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In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 13-34V

Filed: December 30, 2013

* * * * * * * * * * * * * * 

TRACY JONES, and JOHN JONES, as * TO BE PUBLISHED

the parents and natural guardians of P.J., *

a minor, *

* Special Master

* Hamilton-Fieldman

Petitioners, *

v. *

* Decision on the Record, Dismissal of 

SECRETARY OF HEALTH * Claim for Insufficient Proof; Failure to 

AND HUMAN SERVICES, * Submit Expert Report; Human 

* Papillomavirus Vaccine; Tourette

Respondent. * Syndrome.

* * * * * * * * * * * * * *

Mark T. Sadaka, Englewood, NJ, for Petitioners.

Tara J. Kilfoyle, Washington, DC, for Respondent.

DISMISSAL DECISION1

On January 15, 2013, Tracy Jones and John Jones (“Petitioners”) filed a petition 

for Vaccine Compensation under the National Vaccine Injury Compensation Program, 42 

U.S.C. §300aa-10, et seq.

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 (“Program”). Petition (“Pet”) at 1, ECF No. 1. 

 

1 Because this published decision contains a reasoned explanation for the action in 

the case, the undersigned intends to post this decision on the United States Court of 

Federal Claims’ website, in accordance with the E-Government Act of 2002, Pub. L. No. 

107-347 § 205, 116 Stat. 2899, 2913 (codified as amended at 44 U.S.C. § 3501 note 

(2006)). As provided by Vaccine Rule 18(b), each party has 14 days within which to file 

a motion for redaction “of any information furnished by that party (1) that is trade secret 

or commercial or financial information and is privileged or confidential, or (2) that are 

medical files and similar files the disclosure of which would constitute a clearly 

unwarranted invasion of privacy.” Vaccine Rule 18(b). In the absence of such motion, 

the entire decision will be available to the public. Id. 
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After a review of the petition and supporting documents, Petitioners’ counsel filed 

a “Motion For A Dismissal Decision,” stating that after an investigation of the medical 

theories and facts of the case, Petitioners would be unlikely to prove that P.J. is entitled to 

compensation under the Vaccine Program. Motion at 3, ECF No. 24.

I

PROCEDURAL HISTORY 

On January 15, 2013, Petitioners filed a petition for vaccine compensation. Pet., 

ECF No. 1. On January 23, 2013, Petitioners filed medical records labeled Exhibits one 

through three. Filing, ECF No. 4.3

The Chief Special Master issued an Initial Order in this case on January 24, 2013. 

Order, ECF No. 6. Counsel for Respondent, Tara Kilfoyle, also made an appearance on 

this date. Notice, ECF No. 5. 

An initial status conference was held on February 20, 2013. Minute Entry, Feb. 20, 

2013. The Chief Special Master issued a Scheduling Order on February 21, 2013, stating 

that the deadline for the filing of Respondent’s Rule 4 Report was suspended, and that 

Petitioners should file all outstanding medical records by Monday, April 8, 2013. Order, 

ECF No. 7. The Order also directed Respondent to file a status report, assessing the 

completeness of the medical record on or before May 8, 2013. Id. Petitioners were also 

ordered to file a supportive expert report from their retained immunologist by June 10, 

2013. Id. 

The case was reassigned to the undersigned on March 4, 2013, pursuant to 

Vaccine Rule 3(d). Order, ECF No. 8. Petitioners filed medical records from three

 

2 National Childhood Vaccine Injury Act of 1986, Pub L. No. 99-660, 100 Stat. 

3755. Hereinafter, for ease of citation, all “§” references to the Vaccine Act will be to the 

pertinent subparagraph of 42. U.S.C. §300aa (2006).

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Exhibit 1: Vaccination Record; Exhibit 2: Memorial Hospital of Texas CountyMedical Records; Exhibit 3: Specialty Clinic of St. Anne. 
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additional providers4 and a statement of completion on April 8, 2013. Filings, ECF Nos. 

9, 10. Petitioners filed an affidavit on April 9, 2013. Filing, ECF No. 11. 

Respondent filed a status report on April 15, 2013, stating that the medical records 

filed to date were “incomplete and insufficient to evaluate this case.” Status Report at 1, 

ECF No. 12. Respondent requested that Petitioners provide the following:

 An affidavit identifying all medical providers that evaluated or treated P.J., 

from three years prior to her January 27, 2010 Human Papillomavirus 

(“HPV”) vaccination through the date that the petition was filed.

 P.J.’s complete medical records from all medical providers identified 

above.

 Vaccination records for P.J.’s January 27, 2010, and June 8, 2010 HPV 

vaccinations, including manufacturer and lot number information.

