1

In the United States Court of Federal Claims 

OFFICE OF SPECIAL MASTERS

No. 04-1717V 

(To be published) 

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

 * 

ELLENA PROKOPEAS and * 

CHRIS PROKOPEAS, * 

parents of C.A.P., a minor, *

 * Filed: June 14, 2017 

 *

 Petitioners, * 

 * 

 v. * Ruling on factual issues; Autism 

 * 

SECRETARY OF HEALTH AND * 

HUMAN SERVICES, * 

 * 

 Respondent. *

 * 

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

Clifford Shoemaker, Shoemaker, Gentry & Knickelbein, Vienna, VA, for Petitioners 

Voris Johnson, U.S. Department of Justice, Washington, DC, for Respondent 

RULING ON FACTUAL ISSUES 

HASTINGS, Special Master.

This is an action in which the Petitioners, Ellena and Chris Prokopeas, request 

compensation under the National Vaccine Injury Compensation Program (hereinafter “the 

Program”1), on behalf of their minor son, C.A.P., for injuries allegedly suffered from 

vaccinations administered to him during his first year of life. C.A.P.’s vaccinations to which 

Petitioners point include the following: diphtheria-tetanus-acellular pertussis (DTaP), 

haemophilus influenza (Hib), inactivated polio (IPV), pneumococcal conjugate (Prevnar), and 

hepatitis B (Hep B) vaccines. Petitioners allege that C.A.P. suffered from an encephalopathy 

that was “caused-in-fact” by the cumulative effects of those vaccinations. Among C.A.P.’s 

many neurodevelopmental conditions, he has been diagnosed with an autism spectrum disorder 

(ASD). 

 

1

 The applicable statutory provisions defining the Program are found at 42 U.S.C. § 300aa10 et seq. (2012 ed.). Hereinafter, for ease of citation, all "§" references will be to 42 U.S.C. 

(2012 ed.). I will also sometimes refer to the statutory provisions defining the program as the 

“Vaccine Act.” 
2

In this case, Petitioners presented certain facts concerning C.A.P.’s symptomatology from 

the early years of his life that are at variance with his contemporaneous medical records. Thus, a 

“fact hearing” was held on August 1, 2016, to resolve the disputed facts. For all of the reasons 

set forth below, I find that C.A.P.’s contemporaneous medical records are the most reliable 

source of evidence reflecting C.A.P.’s condition during his first year of life. In this regard, I 

reject parental allegations made during the course of this litigation, alleging that C.A.P. suffered 

from additional post-vaccination symptoms not reflected in his contemporaneous medical 

records. 

I 

THE APPLICABLE STATUTORY SCHEME 

 I begin with the relevant law concerning this “fact ruling,” which states that Petitioners 

are required to establish the facts supporting their causation theory by a “preponderance of the 

evidence.” 42 U.S.C. § 300aa–13(a)(1)(a). The preponderance of the evidence standard requires 

a “trier of fact to believe that the existence of a fact is more probable than its nonexistence before 

[he] may find in favor of the party who has the burden to persuade the judge of the fact’s 

existence.” Moberly v. HHS, 592 F.3d 1315, 1322, n.2 (Fed. Cir. 2010) (citations omitted). 

 

When confronted with discrepancies among medical records and affidavits, special 

masters often elect to hold “fact hearings” to evaluate the testimony of the affiants. See Campbell 

v. HHS, 69 Fed. Cl. 775, 779-80 (2006). The process for finding facts in the Vaccine Program 

begins with analyzing the medical records, which are required to be filed with the petition. 42 

U.S.C. § 300aa–11(c)(2). In this regard, the relevant caselaw states that medical records 

“warrant consideration as trustworthy evidence.” Cucuras v. HHS, 993 F.2d 1525, 1528 (Fed. 

Cir. 1993). Accordingly, where subsequent testimony conflicts with contemporaneous medical 

records, special masters usually accord more weight to the medical records. See, e.g., Reusser v. 

HHS, 28 Fed. Cl. 516, 523 (Fed. Cl. 1993) (“[W]ritten documentation recorded by a disinterested 

person at or soon after the event at issue is generally more reliable than the recollection of a party 

to a lawsuit many years later.”). 

To be sure, “it must [also] be recognized that the absence of a reference to a condition or 

circumstance is much less significant than a reference which negates the existence of the 

condition or circumstance. Since medical records typically record only a fraction of all that 

occurs, the fact that reference to an event is omitted from the medical records may not be very 

significant.” Murphy v. HHS, 23 Cl. Ct. 726, 733 (Fed. Cl. 1991), aff’d, 968 F.2d 1226 (Fed. Cir. 

1992). However, in balancing these considerations, special masters in this Program have in most 

cases declined to credit later testimony over contemporaneous records. See, e.g., Stevens v. HHS, 

No. 90-221V, 1990 WL 608693, at *3 (Cl. Ct. Spec. Mstr. Dec. 21, 1990); Vergara v. HHS, No. 

08-882V, 2014 WL 2795491, at *4 (Fed. Cl. Spec. Mstr. July 17, 2014) (“Special Masters 

frequently accord more weight to contemporaneously-recorded medical symptoms than those 

recorded in later medical histories, affidavits, or trial testimony.”); see also Cucuras v. HHS, 993 

F.2d 1525, 1528 (Fed. Cir. 1993) (noting that “the Supreme Court counsels that oral testimony in 

conflict with contemporaneous documentary evidence deserves little weight”).) 
3

Decisions by judges of the Court of Federal Claims have followed Cucuras in affirming 

findings by special masters that the lack of symptoms being reported in contemporaneously 

created medical records can contradict a testimonial assertion that symptoms appeared on a 

certain date. See, e.g., Doe/70 v. HHS, 95 Fed. Cl. 598, 608 (2010) (stating, “[g]iven the 

inconsistencies between petitioner’s testimony and his contemporaneous medical records, the 

special master’s decision to rely on petitioner’s medical records was rational and consistent with 

applicable law”), aff’d sub nom. Rickett v. HHS, 468 Fed. Appx. 952 (Fed. Cir. 2011); Doe/17 v. 

HHS, 84 Fed. Cl. 691, 711 (2008); Ryman v. HHS, 65 Fed. Cl. 35, 41-42 (2005); Snyder v. HHS, 

36 Fed. Cl. 461, 465 (1996) (“[t]he special master apparently reasoned that, if Frank suffered 

such [developmental] losses immediately following the vaccination, it was more likely than not 

that this traumatic event, or his parents’ mention of it, would have been noted by at least one of 

the medical record professionals who evaluated Frank during his life to date. Finding Frank’s 

medical history silent on his loss of developmental milestones, the special master questioned 

petitioner’s memory of the events, not her sincerity.”), aff’d, 117 F.3d 545, 547-48 (Fed. Cir. 

1997). 

The presumption that contemporaneously-created medical records are accurate and 

complete is rebuttable, of course. Special masters are expected to consider whether medical 

records are accurate and complete. To overcome the presumption that written records are 

accurate, testimony is required to be “consistent, clear, cogent, and compelling.” Blutstein v. 

HHS, No. 90-2808V, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). Special 

masters will consider various explanations for inconsistencies between contemporaneously 

created medical records and later given testimony. The Court of Federal Claims listed four such 

explanations. Inconsistencies can be explained by: (1) a person’s failure to recount to the 

medical professional everything that happened during the relevant time period; (2) the medical 

professional’s failure to document everything reported to her or him; (3) a person’s faulty 

recollection of the events when presenting testimony; or (4) a person’s purposeful recounting of 

symptoms that did not exist. La Londe v. HHS, 110 Fed. Cl. 184, 203 (Fed. Cl. 2013), aff’d, 746 

F.3d 1334 (Fed. Cir. 2014). 

 In weighing divergent pieces of evidence, special masters usually find 

contemporaneously-written medical records to be more significant than oral testimony. Cucuras, 

993 F.2d at 1528. Testimony offered after the events in question is less reliable than 

contemporaneous reports when the motivation for accurate explication of symptoms is more 

immediate. Reusser v. HHS, 28 Fed. Cl. 516, 523 (1993). However, compelling oral testimony 

may be more persuasive than written records. Campbell, 69 Fed. Cl. at 779 (“[l]ike any norm 

based upon common sense and experience, this rule should not be treated as an absolute and 

must yield where the factual predicates for its application are weak or lacking.”); Camery v. 

