1

* * * * * * * * * * * * * * * * BRUCE FEDEWA
, * PUBLISHED

* Petitioner, * No. 1 7

- 1808 V

*

v. * Special Master Nora Beth Dorsey * SECRETARY OF HEALTH * Decision Awarding Damages ; Table Injury; AND HUMAN SERVICES, * Pain and Suffering; Influenza (“ F lu”)

* Vaccine; Guillain

- Barré Syndrome (“GBS”). Respondent. *

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

Isaiah Richard Kalinowski

, Maglio Christopher & Toale, P.A., Washington, DC, for petitioner. Christine Mary Becer , U.S. Department of Justice, Washington, DC, for respondent.

DECISION AWARDING D AMAGES 1

I. INTRODUCTION

On November 17, 2017, Bruce Fedewa (“petitioner”) filed a petition for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa

- 10, et seq. , (“the Vaccine Act”). 2 Petitioner alleges that he suffered Guillain

- Barré syndrome (“GBS”) as a result of an influenza (“flu”) vaccine administered to him on October 10, 2016. Petition at 2

- 4

.

1 Because this Decision contains a reasoned explanation for the action in this case, the undersigned is 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, the undersigned agrees that the identified material fits within this definition, the undersigned will redact such material from public access.

2 The National Vaccine Injury Compensation Program is set forth in Part 2 of the National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99

- 660, 100 Stat. 3755, codified as amended, 42 U.S.C. §§ 300aa

- 10 to

- 34 (2012). All citations in this decision to individual sections of the Vaccine Act are to 42 U.S.C. § 300aa. 

# In the Uni ted State s Court of Federal Claims

OFFICE OF S PECIAL M ASTERS File d: March 26, 20202

The issue of pain and suffering damages is ripe for adjudication. For the r easons set fo rth below, the undersigne d finds that $180,000.00 represents a f air and appropriate amount of compensation for petitioner ’ s actual pain and suffering a nd emotional distress.

II. PROCEDURAL HIS TORY

Mr. Fedewa filed his petition for compensation on Nove mber 17, 2017. Petiti on (ECF No. 1). He file d medica l records o n November 30, 2017. Petitioner’s Exhibits (“Pet. Exs.”) 1

- 12. An initial status conference wa s held on January 17, 2018 in which additional evidence w as requested. On March 5, 2018, petitioner filed additional medical records. Pet. Ex. 13. Petitioner filed his affidavit, additional medical records, a nd Statement of C ompletion on April 3, 2018. Pet. Exs. 14-15 (ECF No s

. 13-14). Respondent filed his Rule 4(c) Report on September 17, 2018, in which he did not c ontest that petitioner is entitled to comp ensation. Respondent’s Report (“Resp. Rept.”) at 1 . On September 21, 2018, the undersigned issued an entitlement ruling findin g for th e pe titioner. Ruling on Entitlement dated Sept. 21, 2018 (ECF No. 22). The undersigned then issued a Da mages Order requesting the parties to informally re solve the iss ue of damages. Damage s Order dated Sept. 21, 2018 (ECF No. 23).

On October 22, 2018, p etitioner file d additional affidavits, work information, and medical expense doc umentation to support his da mages claim. Pet. Exs. 16-18. On December 6, 2018, petitioner filed updated medical rec ords, and on January 15, 2019, petitioner file d additional affidavits. Pet. Exs. 19-21. While the pa rties informally re solved unreimbursable expenses and lost earnings, they w ere un able to agree on the appropriate c ompensation for petitioner’s pain and suffering. Pe t. Status Rept., filed May 13, 2019 (ECF No. 38).

The unde rsigned scheduled a R ule 5 status conference on damage s for July 10, 2019. During th e status conferenc e, the undersigned shared her preliminary findin g that petitioner’s case is comparable to Johnson v. Secretary of Heal th & Human Services, No. 16-1356V, 2018 WL 5024 012 (Fed. Cl. Spec. Mstr. July 20, 2018). Rule 5 Order dated July 11, 2019, at 2-3 (ECF No. 39)

. The unde rsigne d encouraged the parties to again consider informal resolution. Id. at 3.

