Gerami v. Secretary of Health and Human Services

127 Fed. Cl. 299, 2014 WL 11428200
United States Court of Federal Claims·Decided July 30, 2014·No. 1:12-vv-00442·Published·Cited by 73 cases

Opinion

National Childhood Vaccine Injury Act, 42 U.S.C. § 300aa-10 et seq,; Diphtheria-Pertussis-Tetanus Vaccine; Off-Table Injury; Six-Month Residual Effects Requirement; Insufficient Evidence; Unpersuasive Medical Evidence.

OPINION

MARY ELLEN COSTER WILLIAMS, Judge

This ease comes before the Court on Zoh-reh Gerami’s motion for review of the Special Master’s decision dismissing her petition for compensation under the National Childhood Vaccine Injury Act (“Vaccine Act”), 42 U.S.C. § 300aa-10 et seq. (2006), for insufficient proof. After receiving the diphtheria-pertussis-tetanus (“DPT”) vaccine, Ms. Gerami suffered skin irritation, a rash, insomnia, celluli-tis, and anxiety, and filed suit under the Vaccine Act seeking compensation for an off-table injury. Because Petitioner failed to demonstrate that her injuries persisted-for six months after her vaccination, the Court affirms the ruling of the Special Master.

Background

Ms. Gerami’s Medical History

On November 27, 2011, Ms. Gerami, then age 61, received a DPT vaccine at a clinic in a Rite-Aid store in San Rafael, California.

Three days later, on November 30,2011, at 9:42 p.m., Ms. Gerami was admitted to the Emergency Room (“ER”) of Marin General Hospital in California with the “chief complaint” of right arm pain, Pet’r’s Notice of Filing Docs. (“Pet’r’s Add’I Docs. #4”) Ex. 11, Jan. 8, 2013.

The physician who saw Ms. Gerami, Dr. Gash-Kim, noted that she had a temperature of 100.3 degrees Fahrenheit and “increasing redness” that had “spread distally” from the DTP injection site on her right arm. Id. Ex. 12. The doctor referred to Ms. Gerami’s injury as “right upper extremity cellulitis,” noted its size as 15 centimeters, prescribed her medications, and instructed her to return to the ER in 24 hours or sooner “for repeat evaluation.” Id. Ms. Gerami was discharged at 2:42 a.m, on December 1, 2011.

On December 2, 2011, Ms. Gerami returned to the ER where Dr. Neill evaluated her. He noted that she “complain[ed] of local itching” but did not report “fever, shaking chills, vomiting or other systemic symptoms.” Id. Dr. Neill’s charts list “local reaction to vaccine versus cellulitis” as the “impression,” and reflect that Ms. Gerami was discharged in “satisfactory stable condition.” Id.

Ms. Gerami, a resident of the United States and Canada, returned to Quebec, Canada, and visited Dr. Naimi who had been her primary care physician since 1988. The first entry in Dr. Naimi’s records is dated May 12, 2008 — more than three years before the vaccine — and states that she “present[ed] with anxiety disorder due to [illegible].” 2 Pet’r’s Notice of Filing Docs. (“Pet’r’s Add’I Docs. # 5”) Ex. 14 at 31, Mar. 4, 2013. On May 1, 2011, almost seven months before her vaccination, Ms. Gerami received a complete physical, and Dr. Naimi’s charts listed her “problems” as periodic anxiety, menopause, Raynaud’s disease, and a fungal infection of the toes.

Within Dr. Naimi’s medical records, separate from the charts, is a form dated February 15, 2012 — almost three months after the vaccine. Entitled “psychiatric evaluation,” the form indicates that Ms. Gerami exhibited anxiety and mentions redness on the light arm, but does not reference the vaccine. Id. at 40-41.

The first post-vaccine entry in Dr. Naimi’s medical charts is dated April 19, 2012, and reflects blood pressure measurements and other metrics and states that “she stopped smoking.” Id. at 32. No reference is made to *301 either the vaccine or her ER visits. On May 22, 2012, Ms. Gerami again visited Dr. Naimi, and his notes reflect that she was worried about why she was taking certain medications. Again, Dr. Naimi makes no mention of the ER visits, vaccine, or alleged vaccine effects. On October 2, 2012, Ms. Gerami “presented] for [follow-up],” and the charts indicate “high anxiety.” Id, at 33.

Dr. Naimi’s medical chart entries for Ms. Gerami on October 23, 2012, November 21, 2012, and January 7, 2013, do not reference anxiety, the ER visits, or the vaccine effects. The other records, however, contain a form entitled “COMPLETE MAJOR PHYSICAL” dated November 21, 2012, listing “Medical— HERPES ZOSTER May 10, 2012; —cellulitis post vaccination Rt Upper Ext. Nov. 30, 2011” under the category “Past Medical History.” Id. at 42. Under the “Problems” section, the form lists only: “1. Hypertension.?! 2. Multinodular Thyroid 3. R/o Hyperthyroidism.” Id. at 43.

In addition to medical charts and forms, the record before the Special Master contained three letters from Dr. Naimi and Ms. Gerami’s affidavit. In her affidavit, dated November 12, 2012, Petitioner related that “immediately after vaccination, [she] experienced symptoms such as severe skin irritation, rash, insomnia, and depression. The scars on [her] skin persisted for several months thereafter ... [and other] symptoms persisted for nearly seven (7) months. To date, [she] still suffers from the residual effects of [the] skin anomaly.” PetYs Notice of Filing Docs. (“PetYs Add’l Docs. #2”) Ex. 9, Nov. 15, 2013.

In his first letter, dated October 10, 2012, Dr. Naimi outlines Ms. Gerami’s medical conditions since 2008 and prior to the vaccination, listing fibrocystic breast disease, varicose veins and varicosity, duodenitis “with a positive result for H. Pylori,” vulvitis, and perianal fungal infection. Restated Claim Ex. 4, at 2.

In his second letter, dated November 27, 2012, with the subject designated as “[m]edical report from January 2011 to November 25, 2012,” Dr. Naimi states that on February 15, 2012:

[T]he patient complained of having anxiety due to a vaccination in California. Soon after vaccination, her right arm (site of vaccination) developed swelling, redness, pain ... ‘cellulitis’?.... Since that time she had been suffering from insomnia, restlessness, and irritability. She was tense and fatigued.
Her somatic symptoms: BP 149/90 (this was high for the first time, due to stress), and had Trachycardia and mild tremors.
Her blood chemistry and urine analysis were normal. Slight sensitivity and redness were observable on her right arm.

Pet’r’s Notice of Filing Docs. (“Pet’r’s Add’l Docs. #3”) Ex. 10, Nov. 27, 2012. Dr. Nai-mi’s second letter also notes that “[o]n May 10, 2012, the patient developed a Herpes Zoster and was treated for it” and that on November 21, 2012, a complete physical evaluation revealed normal lab results and “[n]o other findings.” Id.

The third letter from Dr. Naimi, dated June 20, 2013, states in full:

In response to [Petitioner’s counsel’s] request, this is to state that following Ms. Gerami’s injection (vaccination) in California, she developed, at the site of injestion [sic], certain symptoms which persisted over 6 months, and started fading away over 6 months. But her psychological problems (anxiety disorder) lasted almost a year.

PetYs Notice of Filing Docs. (“Pet’r’s Add’l Docs. # 6”) Ex. 15, June 25, 2013.

Procedural History

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Gerami v. Secretary of Health and Human Services, 127 Fed. Cl. 299, 2014 WL 11428200 (uscfc 2014).

127 Fed. Cl. 299 (Gerami v. Secretary of Health and Human Services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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