HHS, 42 Fed. Cl. 381, 391 (1998) (this rule “should not be applied inflexibly, because medical 

records may be incomplete or inaccurate”). 
4

II

BACKGROUND: THE OMNIBUS AUTISM PROCEEDING (“OAP”)

This case is one of more than 5,400 cases filed under the Program in which petitioners 

alleged that conditions known as “autism” or “autism spectrum disorders” (“ASD”)2 were caused 

by one or more vaccinations. A special proceeding known as the Omnibus Autism Proceeding 

(“OAP”) was developed to manage these cases within the Office of Special Masters (“OSM”). A 

detailed history of the controversy regarding vaccines and autism, along with a history of the 

development of the OAP, was set forth in the six entitlement decisions issued as “test cases” for 

two theories of causation litigated in the OAP (see cases cited below), and will only be 

summarized here. 

 A group called the Petitioners’ Steering Committee (“PSC”) was formed in 2002 by the 

many attorneys who represented Vaccine Act petitioners who raised autism-related claims. 

About 180 attorneys participated in the PSC. Their responsibility was to develop any available 

evidence indicating that vaccines could contribute to causing autism, and eventually present that 

evidence in a series of “test cases,” exploring the issue of whether vaccines could cause autism, 

and, if so, in what circumstances. Ultimately, the PSC selected groups of attorneys to present 

evidence in two different sets of “test cases” during many weeks of trial in 2007 and 2008. In 

the six test cases, the PSC presented two separate theories concerning the causation of ASDs. 

The first theory alleged that the measles portion of the measles, mumps, rubella (“MMR”) 

vaccine could cause ASDs. That theory was presented in three separate Program test cases 

during several weeks of trial in 2007. The second theory alleged that the mercury contained in 

thimerosal-containing vaccines could directly affect an infant’s brain, thereby substantially 

contributing to the causation of ASD. That theory was presented in three additional test cases 

during several weeks of trial in 2008. 

Decisions in each of the three test cases pertaining to the PSC’s first theory rejected the 

petitioners’ causation theories. Cedillo v. HHS, No. 98-916V, 2009 WL 331968 (Fed. Cl. Spec. 

Mstr. Feb. 12, 2009) aff’d, 89 Fed. Cl. 158 (2009), aff’d, 617 F.3d 1328 (Fed. Cir. 2010); 

 

2

“Autism Spectrum Disorder” is a general classification which as of 2010 included five 

different specific disorders: Autistic Disorder, Childhood Disintegrative Disorder, Asperger’s 

Syndrome, Rett Syndrome, and Pervasive Developmental Disorder Not Otherwise Specified 

(PDD-NOS). King v. HHS, No. 03-584V, 2009 WL 892296 at *5 (Fed. Cl. Spec. Mstr. Feb. 12, 

2010). The term “autism” is often utilized to encompass all of the types of disorders falling 

within the autism spectrum. (Id.) I recognize that since the OAP test cases, the consensus 

description of ASDs, contained now in the “DSM-V” as opposed to the prior “DSM-IV,” revises 

the prior subcategories of ASD set forth in the first sentence of this footnote. However, the 

DSM-V retains the same general description of ASDs. An ASD is a serious form of 

neurodevelopmental disorder defined by a collection of symptoms and behaviors, including 

significant impairment of social interaction and language skills, and the presence of repetitive, 

stereotyped interests. E.g., Snyder v. HHS, No. 01-162V, 2009 WL 332044, at *31 (Fed. Cl. 

Spec. Mstr. Feb. 12, 2009). 
5

Hazlehurst v. HHS, No. 03-654V, 2009 WL 332306 (Fed. Cl. Spec. Mstr. Feb. 12, 2009), aff’d

88 Fed. Cl. 473 (2009), aff’d, 604 F.3d 1343 (Fed. Cir. 2010); Snyder v. HHS, No. 01-162V, 

2009 WL 332044 (Fed. Cl. Spec. Mstr. Feb. 12, 2009), aff’d, 88 Fed. Cl. 706 (2009).3 Decisions 

in each of the three “test cases” pertaining to the PSC’s second theory also rejected the 

petitioners’ causation theories, and the petitioners in each of those three cases chose not to 

appeal. Dwyer v. HHS, No. 03-1202V, 2010 WL 892250 (Fed. Cl. Spec. Mstr. Mar. 12, 2010); 

King v. HHS, No. 03-584V, 2010 WL 892296 (Fed. Cl. Spec. Mstr. Mar 12, 2010); Mead v. 

HHS, No. 03-215V, 2010 WL 892248 (Fed. Cl. Spec. Mstr. Mar. 12, 2010). 

The “test case” decisions were comprehensive, analyzing in detail all of the evidence 

presented on both sides. The three test case decisions concerning the PSC’s first theory 

(concerning the MMR vaccine) totaled more than 600 pages of detailed analysis, and were 

solidly affirmed in many more pages of analysis in three different rulings by three different 

judges of the United States Court of Federal Claims, and in two rulings by two separate panels of 

the United States Court of Appeals for the Federal Circuit. The three special master decisions 

concerning the PSC’s second theory (concerning vaccinations containing the preservative 

“thimerosal”) were similarly comprehensive.

 All told, the 11 lengthy written rulings by the special masters, the judges of the U.S. 

Court of Federal Claims, and the panels of the U.S. Court of Appeals for the Federal Circuit 

unanimously rejected the petitioners’ claims, finding no persuasive evidence that either the 

MMR vaccine or thimerosal-containing vaccines could contribute in any way to the causation of 

autism. 

Thus, the proceedings in the six “test cases” concluded in 2010. Thereafter, the Petitioners 

in this case, and the petitioners in other cases within the OAP, were instructed to decide how to 

proceed with their own claims. The vast majority of those autism petitioners elected either to 

withdraw their claims or, more commonly, to request that the special master file a decision denying 

their claim on the written record, resulting in a decision rejecting the petitioner’s claim for lack of 

support. However, a small minority of the autism petitioners have elected to continue to pursue 

their cases, seeking other causation theories and/or other expert witnesses. A few such cases have 

gone to trial before a special master, and in the cases of this type decided thus far, all have resulted 

in rejection of petitioners’ claims that vaccines played a role in causing their child’s autism. See, 

e.g., Henderson v. HHS, No. 09-616V, 2012 WL 5194060 (Fed. Cl. Spec. Mstr. Vowell Sept. 28, 

2012) (autism not caused by pneumococcal vaccination); Blake v. HHS, No. 03-31V, 2014 WL 

2769979 (Fed. Cl. Spec. Mstr. Vowell May 21, 2014) (autism not caused by MMR vaccination); 

Murphy v. HHS, No. 05-1063V, 2016 WL 3034047 (Fed. Cl. Spec. Mstr. Corcoran Apr. 25, 2016) 

(autism not caused by DTaP or MMR vaccines), aff’d, 2016 WL 4926207 (Fed. Cl. Aug. 15, 2016); 

Franklin v. HHS, No. 99-855V, 2013 WL 3755954 (Fed. Cl. Spec. Mstr. Hastings May 16, 2013) 

(MMR and other vaccines found not to contribute to autism); Coombs v. HHS, No. 08-818V, 2014 

WL 1677584 (Fed. Cl. Spec. Mstr. Hastings Apr. 8, 2014) (autism not caused by MMR or Varivax 

vaccines); Long v. HHS, No. 08-792V, 2015 WL 1011740 (Fed. Cl. Spec. Mstr. Hastings Feb. 19, 

2015) (autism not caused by influenza vaccine); Brook v. HHS, No. 04-405V, 2015 WL 3799646 

(Fed. Cl. Spec. Mstr. Hastings May 14, 2015) (autism not caused by MMR or Varivax vaccines); 

 

3

 The petitioners in Snyder did not appeal the decision of the U.S. Court of Federal Claims. 
6

Holt v. HHS, No. 05-136V, 2015 WL 4381588 (Fed. Cl. Spec. Mstr. Vowell June 24, 2015) (autism 

not caused by hepatitis B vaccine), aff’d, (not yet published); Lehner v. HHS, No. 08-554V, 2015 

WL 5443461 (Fed. Cl. Spec. Mstr. Vowell July 22, 2015) (autism not caused by influenza 

vaccine); Miller v. HHS, No. 02-235V, 2015 WL 5456093 (Fed. Cl. Spec. Mstr. Vowell August 

18, 2015) (ASD not caused by combination of vaccines); Allen v HHS, No. 02-1237V, 2015 WL 

6160215 (Fed. Cl. Spec. Mstr. Vowell Sept. 26, 2015) (autism not caused by MMR vaccination); 

R.K. v. HHS, No. 03-632V, 2015 WL 10936124 (Fed. Cl. Spec. Mstr. Vowell Sept. 28, 2015) 

(autism not caused by influenza vaccine), aff’d, 125 Fed. Cl. 57 (2016), aff’d, 2016 WL 7174139 

(Fed. Cir. Dec. 9, 2016); Hardy v. HHS, No. 08-108V, 2015 WL 7732603 (Fed. Cl. Spec. Mstr. 