On August 12, 2019, respondent filed a status rep ort stating the parties were sti ll a t an impasse regarding th e a

ppropriate a mount of compensation for Mr

. Fedewa’s pain and suffering. Re sp. Status Rept., filed Aug. 12, 2019 (ECF No. 41). Respondent requested that the undersigned issue a d amages decision. Id. On October 24, 2019, Mr. Fedewa file d his damages memorandum demanding a mi nimum of $180,000.00 for pa in and suffering. Pe t. Memorandum of Law in Support of Petitioner’s Motion for F indings of Fact and Conclusions of Law Regarding Da mages (“Pet. Mem. on Damages”), filed Oct. 24, 2019, at 10 (ECF No. 43). Respondent provided his response on November 7, 2019, taking the position of $125,000 .00 a s appropria te compensation for pe titioner’s pa in and suffering. Resp

. ’s Brief on Damage s (“Resp. Br. on Dama ges”), file d Nov. 7, 2019, at 1 (ECF No. 44).3

The doctor stuck the needle into my spine for the tap and missed. The pain was excruciating

. . . . He apologized and tried again successfully

. . . . With the spinal tap finished, the triage nu rse went to put in the IV drip, the doctor was talking to me and trying to distract me, but I could feel something running down my arm. I glanced over and along with the pain of a needle digging around in my arm, there was blood running down my arm and dr ipping onto the floor

. . . . The next day they decided I needed an EMG

. . . . The doctor performing the EMG did not know how to run the test

. . . . She poked me deeply with a needle and shocked me hundreds of times for over an hour. Then her supervisor came in and looked over results. He pulled the doctor aside and asked how she got those results, then proceeded to redo most of the tests over again for another hou r

. I was already frazzled, traumatized and trembling with pain . . .

. This was the wors t experience of my life

, but it was only the beginning. III. FACTUAL HISTORY

Mr. Fedewa w as born on November 22, 1962. Petition at ¶ 1. He re sides in Holt, Michiga n with his wife a nd seve n children on a h obby f arm. Pet. Ex. 20 at ¶¶ 2, 4. He works full- time , and often overtime, as a de ntal equipment repairman. Id. at ¶ 2. His medical history includes injuries to his right elbow, left knee p ain and surgery

, arthritis, obstructive slee p apnea, and cholesterol management, though none o f these iss ues appear to contribute to his injury in this case. Petition at ¶ 2; Pet. Ex. 2 at 2-10; Pet. Ex. 3 at 2; P et. Ex. 8 at 6; Pet. Ex. 20 at ¶ 3.

On October 10, 2016, Mr. Fedewa visi ted Ingha m County Health Department and received the measles, mu mps, and rubella va ccine, flu vacc ine, Tetanus-diphtheria-acellular pertussis vacc ine, and hepatitis A and B va ccine. Pet. Ex. 1 at 1. He re ceived these va ccinations in preparation for an overseas mission trip to Ukraine. Pet. Ex. 20 at ¶ 7.

On October 20, 2016, Mr. Fedewa visi ted the Me morial Healthcare Emergency Department complaining of bilateral numbness i n his hands and feet and neck pain. Pet. Ex. 8 at 5, 7. After a compute d tomography sc an without contrast, Mr. Fedewa wa s discharged home with a primary im pression of paraesthesias. Id. at 21. On October 21, 2016, Mr. Fedewa visi ted the Sparrow Hospi tal Emergency Department and explained worsening s ymptoms of numbness in his feet and fingertips. Pet. Ex. 6 at 57. Mr. Fedewa r eceived a lum ba r puncture a nd a prescription for p rednisone. Id. at 65-66. He wa s discha rged home. Id. a t 66.

Mr. Fedewa averred that his condition continually deteriorated over the n ext two days. On October 23, 2016, he fell in hi s ya rd and was unable to get up until his family re turned home and found him on the ground, crying a nd scared. Pet. Ex. 20 at ¶ 13. His wife brou ght him to the Sparrow Hospit a l Emergency Department. Id. Mr. F edewa p rese nted with numbness in both hands and legs, difficulty wa lking

, a nd gait dist urbance. Pet. Ex. 6 at 113. After a nother lumbar puncture wa s performe d, the physician noted that Mr. Fedewa w as likely e xperiencing a cute inflammatory d emyelinating proc ess (“AIDP”)

. Id. at 120. The ph ysicia n admitted Mr. Fedewa. Id. at 113. Regarding thi s admission process, Mr. Fedewa r ecounted several very p ainful moments, particularly of his second lumbar puncture a nd electromyography (“EMG”) :4

Pet. Ex. 20 at ¶¶ 1 5- 17. Mr. Fedewa’s October 24, 2016 EMG results were hig hly su ggestive of AIDP and he r eceived a GBS dia gnosis. Pet. Ex

. 6 at 286, 319. He be ga n the first of his five IVIG treatments on Oc tober 25, 2016. Id.

