Entitlement Ruling – Seizures/Infantile Spasms due to DTaP

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Reilly v. HHS, (Fed. Cl. Spec. Mstr. May 31, 2016) (Hamilton-Fieldman, SM)

After a brain biopsy, it was determined that the child had a focal cortical dysplasia, and Petitioner’s expert testified that this was a predisposition which caused the seizure disorder once triggered by DTaP. Respondent argued that the brain anomaly itself was a sufficient explanation for the development of seizures, i.e., they were inevitable.

Based on petitioner’s literature, the court concluded some insult, or second hit, is necessary in some cases of cortical dysplasia to trigger the inherent potential into the actuality of infantile spasms. Further, the court held, the pertussis component of the DTaP vaccine can act as that second hit.

Prongs 2 and 3 were not significantly disputed. The court was careful to note that her ruling that DTaP can cause infantile spasms should be limited to the unique facts of this case, i.e. the preexisting cortical dysplasia.

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