Hastings Nov. 3, 2015) (autism not caused by several vaccines); Sturdivant v. HHS, No. 07-788V, 

2016 WL 552529 (Fed. Cl. Spec. Mstr. Hastings Jan. 21, 2016) (autism not caused by Hib and 

Prevnar vaccines); R.V. v. HHS, No. 08-504V, 2016 WL 3882519 (Fed. Cl. Spec. Mstr. Corcoran 

Feb. 19, 2016) (autism not caused by influenza vaccine), aff’d, 2016 WL 3647786 (Fed. Cl. June 

2, 2016); Cunningham v. HHS, No. 13-483V, 2016 WL 4529530 (Fed. Cl. Spec. Mstr. Hastings 

Aug. 1, 2016) (autism not caused by MMR vaccine), aff’d, 2017 WL 1174448 (Fed. Cl. Jan. 25, 

2017); T.M. v. HHS, No. 08-284V (Fed. Cl. Spec. Mstr. Corcoran Aug. 9, 2016) (not yet published) 

(autism not caused by DTaP vaccine) (on review); Anderson v. HHS, 02-1314V, 2016 WL 

8256278 (Fed. Cl. Spec. Mstr. Corcoran Nov. 1, 2016) (autism not caused by MMR vaccination), 

aff’d, 2017 WL 1787975 (Fed. Cl. May 5, 2017); Dempsey v. HHS, No. 04-394V, 2017 WL 

105840 (Fed. Cl. Spec. Mstr. Hastings Feb. 23, 2017). 

In addition, some autism causation claims have been rejected without trial, at times over 

the petitioner’s objection, in light of the failure of the petitioner to file plausible proof of 

vaccine-causation. See, e.g., Waddell v. HHS, No. 10-316V, 2012 WL 4829291 (Fed. Cl. Spec. 

Mstr. Campbell-Smith Sept. 19, 2012) (autism not caused by MMR vaccination); Fester v. HHS, 

No. 10-243V, 2016 WL 1745436 (Fed. Cl. Spec. Mstr. Dorsey April 7, 2016) (autism not caused 

by measles, mumps, rubella, and varicella (MMRV) vaccine); Fresco v. HHS, No. 06-469V, 

2013 WL 364723 (Fed. Cl. Spec. Mstr. Vowell Jan. 7, 2013) (autism not caused by multiple 

vaccines); Fesanco v. HHS, No. 02-1770, 2010 WL 4955721 (Fed. Cl. Spec. Mstr. Hastings 

Nov. 9, 2010) (autism not caused by multiple vaccines); Miller v. HHS, No. 06-753V, 2012 WL 

12507077 (Fed. Cl. Spec. Mstr. Hastings Sept. 25, 2012) (autism not caused by DTaP or MMR 

vaccines); Pietrucha v. HHS, No. 00-269V, 2014 WL 4538058 (Fed. Cl. Spec. Mstr. Hastings 

Aug. 22, 2014) (autism not caused by multiple vaccines); Bushnell v. HHS, No. 02-1648, 2015 

WL 4099824 (Fed. Cl. Spec. Mstr. Hastings June 12, 2015) (autism not caused by multiple 

vaccines); Bokmuller v. HHS, No. 08-573, 2015 WL 4467162 (Fed. Cl. Spec. Mstr. Hastings 

June 26, 2015) (autism not caused by multiple vaccines); Canuto v. HHS, No. 04-1128, 2015 WL 

9854939 (Fed. Cl. Spec. Mstr. Hastings Dec. 18, 2015) (autism not caused by DTP and DTaP 

vaccines); Valle v. HHS, No. 02-220V, 2016 WL 2604782 (Fed. Cl. Spec. Mstr. Hastings April 

13, 2016) (autism not caused by DTaP vaccine); Hooker v. HHS, 02-472V, 2016 WL 3456435 

(Fed. Cl. Spec. Mstr. Hastings May 19, 2016) (autism not caused by multiple vaccines). Judges 

of this court have affirmed the practice of dismissal without trial in such cases. E.g., Fesanco v. 

HHS, 99 Fed. Cl. 28 (2011) (Judge Braden affirming); Canuto v. HHS, No. 04-1128V, 2016 WL 

2586510 (Fed. Cl. Apr. 18, 2016) (Judge Yock affirming), aff’d, 2016 WL 5746370 (Fed. Cir. 

Oct. 4, 2016).
7

 In none of the rulings since the test cases has a special master or judge found any merit in 

an allegation that any vaccine can contribute to causing autism.4

III

PROCEDURAL HISTORY 

A. Petitioners’ filing of a “Short-Form Autism Petition”

 On November 29, 2004, Chris and Ellena Prokopeas (“Petitioners”) filed a ShortForm Autism Petition for Vaccine Compensation on behalf of their minor son, C.A.P. (ECF No. 

1.) This case was assigned to my docket at that time. By filing that “Short Form” petition, 

 

4

I am well aware, of course, that during the years since the “test cases” were decided, in 

two cases involving vaccinees suffering from ASDs, Vaccine Act compensation was granted. 

But in neither of those cases did the Respondent concede, nor did a special master find, that there 

was any “causation-in-fact” connection between a vaccination and the vaccinee’s ASD. Instead, 

in both cases it was conceded or found that the vaccinee displayed the symptoms of a Table 

Injury within the Table time frame after vaccination. (See Section I above). 

In Poling v. HHS, the presiding special master clarified that the family was compensated 

because the Respondent conceded that the Poling child had suffered a Table Injury--not because 

the Respondent or the special master had concluded that any vaccination had contributed to 

causing or aggravating the child’s ASD. See Poling v. HHS, No. 02-1466V, 2011 WL 678559, 

at *1 (Fed. Cir Spec. Mstr. Jan. 28, 2011) (a fees decision, but noting specifically that the case 

was compensated as a Table Injury). 

Second, in Wright v. HHS, No. 12-423, 2015 WL 6665600 (Fed. Cl. Spec. Mstr. Sept. 21, 

2015), Special Master Vowell concluded that a child, later diagnosed with ASD, suffered a 

“Table Injury” after a vaccination. However, she stressed that she was not finding that the 

vaccinee’s ASD in that case was “caused-in-fact” by the vaccination--to the contrary, she 

specifically found that the evidence in that case did not support a “causation-in-fact” claim, 

going so far as to remark that the petitioners’ “causation-in-fact” theory in that case was 

“absurd.” Wright v. HHS, No. 12-423, 2015 WL 6665600, at *2 (Fed. Cl. Spec. Mstr. Sept. 21, 

2015). 

The compensation of these two cases, thus, does not afford any support to the notion that 

vaccinations can contribute to the causation of autism. In setting up the Vaccine Act 

compensation system, Congress forthrightly acknowledged that the Table Injury presumptions 

would result in compensation for some injuries that were not, in fact, truly vaccine-caused. H.R. 

Rept. No. 99-908, 18, 1986 U.S.C.C.A.N. 6344, 6359. (“The Committee recognizes that there is 

public debate over the incidence of illnesses that coincidentally occur within a short time of 

vaccination. The Committee further recognizes that the deeming of a vaccine-relatedness 

adopted here may provide compensation to some children whose illness is not, in fact, vaccinerelated.”)
8

Petitioners in effect alleged that C.A.P. suffered from autism, and that his autism was caused by 

either or both (1) the MMR (measles, mumps, rubella) vaccine, and (2) vaccines containing 

“thimerosal”, a mercury-based preservative contained in a number of childhood vaccines until 

about 1999 (but removed from most childhood vaccines soon after that year). Autism General 

Order #1, Exhibit A, Master Autism Petition for Vaccine Compensation, 2002 WL 31696785, at 

*8 (Fed. Cl. Spec. Mstr. July 3, 2002). By filing the “Short Form” petition, the Petitioners also 

were, in effect, making their case part of the “Omnibus Autism Proceeding” (OAP). On 

December 8, 2004, this case, along with many others, was stayed indefinitely pending 

completion of the general inquiry under the Omnibus Autism Proceeding (OAP) regarding the 

possible causal relationship between certain vaccines and autistic spectrum disorders. (ECF No. 

2; See also Section II of the Fact Ruling above.) 

On January 26, 2007, this case was reassigned to Special Master Campbell-Smith. (ECF 

No. 12.) Thereafter, Petitioners filed medical records (marked as Exhibits 1 to 16) on September 

24, 2007. (ECF No. 13.) 

On October 15, 2008, Special Master Campbell-Smith issued an order updating 

Petitioners on the status of the OAP and explaining how their case would proceed. (ECF No. 14.) 