On October 26, 2016, Mr. Fedewa r eported back pain, thigh pain, worsening numbness in his legs, and difficulty s wallowing. Pet. Ex. 6 at 202. Physicians adde d gabapentin and Tramadol to help c ontrol his pain. Id. The re cords a lso reflected Mr

. Fedewa’s anxiety

, for which he wa s prescribe d Xanax (a lprazolam). Id. at 196. Mr. Fedewa felt humiliated when nurses had to help him use the restroom, particularly whe n he ha d difficulty pa ssing stool s. Pet. Ex. 20 at ¶ 23.

Mr. Fedewa recounted in his affidavit that the IVIG tre atments made him a gitated. Pet. Ex. 20 at ¶ 19. He state d, “I did not slee p for th e f irst five days in the hospi tal because [ IVIG treatment] se t my ne rve s so on edge. . . . So many hour s were spe nt totally sleepless, still losing control of my li mbs and getting number. . . . During those long slee pless nig hts, I w anted to die.” Id. at ¶ 20. Medical records note thes e side effects on the fourth day of IVIG treatment. Pet. Ex. 6 at 264. Mr. Fedewa r eceived a pr e-treatment Benadry l for his final dose on October 29, 2016, which eased his agitation. Id. at 266. He re collected that he wa s able to sleep through the night following that IVIG treatment. Id.; Pet. Ex. 20 at ¶ 21.

During th e two -week period of hospitalization and re habilitation, Mr. Fedewa re ceived eleven inpatient occupational therapy se ssions. Pet. Ex. 6 at 176, 193, 235, 247, 291, 663, 677, 699, 722, 747, 759. He was discharged from hospitalization on October 30, 2016 and admitted to inpatient rehabilitation until November 3, 2016. Id. at 319, 771. At the ti me of his discharge from rehabilitation, Mr. Fedewa w as still experiencing numbness in both feet and overall weakness. Id. at 770. He pa rticipated in outpatient physical therapy f rom November 7, 2016 to January 26, 2017, completing twe nty-two physical therapy se ssions. Pet. Ex. 4 at 48-125.

Mr. Fedewa followed up with his primary c are ph ysicia n, Dr. Erik Werk, on December 28, 2016. Pet. Ex. 14 a t 64-67. He c omplained of depressed mood and continued unsteadiness on his fe et. Id. at 64. He wa s still taking gabapentin for int ense ne rve pa in. Id. at 65. On January 31, 2017, his ph ysician noted that Mr. Fedewa c ontinue d experiencing anxiety a nd prescribed him Wellbutrin. Id. a t 59-63. Mr. Fedewa stopp ed taking gabapentin at this time a nd expressed the ne ed to get ba ck to work. Id. at 60; Pet. Ex. 20 at ¶ 32. His physician instructed a twenty-five pound weight restriction for his return to work. Pet. Ex. 14 at 62. Mr. Fedewa expressed that returning t o work was painful and that he had to take si gnificant breaks after each service call. Pet. Ex. 20 at ¶ 34.

Mr. Fedewa show ed some im provement at his February 28, 2017 follow-up with Dr. Werk but continued to experience fa tigue and weakness. Pet. Ex. 14 at 54, 57. Dr. Werk also increased the Wellbutrin dosage to help with Mr. Fedewa’s continued anxiety. Id. at 57. At the April 11, 2017 appointment, Mr. Fedewa reported c ontinued numbness in hands and toes, and fatigue. Id. at 49. The re cords from his June 13, 2017 and September 21, 2017 appointments show that Mr. Fedewa continued to experience nu mbness, fatigue, and mild GBS s ymptoms despite im provements. Id. a t 33-38, 44-47. Mr. Fedewa stopp ed Well butrin on Septembe r 12, 2017. Id. at 39, 43.5

IV. CONTENTIONS OF THE PARTIES

The parties’ j oint s tatus r eport , filed on November 25, 2019 , indicated that all items of damages aside from actual pain and suffering were resolved : $1,800 .00 for past unreimbursable medical expenses, $400 .00 in future unreimbursable medical expenses, and $3,607.16 in past lost earnings , for a total of $5,807.16 . Joint Status Rept

. , filed Nov. 25, 2019 , at 1

- 2 (ECF No. 45). The only disputed issue before the undersigned is the amount of damages to be awarded for Mr. Fedewa’s actual pain and suffering.