 Complete records from P.J.’s February 5, 2010, and July 5, 2012, treatment 

at Memorial Hospital of Texas County, including all physician’s orders, 

consultations, records of physical or neurological examinations, medication 

administration records, nursing notes, and discharge summaries.

 Records from any treating providers that have treated P.J. from July 5, 2012 

through the present.

 Any additional records relating to P.J.’s treatment by Dr. Richard Hoos, or 

any other neurologists that evaluated or treated P.J. from three years prior 

to her January 27, 2010 HPV vaccination through the present.

Id. at 2. A status conference was held on May 21, 2013, before the undersigned. Minute 

Entry, May 21, 2013. The undersigned issued a Scheduling Order on June 11, 2013, 

identifying certain problematic issues in this case. Order, ECF No. 13. The undersigned 

noted the sparse number of medical records filed in the case - only 23 pages of medical 

records had been filed to date. Id. at 1. The undersigned also noted a concern with the

diagnosis of Tourette syndrome since P.J. did not appear to meet the diagnosis criteria.

Id. at 1-2.

On August 6, 2013, Petitioners filed Exhibits eight and nine.5Filing, ECF No. 15. 

Petitioners also filed a status report on this date stating that “[P]etitioner has received 

 

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These records are as follows: Exhibit 4: Jeffrey J. Lim, M.D. Medical Records; 

Exhibit 5: Reed Family Clinic Medical Records; Exhibit 6: High Plains Dermatology 

Medical Records.
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correspondence indicating there are no additional medical records from all of P.J.’s 

medical providers except for Dr. Jeffrey Lim.” Status Report, ECF No. 16. On August 

27, 2013, Petitioners filed Exhibit 10, labeled as a letter from Dr. Jeffrey Lim. Filing, 

ECF No. 17. This letter stated that Petitioner had been provided copies of the patient’s 

record “multiple times.” Id. 

A status conference was held on September 10, 2013, at which the undersigned

requested additional documentation, including: P.J.’s baby records, a video of P.J.’s 

current condition, and further clarification from Dr. Barias regarding P.J.’s diagnosis and 

Dr. Barias’s notations in medical records. Order, ECF No. 19. Petitioners thereafter 

filed Exhibits 11-14 6on October 21, 2013. Filing, ECF No. 22.

A status conference was held before the undersigned on October 22, 2013. Minute 

Entry, Oct. 22, 2013. The undersigned ordered Petitioners to file a status report, 

identifying steps they had taken to procure an independent medical examination, or the

medical records from such an examination, by December 17, 2013. Order, ECF No. 23. 

On December 17, 2013, Petitioners filed a “Motion For A Dismissal Decision.” Motion, 

ECF No. 24.

II 

FACTUAL HISTORY

At the time of vaccination, Petitioners’ daughter, P.J., was 11 years old. Pet’rs’ Ex. 

11 at 83. P.J. received her second HPV vaccination on January 27, 2010. Pet’rs’ Ex. 1 at 

2. 

P.J. visited the Memorial Hospital of Texas County on February 5, 2010,

complaining of continuous eye blinking and occasional jerks of her left arm and leg; her 

doctor ordered blood work and a CT scan, and her blood test revealed a positive ANA 

screen. Pet’rs’ Ex. 3 at 2. P.J. was diagnosed with “Tic Disorder Not Otherwise 

Specified” on this date. Id. at 1. 

P.J. was diagnosed with Tourette syndrome on February 9, 2010, when she 

returned to Memorial Hospital of Texas County and was examined by Dr. Emmanuel 

 

5 Exhibit eight: Medical Correspondence from Healthcare Providers; Exhibit nine: 

Certification of Conversation with Dr. Barias.

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Exhibit 11: Birth and Childhood Records from Memorial Hospital of Texas 

County; Exhibit 12: Letter from Memorial Hospital of Texas County; Exhibit 13: 

Addendum to Medical Record by Dr. Emmanuel Barias at St. Anne’s Specialty Clinic; 

Exhibit 14: Letter from Texas County Health Department (Oklahoma).
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Barias, M.D. Id. at 4. Dr. Barias indicates in his medical notes from this visit that 

“[D]oubt that ANA is significant in this case; fulfills all criteria for tourette.” Id. On June 

8, 2010, P.J. received the third and final HPV vaccine. Pet’rs’ Ex. 1 at 2. 

On July 3, 2012, P.J. returned to seek medical treatment due to continued facial 

tics; she was diagnosed with “[T]ics and spasms, compulsive.” Pet’rs’ Ex. 3 at 5. 