Between May of 2009 and August of 2010, Petitioners submitted numerous medical records.

(See Exs. 17-575; ECF Nos. 22-23, 25, 34-35, 39, 41, 43-45.) 

Petitioners filed a statement on August 20, 2010, indicating that they had filed all 

requested records ordered by the special master. (ECF No. 46.) Thereafter, on September 16, 

2010, Respondent submitted a statement indicating that she would not oppose further processing 

of this case. (ECF No. 47, p. 3.) 

B. First and second Amended Petitions 

In light of the OAP “test cases,” on June 14, 2011, Special Master Campbell-Smith 

issued an order requiring the Petitioners to state whether they wished to pursue their claim 

further. (ECF No. 48.) That order also instructed that, if the Petitioners wished to proceed 

further with this case, then they should file an Amended Petition, which, among other things, 

clearly explained their theory of vaccine causation. (Id.) 

Petitioners filed an Amended Petition on August 15, 2011, alleging that C.A.P. 

“developed encephalopathy from repeated exposures to mercury and other vaccine ingredients”

found in certain vaccinations C.A.P. received during his first year of life. (ECF No. 51, p. 3.) 

The vaccinations alleged to have caused C.A.P.’s injuries included: diphtheria-tetanus-acellular 

pertussis (DTaP), haemophilus influenzae (Hib), inactivated polio (IPV), pneumococcal 

conjugate (Prevnar), and hepatitis B (Hep B). (Id., pp. 2-3.) 

On January 11, 2012, Special Master Campbell-Smith held a status conference to discuss 

her concerns about the Petitioners’ claim. (ECF No. 54.) Specifically, she noted that 

Petitioners’ causation theory in this case, alleging that C.A.P. developed an “encephalopathy 

 

5

 Petitioners filed Exhibit 54 on both July 26, 2010 and July 29, 2010. (ECF Nos. 41, 43.) 

On July 29, 2010, Petitioners moved to strike the documents filed on July 26, 2010, due to an 

inadvertent filing mistake by Petitioners’ counsel. (ECF No. 42.) 
9

from repeated exposure to mercury and other vaccine ingredients,” was “without more, a reprise 

of aspects of theories asserted, considered, and rejected in both the first and second rounds of test 

cases litigated during the Omnibus Autism Proceeding (OAP).” (Id.) Moreover, she highlighted 

her concern that “there is a lack of factual support for the allegation that [C.A.P.] had a fever 

following the administration of vaccines.” (Id., p. 2.) Thus, she ordered Petitioners to (1) file 

updated medical records supporting the allegation that C.A.P. suffered fevers following the 

administration of his vaccinations, and (2) an annotated Amended Petition containing specific 

citations to the supporting medical records. (Id.) 

In response, on March 12, 2012, Petitioners filed a joint affidavit from Chris and Ellena 

Prokopeas (Ex. 58, ECF No. 56), and a second Amended Petition (ECF No. 57), virtually 

identical to the Amended Petition filed on August 15, 2011, except that it added certain citations 

to the exhibits. Between June of 2012 and September of 2012, Petitioners submitted numerous 

updated medical records (Exs. 59-86; ECF Nos. 60, 63-67). This case was then reassigned to the 

docket of Special Master Vowell on March 8, 2013. (ECF No. 70.) 

C. Expert reports and evidentiary hearing 

On July 9, 2013, Petitioners filed the expert report and curriculum vitae of Dr. Joseph 

Bellanti, M.D. (Exs. 87-88; ECF No. 72.) Dr. Bellanti’s expert report of July 9, 2013, however, 

indicated that his opinion was “subject to further consultation with colleagues in the field of 

genetics.” (ECF No. 73.) Thus, on July 12, 2013, Special Master Vowell ordered Petitioners to 

file a supplemental report from Dr. Bellanti addressing the aforementioned statement contained 

in that expert report. (Id.) After several extensions of time (ECF Nos. 74-75, 78), Petitioners 

eventually filed the supplemental expert report of Dr. Bellanti on February 12, 2014 (Ex. 89; 

ECF No. 80). 

On June 3, 2014, Respondent filed the expert reports and curricula vitae of Dr. Gerald 

Raymond, M.D. (Exs. A-B), and of Dr. Judith Miller, Ph.D. (Exs. H-I). (ECF No. 83.) 

Additionally, Respondent also filed medical literature supporting both Dr. Raymond’s expert 

report (Exs. C-G), and Dr. Miller’s expert report (Exs. J-K). (Id.)

On September 16, 2014, Special Master Vowell ordered Petitioners to file all outstanding 

medical records, including C.A.P.’s most recent lab results and reports from C.A.P.’s genetic 

specialist. (ECF No. 88.) Petitioners continued to file outstanding medical records from October 

to December of 2014. (Exs. 90-91, 93; ECF Nos. 89, 91, 93.) Thereafter, on February 13, 2015, 

Petitioners filed medical records6from C.A.P.’s treating geneticist, Dr. Aparna Rajadhyaksha, 

M.D. (Ex. 94), and additional medical literature (Ex. 95). (ECF No. 96.) Thereafter, on April 3, 

2015, Petitioners filed the expert report and curriculum vitae of Dr. Brett Abrahams, Ph.D. (Exs. 

96-97, ECF No. 97.) 

 

6

In filing Exhibit 94, Petitioners’ counsel inadvertently marked that exhibit as an “Expert 

Report,” instead of properly marking that exhibit as “medical records.” (Ex. 94, ECF No. 96.) 

Exhibit 94 contains only C.A.P.’s medical records, including genetic test results from his 

medical examination by Dr. Rajadhyaksha. (Id.) 
10

On June 8, 2015, this case was reassigned to my docket due to the impending retirement 

of then-Chief Special Master Vowell. (ECF No. 103.) Thereafter, on December 1, 2015, 

Petitioners filed the expert report of Jean-Ronel Corbier, M.D. (Ex. 98; ECF No. 112.) 

Subsequently, on December 4, 2015, Petitioners filed the curriculum vitae and supplemental 

expert report of Dr. Corbier. (Ex. 99; ECF No. 113.) On March 29, 2016, Respondent submitted 

the supplemental expert report of Dr. Raymond (Ex. L), and the corresponding medical literature 

cited in that report (Exs. M-S). (ECF No. 116.) 

I held a telephonic status conference with both parties on April 7, 2016. (ECF No. 118.) 

At that time, Petitioners’ counsel observed that the viability of the Petitioners’ expert reports was

predicated on the accuracy of parental reports describing symptoms not reflected in the 

contemporaneous medical records. (Id.) Thus, Petitioners’ counsel proposed a “fact hearing” in 

order to determine whether such family reports can be found credible in light of the 

contemporaneous medical records. (Id.) On June 13, 2016, Petitioners’ counsel filed a status 

report informing the Court that four witnesses would testify at the “fact hearing” -- Ellena 

Prokopeas; Chris Prokopeas; Nick Chrissikos; and Naomi de la Torre. (ECF No. 124.) 

Concurrently, Petitioners submitted the statement of Nick Chrissikos (Ex. 100); Amendment to 

Ellena Prokopeas’ Affidavit (Ex. 101); and the statement of Naomi de la Torre (Ex. 102).7(ECF 

No. 125.) 

I conducted the requested “fact hearing” in Washington, D.C. on August 1, 2016. At that 

time, only Ellena Prokopeas testified for the Petitioners. (ECF No. 130; Tr. 4-5.) This matter is 

now ripe for a ruling on the disputed facts. 

IV

FACTS 

A. Medical history appearing in C.A.P.’s medical records 

1. C.A.P.’s first month of life

C.A.P. was born on December 6, 2001. (Ex. 1, pp. 1-2.) During his first month of life, 

C.A.P. was seen by Pediatric Associates of Dallas for routine childhood illnesses. (See Ex. 34-2

generally.) Specifically, on December 11, 2001, jaundice was noted (Ex. 34-2, p. 30); and on 

December 27, 2001, he was treated for a fever, congestion, runny nose, and decreased appetite 

(id., pp. 31-32). However, at both his two-week well visit of December 20, 2001, and his onemonth well-visit of January 8, 2002, C.A.P. was recorded as being a “well” baby. (Id., pp. 32-

33.) 

 

7

 Petitioners filed a status report on June 24, 2016, indicating that they did not intend to file 

an additional affidavit for Chris Prokopeas, choosing, instead, to rely on the signed joint 

statement of Chris and Ellena Prokopeas (filed as Exhibit 58), to be the entirety of Mr. 