A. Petitioner’s Position

Petitioner demands a minimum of $180,000 .00 for actual pain and suffering. Pet. Mem.

on Damages at 9. He explains that he suffered sig nificant pain as a result of GBS and still suffers from fatigue. Id. at 7 . Mr. Fedewa also explains that recovering from GBS “crushed his positive outlook on life and broke his spirit, to the great concern of everyone who knew him.” Id. at 8. Additiona lly, petitioner compares his case to Johnson and finds that he experienced as much, if not more pain, than the petitioner in Johnson

. Id. at 6

- 8. He notes that he experienced longer hospitalization than Ms. Johnson and was admitted to inpatient rehabilit ation whereas Ms. Johnson was not. Id. at 7. He suffered limb weakness and difficulty swallowing unlike Ms. Johnson, and Mr. Fedewa had particularly traumatic experiences in the hospital. Id. at 6

- 7. Mr. Fedewa additionally contends that like Ms. Johnson ’s incontinence, he too had issues with his bowel movements during his hospitalization. Id. at 7. As the petitioner in Johnson was awarded $180,000 .00
, Mr. Fedewa states that he should be awarded no l ess than $180,000 .00 for actual pain and suffering

. Id. at 8. Petitioner does not seek future pain and suffering damages.

B. Respondent’s Position

Respondent proposes no more than $125,000 .00 in actual pain and suffering damages. Resp. Br. on Damages at 1. In his brief, respondent recognizes that “ GBS cases have historically On December 19, 2017, Mr. Fedewa w as evaluated for a nd diagnosed with moderately

severe d epression by D r. Werk. Pet. Ex. 14 at 26-32. He e xperienced little interest or pleasure and had chronic fa tigue and a de pressed mood. Id. a t 26. Mr. Fedewa resumed Wellbutrin at this visit for his depression. Id. at 31. His affidavit state s, “I was exhausted, depresse d . . . at times wishing m y li fe were ove r.” Pet. Ex. 20 at ¶ 36.

At his Apr il 17, 2018 appointment, Mr. Fedewa re ported continued depression, difficulty functioning, fatigue, a nd muscle weakness. Pet. Ex. 19 at 20. At hi s July 2 5, 2018 visit, Mr. Fedewa’s depression had im proved and he stopp ed taking W ell butrin. Id. at 27, 31. His fatigue similarly im proved though it did not c ompletely go away. Id. at 27. He di d not report weakness or numbness. See id. a t 27-31. During thi s time, Mr. Fedewa w a s still unable to participate in activities with his family due to his constant fatigue a nd depressi on. Pet. Ex. 18 at 1-2; Pet. Ex. 21 at ¶¶ 12 -14. His children missed story-time and play-time with their father. Pet. Ex. 18 at 1- 2. Mr. Fedewa stated tha t physical and social activities he onc e e njoyed, such as biking, swimming, and handing out drinks with his daughter as part o f weekly stud e nt outreach at Michigan State Univ ersity (“MSU” ) are dif ficult. Pet. Ex. 20. at ¶¶ 4 -6.6

I.D. , 2013 WL 2448125

, at *9

- 11 ( citing McAllister

, 1993 WL 777030, at *3 ) . In evaluating these factors, the undersigned has reviewed the entire record, including medical records, affidavits submitted by petitioner and others, and hearing testimony.

A. Determining Petitioner’s Award in This Case

In determining an award in this case, the undersigned does not rely on a single decision or case. Rather, the undersigned has reviewed the particular facts and cir cumstances in this case, giving due consideration to the circumstances and damages in other cases cited by the parties and other relevant cases, as well as her knowledge and experience adjudicating similar cases. run the spe ctrum from cases involving se vere se quelae r equiring li fe c are pl ans to assess prospective da mages, to cases in which the petitioner nearly or completely recovers shortly after the six mon th minimu m duration of s ymptomatology r equired to qualify for compensation.” Id. at 12. Respondent argues that Mr. Fedewa’s pa in and suffering “demonstrates a less severe

course of GBS than others , comparatively spe aking.” Id.