III

DISCUSSION

To receive compensation under the Program, Petitioners must prove either: 1) that 

their daughter, P.J., suffered a “Table Injury”- i.e., an injury falling within the Vaccine 

Injury Table-corresponding to one of her vaccinations, or 2) that she suffered an injury 

that was actually caused by a vaccine. See §300aa-13(a)(1)(A) and §300aa-11(c)(1). 

Petitioners’ petition alleged that P.J. suffered from Tourette syndrome as a result 

of receiving a second HPV vaccination on January 27, 2010. Pet’rs’ Ex. 1 at 1.

To establish vaccine causation, Petitioners must satisfy all prongs of the test 

established by the court in Althen v. Sec’y of Health & Human Servs., 418 F.3d 1274, 

1278 (Fed. Cir. 2005). To satisfy the first prong of the Althen test, Petitioners must 

provide “a medical theory causally connecting the vaccination and the injury.” Id.

(quoting Grant v. Sec’y of Health & Human Servs., 956 F.2d 1144, 1148 (Fed. 

Cir.1992)). Petitioners’ theory must show that it is more likely than not that the vaccine 

P.J. received can cause the injuries that Petitioners allege the vaccine caused. See 

Moberly v. Sec’y of Health & Human Servs., 592 F.3d 1315, 1323-24 (Fed. Cir. 2010).

To satisfy the second prong of the Althen test, Petitioners must establish “a logical 

sequence of cause and effect showing that the vaccination was the reason for the injury.” 

Althen, 418 F.3d at 1278. That is, Petitioners must show by preponderant evidence (more 

likely than not) that the vaccine their daughter received did cause the injuries they allege 

it caused. See Capizzano v. Sec’y of Health & Human Servs., 440 F.3d 1317, 1326 (Fed. 

Cir. 2006).

Finally, to satisfy the third prong of Althen, Petitioners must produce preponderant 

evidence of “a proximate temporal relationship between vaccination and injury.” Althen, 

418 F.3d at 1278. This prong helps to establish the connection between the causal theory 

of prong one and the more fact-based cause and effect arguments of prong two by 

demonstrating, “that the onset of symptoms occurred within a timeframe for which, given 

the medical understanding of the disorder’s etiology, it is medically acceptable to infer 
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causation-in-fact.” De Bazan v. Sec’y of Health & Human Servs., 539 F.3d 1347, 1352 

(Fed. Cir. 2008).

The undersigned is not authorized to make a finding of causation based on the 

claims of a Petitioner alone, unsubstantiated by medical records or a medical opinion. See 

42 U.S.C. §300aa-13(a)(1). Petitioners moved for a decision by the Special Master 

dismissing the case on the grounds that “[a]n investigation of the facts, medical theories, 

and legal precedents supporting this case have demonstrated to Petitioners that they will 

likely be unable to prove that P.J. is entitled to compensation from the Vaccine Program.” 

Motion at 3, ECF No. 24. Although Petitioners were diligent in their efforts to collect 

certain medical records requested by the undersigned and Respondent’s counsel, the 

undersigned expressed concerns about the credibility of Dr. Barias, P.J.’s diagnosing and 

primary treating physician. As such, the undersigned directed Petitioners’ counsel to have 

P.J. independently evaluated by another treating physician and file those medical records 

with the Court. Order, ECF no. 23. 

No such independent medical evaluation occurred in this case. No expert report 

has been filed in this case. A review of the record in this case provides no evidence 

demonstrating that P.J.’s medical condition was vaccine-caused. 

Without evidence of a reliable, scientific theory, a logical sequence of cause and 

effect, and a proximate temporal relationship between vaccination and alleged injury, 

Petitioners cannot meet their burden of proof under the three-prong test of Althen. The 

undersigned therefore GRANTS Petitioners’ Motion to Dismiss.

IV

CONCLUSION

The undersigned is sympathetic to the fact that P.J. suffers from a medical 

condition. However, under the law, the undersigned can authorize vaccine injury

compensation only if a medical condition or injury either falls within one of the “Table 

Injury” categories, or is shown by medical records or a competent medical opinion to be 

vaccine-caused. No such proof exists in this record. Thus, this case is dismissed for 

insufficient proof. The Clerk shall enter judgment accordingly.7

 

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To preserve whatever right Petitioners may have to file a civil action in another 

court, they must file an “Election to File a Civil Action” which rejects the judgment from 

this court within 90 days of the date judgment was filed.
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IT IS SO ORDERED.

 /s/ Lisa D. Hamilton-Fieldman

Lisa D. Hamilton-Fieldman

Special Master