Prokopeas’ testimony in this case. (ECF No. 127.)
11

2. C.A.P.’s first set of vaccinations and following care 

C.A.P. had his two-month well-visit on February 5, 2002. (Ex. 34-2, p. 34.) At that time, 

he presented with a “stuffy nose” and diarrhea, and was recorded to be sleeping three to four 

hours per night. (Id.) He was described as a “well baby,” and was administered the following 

vaccinations: DTaP, IPV, Comvax (combination dose of the Hib and hepatitis vaccines), and 

Prevnar. (Id.) 

3. C.A.P.’s second set of vaccinations and following care

C.A.P. was next seen by his pediatrician for his four-month well-visit on April 9, 2002. 

(Ex. 34-2, p. 35.) No reaction to the vaccinations of February 5, 2002, was recorded. (Id.) At 

that time, he was recorded to be sleeping up to five hours a night, was assessed as a “well baby,” 

and was administered the DTaP, IPV, Hib, and Prevnar vaccinations. (Id.) C.A.P. saw his 

examining physician again on April 30, 2002,

8

presenting with a cough, runny nose, and a rash 

throughout his body -- symptoms that were reported to have persisted for one week. (Id.) At that 

visit, he was reported, among other things, to be “happy,” and was diagnosed with having an 

upper respiratory infection (“URI”). (Id.) 

4. C.A.P.’s third set of vaccinations and following care

 C.A.P. had his seven-month well-visit on July 22, 2002. (Ex. 34-2, p. 36.) C.A.P.’s

pediatrician recorded that he was sleeping approximately four hours per night, and was assessed 

as a “well child” overall, receiving the DTaP, Hib, Hep B, and Prevnar vaccinations at that visit.

(Id.) 

On July 23, 2002, C.A.P.’s medical records include a notation of a phone call from Mr. 

Prokopeas, relaying that C.A.P. had a fever of 102-103 degrees Fahrenheit. (Ex. 34-2, p. 36.) 

Mr. Prokopeas described C.A.P. as being “fussy,” but reported that he was feeling better with 

Motrin, and was “eating ok.” (Id.) However, Mr. Prokopeas reported that both parents were 

concerned because C.A.P.’s fever had not come down. (Id.) That medical record further reveals 

that a staff member from C.A.P.’s pediatrician’s office documented discussing a variety of topics 

concerning fevers with C.A.P.’s parents, including fever control, and fever as a reaction to 

immunizations. (Id.) Specifically, that staff member documented advising the parents that fevers 

as a reaction to immunizations can last up to 24 to 36 hours post-immunizations, and 

documented advising them to call back the next day (i.e., on July 24, 2002), if C.A.P. still had a 

fever the next morning, or if any new symptoms developed during that time period. (Id.) 

 

8

 This medical record from April of 2002 (Ex. 34-2, p. 35) is unclear at first glance as to 

the precise date. At the fact hearing, Mrs. Prokopeas testified that she believed that C.A.P.’s 

visit was most likely on April 13, 2002. (Tr. 17-18.) As discussed at Section VII(A)(2) below, 

however, I do not accept Mrs. Prokopeas’ interpretation of C.A.P.’s sick visit to be on April 13, 

2002. Instead, I find that that medical visit was on April 30, 2002. 
12

C.A.P.’s medical records also reflect a notation9of a second phone call at a later time on July 23, 

2002, by Mrs. Prokopeas. (Id., p. 37.) That phone call notation reflects Mrs. Prokopeas reporting 

that C.A.P. had a temperature of 102-103 degrees Fahrenheit; however, she also reported C.A.P. 

as being “playful,” and having no additional symptoms other than his fever. (Id.) 

On July 24, 2002, C.A.P. was taken back to his pediatrician, and his fever symptoms 

were reported to have continued for the past two days. (Ex. 34, p. 37.) That medical record 

reflects C.A.P.’s parents describing C.A.P. as “not himself,” and reporting his temperature to be 

as high as 103 degrees Fahrenheit. (Id.) C.A.P.’s temperature was taken during that examination 

visit, and was recorded to be 101.4 degrees Fahrenheit. (Id.) Moreover, C.A.P. was reported to 

be taking “Tylenol/Motrin” to control his fever. 10 (Id.) 

On July 25, 2002, Mrs. Prokopeas took C.A.P. to see another pediatrician, Dr. Porter. 

(Ex. 10, p. 4.) During that visit, Dr. Porter recorded Mrs. Prokopeas’ accounts of C.A.P.’s 

ongoing symptomatology, noting that C.A.P. was experiencing a fever for four days (“F x 4”), 

with his highest temperature reaching 103.9 degrees Fahrenheit. (Id.) Mrs. Prokopeas also 

reported that C.A.P. had vomited three times (“V x 3 times”), had diarrhea twice (“D x 2 times”) 

since the previous day, was fussy, and could not “keep anything down.” (Id.) However, on the 

day of the visit, C.A.P. was reported to have been successfully breast-fed three times that day,

with no further diarrhea, and observed by Dr. Porter to be “happy” and “playful.” (Id.) Dr. 

Porter diagnosed C.A.P. with “viral gastroenteritis,” recommending that C.A.P. stay “well 

hydrated,” and asked Mrs. Prokopeas to call back if C.A.P. exhibited increased listlessness, 

increased vomiting, or if his fever persisted for more than 48 hours. (Id.) 

Thereafter, C.A.P.’s medical records reflect that Mrs. Prokopeas contacted C.A.P.’s

pediatrician’s office on August 13, 2002. (Ex. 10, p. 4.) That notation reflects a phone call from 

Mrs. Prokopeas, relaying her worries that C.A.P. had diarrhea again for the past week (“D again 

x 1 wk”), had no appetite (“no app.”), was not nursing well, had some dry diapers, and wanted 

C.A.P. to be seen by the pediatrician. (Id.) C.A.P. was seen by Dr. Porter on August 14, 2002, at 

which time Mrs. Prokopeas reported that C.A.P. was not sleeping well, was fussy, had a cough 

for the past three days (“C x 3 days”), had diarrhea for 7 days (“D x 7 days”), and spat up yellow 

mucus. (Id.) C.A.P.’s pediatrician diagnosed him with oral thrush (“thrush”), and “feeding 

issues.” (Id.) He was prescribed Gentian Violet (a common medication to treat oral thrush), and 

the pediatrician encouraged his parents to feed him solids, and asked to be updated by the parents 

if C.A.P.’s symptoms persisted. (Id.) 

 

9

 Mrs. Prokopeas testified at the fact hearing that the second phone call of July 23, 2002, 

was initiated by C.A.P.’s pediatrician, who was calling her back to check on C.A.P.’s condition. 

(Tr. 22.) 

10 This medical record of C.A.P.’s sick visit of July 24, 2002, is partly illegible. (Ex. 34-2, 

p. 37.) One of the notations on that medical note may possibly read “? Rx to shot” (that is, 

“reaction” to shot). (Id.) 
13

5. C.A.P.’s vaccination on September 24, 2002, and following care. 

C.A.P. had his nine-month well-visit on September 24, 2002. (Ex. 10, p. 3.) That medical 

record, among other things, reflects that C.A.P. “crawls,” and “stands with assistance.” (Id.) He 

was assessed as being a “well” nine-month old, and was administered his third dose of the 

Hepatitis B vaccine. (Id.) 

Mrs. Prokopeas took C.A.P. to his pediatrician on September 30, 2002, reporting, among 

other things, that C.A.P. had congestion, and a runny nose (“RN”) for the past three days (“x 3 

day”). (Ex. 10, p. 3.) Moreover, Mrs. Prokopeas reported that C.A.P. was sneezing, had vomited 

once a day for seven days, was teething, and was not sleeping well. (Id.) Dr. Porter recorded that 

C.A.P. was alert and cooperative during the medical examination, and diagnosed him as 

suffering from a viral upper respiratory infection (“URI/Viral”), vomiting phlegm (“Vom 

phlegm”), and having feeding problems. (Id.) 

On October 13, 2002, C.A.P. was seen in the Emergency Department of the Medical City 

of Dallas Hospital, for complaints of vomiting and diarrhea that had started on the same day. 

(Ex. 35, pp. 16-19.) Upon examination, C.A.P. was diagnosed with having “[g]astroenteritis.”

(Id., p. 19.) 
14

6. C.A.P.’s medical care from November of 2002 to August of 2003. 11

 In an affidavit of December 1, 2014, Mrs. Prokopeas reported that “there are no medical 

records for C.A.P. from 11 months old to 20 months old” (covering the time period from 

November of 2002 to August of 2003), stating that she did not take C.A.P. to a physician during 

that time period, as she could not find a pediatrician amenable to postponing C.A.P.’s future 

vaccinations. (Ex. 91, p. 1.) However, in her affidavit of June 13, 2016, Mrs. Prokopeas 

indicated that “Dr. Kotsanis,” a family friend, provided some care when C.A.P. was 12 months 

of age until he was 20 months of age. (Ex. 101, p. 1, ¶ 4.) In any event, Petitioners have not 

submitted records of any medical care received by C.A.P. between October 13, 2002, and 

October 23, 2003. (See generally Exs. 10 and 34.) 