I n res ponse to petitioner’s comparison t o Johnson, re spondent notes that Ms. Johnson had

a diff erent course with GBS post -hospitalization. Resp. Br. on Damage s at 13. She de alt with “being una

ble to drive and walk on her ow n for months a nd being un able to tell when she ne eded to use the ba throom [] , and she wa s still seeking care for the residual symptoms of her GBS two

to- three years afte r her init ial diagnosis.” Id. Respondent explains that Mr. Fedewa did not experience suc h significa nt difficulties afterwards: “ [H]e wa s able to stop treatment for his GBS within a fe w months of its onset, and he did not suff er significant ongoing s equelae li ke incontinence. If c omparing the two case s, as petitioner requests, the pain and suffering a ward should reflect that fact.” Id. Respondent further notes tha t Johnson is not controlling pre cedent, but rather “ one fa ctor the C ourt can consider” a nd “a sing le, and not analogous, decision.” Id. at 14.

V. DISCUSSION AND ANALYSIS

There is no fo rmula for a ssigning a moneta ry v alue to a person’s pain and suffering a nd emotional distress. I .D. v. Sec’y of Health & Human Servs. , No. 04-1593V, 2013 WL 2448125, at *9 (Fed. Cl. Spec. Mstr. May 14, 2013) ( “Awards for e motional distress ar e inhe rently subjective a nd cannot be determined by usi ng a m athematical formula.” ); Stansfield v. Sec’y of Health & Human Servs.

, No. 93-0172V, 1996 WL 300594, at *3 (Fed. Cl. Spec. Mstr. May 22, 1996) (“ [T]he a ssessment of pain and suffering is inherently a subj ective evaluation.”). Factors to be considere d when determining a n award for pain and suffering include : 1) awareness of the injury; 2) severity of the injury; and 3) du ration of the suffering. I.D., 2013 W L 244 8125, at *9 (quoting McAllister v. Sec’y of Health & Huma n Servs. , No. 91-1037V, 1993 WL 777030, at *3 (Fed. Cl. Spec. Mstr. Mar. 26, 1993)
, vacated a nd remanded on othe r grounds, 70 F.3d 1240 (Fed. Cir. 1995)).

Compensation awarded pursuant to the Vaccine Act shall include “ actual and p rojected pain and suffering a nd emotional distress from the va ccine-related injury

. . . not to exceed $250,000.” § 15(a)(4). In determining an award for pain and suffering a nd e motional distress, it is appropriate to consider the severity of injury a n d awareness and duration of suffering. See7 i. Awareness of Suffering

In the experience of the undersigned, awareness of suffering is not typically a disputed issue in cases involving GBS. In this case, neither party has raised, nor is the undersigned aware of, any issue concerning petitioner’s awareness of suffering and the undersigned fin ds that this matter is not in dispute. Thus, based on the circumstances of this case, the undersigned determines that petitioner had full awareness of his suffering.

ii. Severity of t he Injury

Prior to Mr. Fedewa’s hospital admittance, he sought medical tr eatment three times, complaining of progressively worsening numbness and weakness. When Mr. Fedewa was admitted to Sparrow Hospital, he was hospitalized for approximately eight days then admitted to inpatient rehabilitation for five days post

- hospitalizat ion. He reported terrible experiences with his lumbar puncture and EMG tests, and he had a difficult time with his five rounds of IVIG treatment. Pet. Ex. 20 at ¶ 19. His injury and treatment necessitated rehabilitation therapy which began during his ho spitalization and continued in his inpatient rehabilitation stay. He completed eleven sessions before h e was discharged home and was discharged from outpatient physical therapy after completing twenty

- two sessions over the span of three months. He was un able to drive or work for three months.

Mr. Fedewa’s affidavit and medical records establish GBS interfered with his ability to work. He was unable to return to his dental repairman position for three months after his hospitalization. At the age of fif ty

- four, Mr. Fedewa was working eight to twelve hours a day, five days a week, as a dental equipment repairman . His job required him drive to service locations and to lift and move equipment up to 250 pounds. Pet. Ex. 20 at ¶ 2 . When Mr. Fedewa returned to work approximately three months after his hospitalization, it was against the advice of his family and influenced by the pressure he felt to support his wife an d seven children

. Id. at ¶ 33. Although he returned to work, his physician requested a twenty

- five pound weight restriction, one

- tenth of the weight

- lifting capacity his job required. Pet. Ex. 14 at 62. He averred that working was painful and difficult for many months

. Pet. Ex. 20 at ¶ 34. H e had to take breaks after each service call. Id.

