Houston v. Sec'y of HHS

Houston v. Sec'y of HHS

Opinion

OFFICE OF SPECIAL MASTERS

ENTITLEMENT DECISION¹

On March 22, 2018, Joy Houston filed a petition for compensation under the National Vaccine and Injury Compensation Program (the "Vaccine Program").² (ECF No. 1) ("Petition"). The Petition alleged that Ms. Houston experienced chronic inflammatory demyelinating polyneuropathy ("CIDP") after receipt of a tetanus-diphtheria-acellular pertussis ("Tdap") vaccine administered on October 6, 2016, and/or a Measles, Mumps, & Rubella II ("MMR") vaccine on October 17, 2016.

The parties have requested an entitlement determination based solely on the filed medical records, plus expert reports and associated medical articles and literature, and have waived the opportunity to file briefs in support of their respective positions. Having reviewed the record, I find that Petitioner has not carried her evidentiary burden. Although Petitioner's CIDP diagnosis [*2]  is not disputed, she has not preponderantly established that the Tdap vaccine (the vaccine Petitioner's expert focuses on) can cause CIDP, or did so here.

I. Factual Background

Pre-vaccination History

Ms. Houston was 33 years-old at the time of her vaccinations, and pregnant for the fifth time. Her prior medical history included uncontrolled insulin-dependent type 2 diabetes with neuropathy. Ex. 2 at 428. As early as 2011 (five years before the vaccinations at issue) she was experiencing tingling in her hands, and it had been proposed by endocrinologists at that time that she had a diabetic neuropathy. Ex. 20 at 271-75. She experienced more tingling incidents in 2013, and was assessed as having a peripheral neuropathy. Id. at 12-15, 40-49. Petitioner's preexisting diabetes (which is not alleged to have been exacerbated by vaccination) and its sequelae loom large over her alleged post-vaccination injury.

Ms. Houston was pregnant when she was vaccinated in October 2016, and the kinds of diabetic issues endemic to her general pre-vaccination medical history also impacted her pregnancy. Ex. 2 at 268-69, 274-76, 963-67, 980. Throughout this time period (spring and summer 2016), her medical [*3]  treatment included both standard prenatal care and repeat visits to the Ochsner Medical Center ("OMC") emergency department, where she reported complaints of lower extremity edema and cellulitis. Ex. 3 at 9-11, 68-70, 92-94. By September 2016 she returned to OMC, now complaining of epigastric pain associated with hot and cold feeling, generalized malaise, and body aches for a day, and also sought treatment for this in connection with her OB-GYN visits. Id. at 119-22; see also Ex. 2 at 847, 850-51. Ms. Houston was eventually admitted to Tulane Medical Center, and physicians there proposed she might be experiencing preeclampsia due to increased urine protein above her baseline, treating her in part with insulin (which she had in the past irregularly taken). Id. at 715-16.

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