7. C.A.P.’s playground head injury and following care. 

C.A.P.’s medical records reflect that he was examined by Dr. Kotsanis12 on October 23, 

2003, for a head injury. (Ex. 67, p. 3.) At that time, Dr. Kotsanis recorded a medical history of 

 

11 C.A.P.’s vaccination administration record from Dr. Porter (Ex. 10, p. 1) reflects a 

stamped date of December 10, 2002 (“Dec 10 2002”), with a notation of “n/s” next to the rows 

entitled “MMR1”; “Varivax”; and “Prevnar.” (Ex. 10, p. 1.) The exact meaning of the notation 

of “n/s” is not clear in that record; however, that notation could possibly mean “no show.” 

(Medical Abbreviations: 32,000 Conveniences at the Expense of Communication and Safety, 15th

ed., p. 232.) 

In closely examining Ex. 10, p. 1, I note the contrast between C.A.P.’s documented 

vaccination of September 24, 2002, versus the stamped notation of December 10, 2002. (Ex. 10, 

p. 1.) In this regard, I point out that, on the column entitled “Signature of Parent or Guardian,” 

that record reflects Mrs. Prokopeas’ signature by the corresponding row, documenting C.A.P.’s 

administered Hep B vaccination of September 24, 2002. (Id.) In contrast, there is no such 

corresponding signature by the date stamps of December 10, 2002, by the “MMR1,” “Varivax,” 

and “Prevnar” columns. (Id.) Moreover, I note that while there is documentation by Dr. Porter of 

C.A.P.’s office visit of September 24, 2002 (Ex. 10, p. 3), no such documentation exists for any 

such visit from December 10, 2002 (see generally Ex. 10). Thus, it seems unclear whether 

C.A.P. was administered any vaccinations on December 10, 2002. 

Regardless of the precise significance of the “n/s” notation, I note that none of 

Petitioners’ pleadings (ECF Nos. 1, 51, 57), affidavits (Exs. 58, 91, 100-102), or expert reports 

(Exs. 87, 89, 96, 98-99) submitted in this case allege that C.A.P.’s present condition is due to any 

potential vaccinations received by C.A.P. on December 10, 2002. 

12 I note that the extent to which Dr. Kotsanis was a treating physician of C.A.P. is unclear 

in this case. Several of C.A.P.’s medical records submitted in this case reflect Dr. Kotsanis 

serving as a non-primary care provider to C.A.P. (E.g., Exs. 5, 25, and 48 generally.) Moreover, 

in one of those medical records, Dr. Kotsanis himself stated that his role in C.A.P.’s treatment 

was limited to that of “being supportive for convenience reasons.” (Ex. 48, p. 2.) However, in 

her affidavit of June 13, 2016, Mrs. Prokopeas referenced Dr. Kotsanis as being C.A.P.’s sole 
15

C.A.P., as reported by Mrs. Prokopeas. (Id.) That note indicates that, on September 20, 2003,13

C.A.P. suffered a head injury in a fall and was taken to the emergency room to be further 

evaluated.14 (Id.) C.A.P. had a “very large” head hematoma (swelling due to collection of blood 

in the blood vessels), and underwent a CT scan, among other additional testing, during that 

emergency room visit. (Id.) Mrs. Prokopeas reported that those test results from C.A.P.’s 

emergency room visit “appeared to be normal.”

15 (Id.) 

Furthermore, Mrs. Prokopeas relayed that, after C.A.P.’s head injury accident, he was “a 

bit unsteady,” and that he had “decreased in verbalization.” (Ex. 67, p. 3.) Dr. Kotsanis recorded 

in the oral history section that, besides the playground head injury, “other active problems at this 

time are none.” (Id.) Upon examination at that time, Dr. Kotsanis recorded that the “area of the 

trauma has healed very nicely,” but that C.A.P. appeared to “drift slightly to the right side,” and 

that he was “irritable.” (Id.) Overall, Dr. Kotsanis diagnosed C.A.P. with “post-concussion 

syndrome,” referring him for hearing and speech evaluations. (Id.) 

 

medical care provider when C.A.P. was 12 months of age until he was 20 months of age, 

alleging as follows: 

 

From 12-20 months old, [C.A.P.] was cared for by his mother and a family doctor friend, 

Dr. Kotsanis. Before moving to New Orleans, Dr. Kotsanis ran a variety of lab test [sic] 

on [C.A.P.] as indicated in his medical records. 

(Ex. 101, p. 1, ¶ 4.) 

 

13 This medical record is not completely clear as to the exact date of C.A.P.’s head injury. 

(Ex. 67, p. 3.) The type-written date of C.A.P.’s head injury appears to be on “10/20/2003.” (Id.) 

However, there is a hand-written “9” transposed on top of the “10,” seeming to reflect Dr. 

Kotsanis’ hand-written correction that C.A.P.’s head injury occurred a month prior, on 

“9/20/2003.” (Id.) Thus, based on a close examination of that record, and the surrounding 

context, it appears that C.A.P.’s playground injury likely occurred in September of 2003. 

However, I am also mindful that C.A.P.’s medical records reflect alternating references to 

C.A.P.’s head injury in either September or October of 2003. (See Ex. 54-2, pp. 43-44; Ex. 16, p. 

1.) 

14 Petitioners did not submit C.A.P.’s medical records from the emergency room visit of 

September or October of 2003 seeking treatment for C.A.P.’s head injury. As a result, the record 

of this case contains only secondary medical records describing C.A.P.’s head injury of 

September or October of 2003. Thus, all the medical records which reflect C.A.P.’s head injury 

of September or October of 2003, reflect parental descriptions of C.A.P.’s playground accident 

during which C.A.P. injured his head, as relayed to subsequent medical care providers while 

seeking treatment for C.A.P.’s developmental issues. (See Ex. 67, p. 3; Ex. 54-1, p. 3; Ex. 54-1, 

p. 4; Ex. 54-2, pp. 43-44; and Ex. 16, p. 1.) 

15 Petitioners have not submitted C.A.P.’s emergency room diagnostic testing results to the 

record in this case. 
16

8. C.A.P.’s medical care subsequent to October of 2003

a. C.A.P.’s care from November of 2003 to January of 2004 

A referral form dated November 17, 2003, from Early Childhood Intervention of 

Richardson/North Dallas (hereafter “ECI”), indicates that C.A.P. was referred to that practice to 

be evaluated for speech delay. (Ex. 54-1, p. 3.) Under the “Additional Information” section of 

that referral form, the following information was stated: 

Child was hit by an iron gate and was hit in the fore head. Child had a big bump. The 

accident happen [sic] in September. Child is not speaking like he use [sic] to speak 

before the accident. 

(Ex. 54-1, p. 3.) 

On November 20, 2003, C.A.P. underwent an evaluation by ECI. (Ex. 54-1, p. 4.) The 

intake form of that evaluation, which appears to be filled out by Mrs. Prokopeas, reflects that she 

was “most concerned” about C.A.P.’s “speech delay and temper tantrums.” (Id.) The medical 

care provider examining C.A.P. at that time also recorded an oral history, as given by Mrs. 

Prokopeas, describing the circumstances of C.A.P.’s head injury in September of 2003. (Id.) 

That medical evaluation note recorded that C.A.P. was “hit by an iron gate” while at Disneyland, 

and that he was “not talking much at all” after his accident. (Id.) Moreover, that medical note 

records Mrs. Prokopeas as saying that prior to C.A.P.’s head injury accident in September of 

2003, C.A.P. “only had about 10 words”; however, by the time of his evaluation as of November 

20, 2003, he was unable to speak any words, and was using “a lot of gestures.” (Id.) 

 On December 5, 2003, C.A.P. was once again evaluated by ECI. (Ex. 54-1, pp. 29-31.) 

During that evaluation (when C.A.P. was approximately two years of age), several of his 

developmental parameters were listed as being “of concern.” (Id., pp. 29-30.) Specifically, his 

social-emotional development was listed to be within the 18-month age range; his 

communication development was listed to be at 15-months of age; his expressive development 

was listed as being in the 15-month age range; his cognition was listed to be within the 18-month 

age range; and his fine-motor development was listed to be within the 15.5 month age range. 

(Id.) Also, C.A.P.’s gross-motor development (within the 21-month age range) and self-help 

skills (within the 24-month age range) were noted to be “WNL” (within normal limits). (Id., p. 