Mr. Fedewa’s GBS course post

- hospitalization required various medications. Mr. Fedewa continued taking gabapentin for three months following his hospitalization. He explained that he “stopped taking it as soon as he could tolerate the pain, in order to be able to return to work.” Pet. Mem. on Damages at 7. Mr. Fedewa required additional medication in the following months. His anxiety required Wellbutrin in add ition to Xanax

, but w h en his anxiety lessened and he stopped taking his medication

, he suffered depression. His moderately severe depression required him to return to Wellbutrin. In total, Mr. Fedewa took Wellbutrin for approximately fifteen months post

- hospitalization

.

GBS also altered Mr. Fedewa’s family and social life. He lives on a hobby farm on several acres of land with his wife and seven children. Prior to GBS, he was physically active on his farm raising animals

, tending to plants , and enjoy ing outdoor activities with his chi ldren. He8 iii. Duration of the Suffering

Mr. Fedewa dealt with the residual symptoms of his GBS for over two and a half years. Mr . Fedewa stated that his “greatest los s has been the continuing trauma that has made life hard and took the joy out of living.” Pet. Ex. 20 at ¶ 40. His wife noted, “Every day he complains about how hard everything is and how much he is hurting.” Pet. E x. 21 at ¶ 13. Mr. Fedewa reported continued numbness ten months after his diagnosis, and his medical records indicate muscle weakness as recent as April 17, 2018, a year and a half after his diagnosis with GBS. While muscle weakness and numbness in his extremities were not noted in his medical records after April 17, 2018 and Mr. Fedewa stopped taking Wellbutrin by July 25, 2018, Mr. Fedewa , in

an August 2019 status report, noted that his chronic fatigue has not abated since his injury. See Pet. Status Rept

. , filed Aug. 9, 2019 , at ¶ 9 (ECF No. 40)

. He further stated that he continues to experience depression and psychological issues. Id. Mr. Fedewa, who once regularly swam, walked, rode his bicycle, cut and split firewood, and performed home improvement projects, hopes to return to moderate bicycle riding and swimming.

B. Comparison to Other GBS Awards

As noted in the Rule 5 Order, the und ersigned preliminarily found petitioner’s case comparable to Johnson , which proves helpful as reference in the undersigned’s evaluation of Mr. Fedewa’s situation. Similarly, Dillenbeck v. Secretary of Health & Human Services proves helpful in evaluating M r. Fedewa’s case given the similar ity in facts. No. 17

- 428V, 2019 WL 4072069 (Fed. Cl. Spec. Mstr. July 29, 2019)

, aff’d in part

, No. 17

- 418V, 2020 WL 582588 , at *6 (Fed. Cl. Feb. 6, 2020) (remanded on lost wages damages, affirmed on pain and suffering)

.

i. Johnson

Ms. Johnson was sixty

- one when she diagnosed with GBS after receiving a flu vaccine

, and was awarded $180,000 .00 for actual pain and suffering. Johnson

, 2018 WL 5024012, at *1

- 2 . Ms. Johnson worked as a school bus driver for her local school district and as a part

- time school librarian. Id. at *2. Ms. Johnson received a flu vaccine in November 2015 and was subsequently hospitalized for five days, from December 10 to December 1 5, 2015, for GBS. Id. at *3. She received a lumbar puncture and five rounds of IVIG. Id. She did not take gabapentin following her injury because she feared being dependent on medication and suffering adverse effects of medi cation

. Id. at *7. After t hree months, she was approved to work half

- days up to three times a week as a librarian, but could still not return to work as a school bus driver

. Id. at *4. Approximately three and a half months after her diagnosis, Ms. Johnson was cautiously was an active membe r in his community as well, routinely host ing churc h members for dinner. With his nineteen-year-old daughter, Mr

