procedural History

Approximately 13 months after this case was initiated, Respondent filed his Rule 4(c) Report on November 22, 2019, conceding that Petitioner was entitled to compensation. ECF No. 30. A ruling on entitlement was issued on November 25, 2019. ECF No. 31. The parties thereafter attempted to informally resolve damages but were unsuccessful. ECF No. 38. A status conference was held the next month, and a scheduling order was issued on March 25, 2020, regarding the briefing of disputed damages issues. ECF No. 39. The parties filed their respective briefs (ECF Nos. 42 (“Br.”), 44 (“Opp.”), and 46 (“Resp.”)). I proposed that the parties be given the opportunity to argue their positions at a motions hearing, at which time I would decide the disputed damages issues. ECF. No. 48. That hearing was held on July 31, 2020,3 and the case is now ripe for a determination.

II. Relevant Medical History

A complete recitation of the facts can be found in the Petition, the parties’ respective pre-hearing briefs, and in Respondent’s Rule 4(c) Report. In brief summary, on September 12, 2016, Petitioner received a flu vaccine. Ex. 1 at 4. Prior to vaccination, Petitioner was a generally healthy and very active medical doctor, including running cross country, racing Ironman triathlons, racing road bicycles, and cross country and back country skiing. Ex. 7 at 1. Petitioner’s medical history was, however, significant for some injuries bearing on damages – specifically, a right shoulder dislocation, torn labrum, and surgical repair due to a bicycle crash in March 2015, and gastroesophageal reflux disease (GERD). Ex. 2 at 49, 71-75, 82-85.

According to Petitioner, a little more than three weeks after vaccination, on October 6, 2016, after he finished a late emergency room (ER) shift, he started to feel very ill, including uncontrollable shaking, profound fatigue, increasing muscle pain and a sense of weakness, but no fever. Ex. 7 at 3. Petitioner continued to experience symptoms, including difficulty feeding his children. Id.

On October 9, 2016, Petitioner presented to the hospital with complaints of hand weakness, generalized weakness, and significant myalgias. Ex. 5 at 7. The decision was made to admit him for IVIG therapy, and for a neurology reevaluation in the morning. Id. at 8. After receiving the first IVIG treatment, Petitioner reported that his symptoms were a little better. Id. at 5. His neurologist determined that as long as Petitioner continued to improve, he could continue the remainder of his IVIG course at home. Id. at 5-6.

Petitioner was discharged from the medical center on October 10, 2016, after receiving his second IVIG treatment with a diagnosis of “Probable Guillain-Barre.” Ex. 5 at 3. Petitioner received three IVIG treatments as an outpatient on October 11-13. Id. at 150-155, 276-280. Petitioner received a total of five IVIG treatments. Id. Over the course

3 At the end of the hearing held on July 31, 2020, I issued an oral ruling from the bench on damages in this case. That ruling is set forth fully in the transcript from the hearing, which is yet to be filed with the case’s docket. The transcript from the hearing is, however, fully incorporated into this Decision.

2 of the next several weeks, Petitioner’s weakness improved, and he continued to get stronger, but still experienced some fatigue and other symptoms. By November 8, 2016, Petitioner had resumed working half-day shifts and doing yard-work, although both activities resulted in fatigue. Ex. 4 at 66-67.

On November 30, 2016, Petitioner presented to his primary care physician with shoulder pain. Ex. 4 at 25. Petitioner had fallen while carrying his son and thought he may have torn his rotator cuff. Id. On exam, it was noted that Petitioner was positive for paresthesia and weakness (left leg felt atrophied and weak compared to right light). Petitioner continued to have instability in his upper extremities, and physical therapy (PT) was recommended. Ex. 4 at 62-66.

On December 29, 2016, Petitioner had a PT evaluation for bilateral shoulder pain and diminished strength. Ex. 6 at 10. Petitioner thereafter received PT through August 21, 2017, his twenty-ninth PT session. Id. at 130. Petitioner conveyed that he was “doing well,” and was “more active and doing more things on his own,” so he thought he was ready to “graduate.” Id. The therapist agreed, and discharged Petitioner to continue with a home exercise program. Id. at 131.

Almost a year later, in late November 2017, Petitioner saw his primary care physician for a follow-up visit. Ex. 4 at 21. His GBS was deemed largely resolved, with symptoms mostly absent other than fatigue that expressed itself after exertion. Id. Petitioner at this time also mentioned his GERD, although the record does not suggest it was a significant concern at this time. Id. at 21. By his April 2018 follow-up, Petitioner noted that he felt even better, other than experiencing weakness that “never went fully away.” Id. at 57. And beyond absent reflexes in his right bicep, his clinical examination, including strength, was normal. Id. at 57-58.

The GERD that Petitioner had experienced pre-vaccination came up around this time again.

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