31.) 

On December 11, 2003, C.A.P. underwent an evaluation by ECI of Richardson’s 

Individual Family Service Plan (“ECI IFSP”). (Ex. 54-2, pp. 43-51.) The “Integrated Summary”

section of that evaluation reflects an accounting given by Mrs. Prokopeas concerning C.A.P.’s

medical history, relaying that he “had no significant medical problems” until his head injury 

accident at Disney land in October of 2003.16 (Id., pp. 43-44.) At that time, Mrs. Prokopeas 

 

16 The “Integrated Summary” section of this medical record summarizes that: 

[W]hen [C.A.P.] was in Disney Land in October he was accidentally hit with a hard iron 

gate/door. His mother is unsure if he was knocked unconscious. She did not see it 

happen. She heard him crying and was told what had happened. It is unknown how hard 
17

relayed her concerns that C.A.P.’s skills appeared to have regressed since the head injury 

accident, observing C.A.P. to be “speaking more before the accident,” whereas after his accident 

C.A.P. was using “gestures or screaming cries to get his needs met.” (Id., pp. 43-44.) That 

medical note also reflects that C.A.P.’s parents were “researching other areas,” such as an

“autism spectrum” disorder, for C.A.P.’s apparent regression. (Id., p. 44.) 

From December of 2003 to August of 2004, C.A.P. continued to receive regular 

development therapy by ECI IFSP. (Exs. 54-1 through 54-4.) 

b. C.A.P.’s medical history reflected in certain of Dr. Kotsanis’ treatment notes 

An undated medical record from Dr. Kotsanis reveals the following medical history of 

C.A.P.: 

In October 2003 the child came to my office for the first time because of a head injury 

while at Disney World. The CT [at] the ER in Florida was normal. The trauma did not 

change anything. 

(Ex. 5, p. 1.) Additionally, Dr. Kotsanis recorded the following relevant medical history: 

The postvaccination injury that is reported by the parents goes along with my knowledge 

about [C.A.P.] socially from our Church gatherings and eventually as a doctor in my 

office. I remember that [C.A.P.] was initially a normal healthy child and eventually 

matched the traits of autistic spectrum disorder children that visit my office. 

(Ex. 5, p. 1.) Moreover, his impression was that C.A.P. had an “Autistic Spectrum Disorder 

most likely secondary to vaccination injury.” (Id.) 

On January 6, 2004, Mr. and Mrs. Prokopeas had a telephonic consultation with Dr. 

Kotsanis. (Ex. 5, pp. 2-4.) Dr. Kotsanis’ recorded notes from that phone consultation reveals that

C.A.P.’s parents believed that he suffered a “vaccination injury.” (Id., p. 2.) At that time, 

C.A.P.’s parents also reported that he suffered from allergies and behavior problems that were 

“out of control.” (Id., p. 2.) 

Moreover, Dr. Kotsanis’ medical notes from the phone consultation of January 6, 2004, 

state that he “conducted an extended history” of C.A.P.’s “progress and problems since birth.” 

(Ex. 5, p. 2.) In this regard, Dr. Kotsanis recorded an oral medical history, as given by C.A.P.’s

parents, concerning C.A.P.’s early years of life. (Id.) At that time, C.A.P.’s parents reported that 

he had “met all” of his developmental milestones until July of 2002, but that they started noticing 

problems after his vaccinations administered later that month. (Id., pp. 2-3.) They further 

described C.A.P.’s condition after his vaccinations of July 22, 2002, stating that C.A.P. had 

“diarrhea for two consecutive weeks after the vaccinations,” in addition to having a “persistent 

 

his head was hit, but family took him to hospital immediately following. Cat scan showed 

nothing. 

 

(Ex. 54-2, pp. 43-44.) (Compare Ex. 67, p. 3, reflecting that C.A.P.’s head injury accident 

possibly occurred in September of 2003.) 
18

dry cough,” a fever, refusing to breast feed, difficulties sleeping, and being in constant motion 

when awake. (Id., p. 3.) They additionally reported that “as time went on,” C.A.P. exhibited 

additional symptoms, such as: “head banging;” “uncontrollable crying for no reason;” “increased 

hyperactivity;” displaying a “fear of being alone;” having worsening sleeping patterns; and being 

“nonverbal.” (Id.) 

Furthermore, in his phone consultation note of January 6, 2004, Dr. Kotsanis also 

recorded that “[i]n the summer/fall of 2002,” C.A.P.’s parents attended one of Dr. Kotsanis’ 

“public lectures,” during which he advised them to “do a comprehensive pediatric evaluation 

with a pediatrician that is aware of possible postvaccination injury,” thus reinforcing the parents’

decision to “withhold vaccinations.” (Ex. 5, p. 3.) Overall, Dr. Kotsanis recommended that 

C.A.P. be seen by a new pediatrician, Dr. Hamel, but noted that he would continue to monitor 

C.A.P.’s condition by phone until C.A.P. found “proper care.” (Id., p. 4.) 

c. C.A.P.’s continuing care from February of 2004 

On February 9, 2004, C.A.P. underwent an audiological evaluation during which his 

treating audiologist recorded Mrs. Prokopeas’ concerns about C.A.P.’s condition. (Ex. 16, p. 1.) 

Mrs. Prokopeas reported that C.A.P. was “not talking as well as his peers,” was “having periods 

when he is not verbal,” and was having “problems with behavior.” (Id.) Moreover, Mrs. 

Prokopeas stated that her concerns “began in October 2003, when [C.A.P.] had an injury to his 

forehead.” (Id.) Upon examination, the treating audiologist diagnosed C.A.P. with having 

“abnormal auditory signs and symptoms.” (Id.) 

C.A.P.’s medical records additionally reflect that, on June 23, 2004, Mrs. Prokopeas 

filled out a “Review Of Systems By Symptoms” intake history form in preparation to be seen by 

Charles Hamel, M.D. (Ex. 18, pp. 3-6 of 14.) Within the “Patient History Questionnaire” section 

of that intake form, Mrs. Prokopeas described the purpose of her visit with Dr. Hamel to be to 

“[h]elp my son recover from PDD (pervasive development delay) which is part of the ‘autism 

spectrum disorder.’”17 (Id., p. 6.) 

On June 25, 2004, C.A.P. went to the emergency room to be evaluated for head 

lacerations sustained when he fell in his bathtub. (Ex. 17, p. 10.) Thereafter, on July 19, 2004, 

C.A.P. was seen by Dr. Hamel. (Ex. 18, p. 7.) During that visit, Dr. Hamel’s impression was that 

C.A.P., among other things, had autism, a possible pervasive developmental disorder (“? PDD”), 

and food allergies. (Id.) 

On July 22, 2004, C.A.P. was seen by Gordon Bourland, Ph.D., for an evaluation of an 

autism spectrum disorder (ASD) diagnosis. (Ex. 9, p. 1.) At that time, Dr. Bourland took a 

history of C.A.P.’s symptoms, and recorded Mrs. Prokopeas’ recollections of C.A.P.’s 

 

17 Mrs. Prokopeas also listed that C.A.P. had magnetic resonance imaging (MRI) testing 

done on “9-20-03.” (Ex. 18, p. 6.) The context indicates that Mrs. Prokopeas was possibly 

referring to the MRI testing conducted at the time of C.A.P.’s head injury accident during 

September or October of 2003. (Compare Ex. 67, p. 3; and Ex. 54-1, p. 3.) 
19

developmental history. Specifically, Dr. Bourland recorded the following oral history, as 

reported by Mrs. Prokopeas: 

This past November [of 2003] [C.A.P.]’s parents noted a substantial change in his 

behavior. He began fussing and crying much more than previously had been the case, his 

eye contact, reported as previously typical became briefer and less consistent, he 

responded less consistently to people speaking to him, and his attention span shortened 

considerably, as well as he became more insistent upon things and activities being as he 

preferred. 

(Ex. 9, p. 1.) Dr. Bourland diagnosed C.A.P. with Pervasive Developmental Disorder-Not 

Otherwise Specified (PDD-NOS), a form of autism. (Id., p. 4.) Also on July 22, 2004, Mrs. 

Prokopeas had a phone consultation with Dr. Kotsanis, who noted that Mrs. Prokopeas “had a lot 

of questions on chelation and vaccination injury,” but that he addressed both of her concerns in 

detail, and that C.A.P. was “scheduled to start chelation with Dr. Hamel.” (Ex. 5, p. 5.) In his 

notes from the phone consultation of July 22, 2004, Dr. Kotsanis recorded that C.A.P. had an

“autistic spectrum disorder by history from my office,” which he classified as being secondary to 

“vaccination trauma syndrome.” (Id.) 