. Fedewa hande d out drinks and snacks to students at MSU from eight to midnight on Friday ni ghts. However, Mr. Fedewa ha s not participated in the MSU student outreach since his injury because he c annot stay up afte r ten o’clock at night . Pet. Ex. 20 at ¶ 39. Mr. Fedewa ha s lost a part of his relationship with his nineteen-year- old daughter and cannot care for his younger childre n in the way he did prior to injury. Id. at ¶¶ 38 -39. He is limited in his a bility to participate in physical activities, such as biking a nd swimm ing, and service proj ects he used to enjoy.9 ii. Dillenbeck

Ms. Dillenbeck was sixty

- one when she was diagnosed with GBS after receiving the flu vaccine

. Dillenbeck , 2019 WL 4072069, at * 1. S he was awarded $170,000 for actual pain and suffering. Id. at * 1 4

- 15 . Ms. Dillenbeck was hospitalized for five days, from December 3 to December 8, 2015, then transferred into a rehabilitation center for five days until December 13, 2015. Id. at *2. She received two rounds of IVIG treatment during hospitalization and physical therapy three times a day during her five

- day rehabilitation. Id. She attended and was discharged from outpatient physical therapy by the end of January 2016. Id. Ms. Dillenbeck returned to work on March 1, 2016, approximately three months after her hospitalization, though with a fifteen

- pound weight restriction. Id. In April 2016

, Ms. Dillenbeck requested to be free of work restrictions despite still reporting symptoms of paresthesia in hands and feet, chest sensitivity, and an unsteady gait. Id. Ms. Dillenbeck took gabapentin for the six months following her hospitalization. Id

. at *3. At the time of her testimony in February 2019, Ms. Dillenbeck still reported GBS sequalae

, including lack of sensation in hands and feels, increased sensitivity on chest, abdomen, and back, weakness in her hands, and generalized fatigue , and s he continue d to take prednisone for GBS sequalae. Id. at * 3

- 4.

In addition to the similarities between Dillenbeck and case at hand, the s pecial m aster in Dillenbeck found that damages for pain and suffering “reflect the personal cost of having to suffer GBS ” and “the lost opportunity to continue to perform vet tech duties from which she clearly took great pleasure.” Dillenbeck , 2019 WL 4072069, at * 14 . The s pecial m aster accepted Ms. Dillenbeck’s explanati on that her quick return to work and release from restrictions was due to the pressure she felt to return to work rather than a reflection of her true health or readiness. Id. at * 9

- 10. driving a gain and walking without he r walking sti cks. Id. Subsequently

, Ms. Johnson passed her physical examination in 2016 and returne d as the school bus drive r for t he 2016 -2017 school year. Id. Ms. Johnson had initially c ompleted some in home therapy a nd three se ssions of outpatient therapy be tween March 2016 and June 2016, but she did not pa rtake in therapy between June 2016 a nd February 2017. See id. A li ttle over a yea r after Ms. Johnson’s hospitalization, she c ompleted forty-five pe rsonal exercise visits betwee n February 27, 2017 and February 26, 2018. Id.

At the time of her damages hearing in January 201 8, over tw o years after her hospitalization, Ms. Johnson still reported GBS se qualae includin g incontinenc e, decrease d work duties, fatigue, and residual numbness in her le gs. Johnson, 2018 WL 502 4012, at *5. She stated that she c an no longe r hike with he r family and dog li ke she used to. Id. at *4. She a lso testified that incontinence mea nt that she was unable to tell when she ne eded to use the bathroom and trave led with spare clothing. Id. at *5. Finally, Ms. Johnson testified that she sti ll ha d numbness in her le gs and c ould not tell when her feet were c old. Id. Based on the facts and circumstances of the c ase, Ms. Johnson was awarded $180,000.00 for actual pain and suffering. Id. at *9.10 C. Petitioner’s Pain and Suffering

The undersigned finds Mr. Fedewa’s situation most similar to Dillenbeck and Johnson

. Like Ms. Johnson, he received five rounds of IVIG treatment during his hospitalization

, and like Ms. Dillenbeck

, he was in rehabilitation for five days. However, petitio ner’s hospitalization was slightly longer than both Ms. Johnson’s and Ms. Dillenbeck’s, and he reported particularly painful experiences during his hospitalization.

Mr. Fedewa completed half the number of physical therapy sessions that Ms. Johnson compl eted in exercise therapy. However, his physical therapy sessions followed immediately after his hospitalization whereas Ms. Johnson was not admitted into inpatient rehabilitation nor did she participate in her exercise therapy until over a year from her h ospitalization. While Ms. Dillenbeck was discharged from outpatient physical therapy within a month, Mr. Fedewa was not discharged from outpatient therapy for three months.

Regarding work interference, Ms. Johnson was only able to return to work part

- ti me three months after her diagnosis, while both Ms. Dillenbeck and Mr. Fedewa returned to work full time after three months, albeit with weight restrictions. Even though Mr. Fedewa returned to work sooner than other individuals who have suffered from GBS, the undersigned finds Mr. Fedewa’s explanation of his quick return to work reasonable. Mr. Fedewa was concerned about being moved onto long

- term disability and being the sole provider for his wife and seven children. As noted in Dillenbeck , a petitioner returning to work quickly does not necessarily represent their health at the time or necessarily lessen the severity of their injury. See Dillenbeck , 2019 WL 4072069, at *3

- 4. In this case, Mr. Fedewa felt external pressures to return to work even thoug h he likely was not ready.

Respondent notes in his Brief on Damages that a distinct difference between Mr. Fedewa’s and Ms. Johnson’s course post

- hospitalization was Ms. Johnson’s inability to drive for several months. However, the difference is only a bout a month : Ms. Johnson was driving four months after hospitalization and Mr. Fedewa was driving three months after hospitalization. Indeed Ms. Johnson’s job as a school bus driver was completely impacted by an inability to drive, as driving is the job, but Mr. Fedewa’s job also required him to drive from service location to service location. The difference in duration of inability to drive between Mr. Fedewa and Ms. Johnson is not medically significant in the undersigned’s determination of petitioner’s actual pain and suffering

. The greatest difference between the cases is the residual sequelae each petitioner experienced. Ms. Johnson continued to experience incontinence, fatigue, and some numbness in her legs two years post

- hospitalizati on . Her bladder and bowel incontinence was particularly significant. Ms. Johnson did not continue gabapentin or other medication for her residual sequelae due to her fear of medication. Ms. Dillenbeck continued to experience lack of sensation in extremi ties, weakness in her hands, increased sensitivity on chest, abdomen, and back, and generalized fatigue two and a half years post

- hospitalization

. As of her testimony in 2019, she continues to take prednisone.11

VI. CONCLUSION

In light of all of the above, the undersigned awards the following compensation:

A lump sum payment of $1 85,807.16 , representing $1 80 ,000 .00 for actual pain and suffering and $5,807.16 for unreimbursed medical expenses and past lost wages , in the form of a check payable to peti tioner, Bruce Fedewa

. This amount represents compensation for all damages that would be available under 42 U.S.C. § 300aa

- 15(a).

The clerk of the court is directed to enter judgment in accordance with this decision. 3

IT IS SO ORDERED.

s/Nora Beth Dorsey Nora Beth Dorsey Special Master

3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice renouncing the right to seek review. Mr. Fedewa’s residual sequelae most ly consi sts of fatigue a nd emotional distress. Unlike Ms. Johnson and Ms. Dillenbeck, Mr. Fedewa h as not reported numbness or weakness in his extremities since a yea r and a ha lf post-hospitalization. He did not re port incontinence or additional bodily pa in. However, neither Ms. Dillenbeck or Ms. Johnson were tr ea ted for anxiety o r depression. Mr. Fedewa’s anxiety a nd moderately se vere d epression required him to take W ellbutrin for ove r a year. Additionally, as the spec ial master in Dillenbeck considered inabil ity to perform duties from which petitioner take s great pleasure, Mr. Fedewa’s limitation in caring for his children a s a fa ther is a c onsidera ble suffering. At the time of his injury, two of his children were young, requiring ph ysica l care that Mr. Fedewa could not pr ovide. See Pet. Ex. 18 at 1-2. He w as also unable to perform parental duties for his older c hildren. His limited capacity to play with, care

, and support his children resulted in substantial pain.

Though the type of actual pain and suffering Mr. Fedewa experienced is different from Ms. Johnson ’s and Ms. Dillenbeck ’s , Mr. Fedewa’s actual pain and suffering is comparable to Ms. Johnson ’s and slightly more severe than Ms. Dillenbeck ’s

.

For all of the reasons discussed above

, a nd base d on consideration of the record as a whole, the undersigne d finds that $180,000.00 represents a fair a nd appropriate a mount of compensation for petitioner’s actual pain and suffering and emotional distress.