 On October 11, 2004, C.A.P. underwent a psychological evaluation by William Brasted, 

Ph.D. (Ex. 69.) In relevant part, Dr. Brasted recorded the following accounting of C.A.P.’s 

developmental history, as given to him by Mr. Prokopeas:18

At 9-12 months, the family noticed that [C.A.P.] was not achieving developmental 

milestones within normal limits. He (sic) speech appeared delayed. At 9 months of age, 

[C.A.P.] appeared to have a reaction to his immunization shots. He began having temper 

tantrums and banging his head at 12 to 14 months of age and was easily irritated. 

(Ex. 69, p. 4.) During that visit, C.A.P. was classified as functioning in the “Mild Range of 

Mental Retardation with regard to both intellectual abilities and the performance of adaptive 

skills.” (Id., p. 5.) 

A letter dated March of 2005, from Carmela Tardo, M.D., reflects that she evaluated 

C.A.P. for autism on November 8, 2004. (Ex. 75, p. 2.) In that letter, Dr. Tardo stated that 

during her consultation with C.A.P. on November 8, 2004, she had “no records available for 

review”. (Id.) As such, at that time, Dr. Tardo recorded an oral history of C.A.P.’s condition, as 

reported to her by Mrs. Prokopeas. (Id.) Mrs. Prokopeas stated that she became concerned about 

C.A.P.’s development “when he was approximately 20 months of age,” initially thinking that

C.A.P. was “just a late talker,” but subsequently became concerned about his socialization. (Id.) 

Mrs. Prokopeas additionally relayed to Dr. Tardo that C.A.P. walked at 14 months of age, and 

that at around one year of age, C.A.P. had approximately ten words in his expressive vocabulary, 

but that his speech had subsequently regressed since that time. (Id.) 

 

18 That medical record lists “Chris Prokopeas (father)” as the “Informant” on that evaluation 

report. (Ex. 69, p. 2.) Additionally, that record states that C.A.P. “was accompanied to the 

current testing session by his father, Chris Prokopeas.” (Id., p. 4.) 
20

In her letter from March of 2005, Dr. Tardo further stated that during C.A.P.’s 

consultation visit of November 8, 2004, she could not conclusively diagnose C.A.P. with autism 

due to her limited examination of C.A.P. at that time; however, she believed that an autism 

diagnosis “would be a strong possibility” in explaining his condition. (Ex. 75, p. 2.) 

From May to September of 2005, C.A.P. continued to receive developmental therapy 

from the Central Texas Autism Center (“Autism Center”). (See Exs. 19 and 49.) An evaluation 

note generated from one of C.A.P.’s visits to the Autism Center reflects C.A.P.’s parents 

reporting that C.A.P. was diagnosed with autism on November 8, 2004.19 (Ex. 19, pp. 4, 12.) 

Additionally, a letter dated July 26, 2005, from Anju Usman, M.D., documents C.A.P.’s 

consultation visits under her care. (Ex. 23.) In relevant part, Dr. Usman’s records state the 

following treatment history: 

[C.A.P.] was originally seen on 12/13/04. His mother reported a history of aggressive 

outbursts *** and headbanging. He was also diagnosed with toxic encephalopathy. 

(Ex. 23, p. 2.) 

On May 4, 2007, C.A.P. was examined by Mark Geier, M.D., who conducted a 

neurodevelopmental disorder assessment of C.A.P. (Ex. 25-2, pp. 43-53.) As part of that 

evaluation, Mrs. Prokopeas filled out a form in which she relayed C.A.P.’s developmental 

history. In the “developmental history” section of that form, Mrs. Prokopeas20 reported that

C.A.P. regressed at “19-20 months,” with “loss of language,” “behavioral problems,” “hand 

flapping/head banging,” and “stereotypic behaviors.” (Id., p. 48.) 

In a letter dated April 9, 2010, Dr. Kotsanis stated that he had “seen [C.A.P.] as a patient 

on and off since 2002-2003,” and that his “working diagnosis was ‘autistic spectrum disorder.’”

(Ex. 48, p. 2.) 21 Furthermore, Dr. Kotsanis stated as follows: 

My role in [C.A.P.]’s treatment had only being (sic) supportive for convenience reasons. 

I was never his primary care physician. Over the years I have ordered a few tests and 

written a few prescriptions as per parent’s request and Dr. Edelson’s recommendation. 

 

19 As noted immediately above, however, Dr. Tardo’s letter from March of 2005 reveals 

that she had not diagnosed C.A.P. with an autism spectrum disorder on November 8, 2004, but 

was simply of the belief that an autism diagnosis “would be a strong possibility.” (See Ex. 75, p. 

2.) 

20 That medical record reflects that the “Autism Treatment Evaluation Checklist” (ATEC) 

was completed by “Ellena Prokopeas.” (Ex. 25-2, p. 43.) 

21 That letter from Dr. Kotsanis additionally stated that to the best of his knowledge, 

C.A.P.’s parents had decided over time to “seek medical advice and treatment by Stephen B. 

Edelson MD in Atlanta, Georgia.” (Ex. 48, p. 2.) 
21

(Ex. 48, p. 2) Additionally, Dr. Kotsanis remarked that he could not find medical records of 

C.A.P.’s treatment under his care from 2002 to 2003; however, he stated that to the best of his

recollection, C.A.P. had an “autistic spectrum disorder.” (Id.) 

9. C.A.P.’s genetic testing 

Starting in May of 2007, C.A.P. also underwent genetic testing. (Ex. 25, p. 8.) However, 

the existence of these genetic testing results is not disputed by the parties, and thus is not relevant 

in resolving the disputed facts in this case. Thus, I will not discuss his genetic testing results 

further in this ruling. 

B. Additional medical history reported by C.A.P.’s parents and family friends 

In this section, I list additional allegations, made by C.A.P.’s parents and family friends, 

which are at variance with his medical records concerning two key issues: (1) C.A.P.’s 

symptomatology following each set of vaccinations administered to him in his first year of life; 

and (2) C.A.P.’s alleged neuro-developmental medical history from his early months of life -- a 

medical history which, according to his parents, is not properly documented in his medical 

records. 

1. Ellena Prokopeas 

Mrs. Prokopeas submitted affidavits on March 12, 2012 (Ex. 58), December 1, 2014 (Ex. 

91), and June 13, 2016 (Ex. 101). She also testified at the “fact hearing” held on August 1, 2016. 

(Tr. 4-41.) Her first affidavit (Ex. 58) was a joint affidavit with her husband, Chris Prokopeas. 

(Ex. 58, p. 4.) 22 However, only Mrs. Prokopeas, and not her husband, testified at the “fact 

hearing.” Accordingly, while in this section of this Ruling, for convenience’s sake, I summarize 

the affidavits and testimony of Ellena Prokopeas, I am well aware that Ex. 58 contains the joint 

representations of both Ellena and Chris Prokopeas. 

a. C.A.P.’s alleged symptoms following his first set of vaccinations. 

 Mrs. Prokopeas testified that “within a few minutes” of C.A.P.’s first set of vaccinations 

of February 5, 2002, he began to scream and cry uncontrollably, followed by a “deep sleep for 

many hours.” (Ex. 58, p. 1; Tr. 11-14.) She alleged that even after C.A.P. woke up, he was “red 

and swollen” at the place of the vaccination site; was screaming, crying, and being very fussy; 

rejected nursing, had lost his appetite, appeared “very weak,” and ran a high fever of 103.9 

degrees Fahrenheit overnight. (Tr. 14-15.) Mrs. Prokopeas added that she called C.A.P.’s 

pediatrician the next morning (i.e., on February 6, 2002), and was told that a fever due to his 

vaccinations could last up to 24 to 48 hours. (Tr. 15.) She testified that C.A.P.’s fever did go 

down within 24 to 48 hours, and that “some” of his additional symptoms had also decreased 

during that timeframe. (Id.) Additionally, in her affidavit of March 12, 2012, Mrs. Prokopeas 

alleged that C.A.P.’s “injection site was swollen and red on both legs for days,” and that he 

rejected nursing for five days following his vaccinations of February 5, 2002. (Ex. 58, p. 1, ¶ 4.) 

 

22 Although that exhibit was filed on March 12, 2012, it appears that Mr. and Mrs. 

Prokopeas signed and dated that affidavit on October 21, 2004. (Ex. 58, p. 4.) 
22

b. C.A.P.’s alleged symptoms following his second set of vaccinations. 

Mrs. Prokopeas asserted that after receiving his vaccinations of April 9, 2002, C.A.P. 

experienced symptoms “very similar” to those that he had after his first set of vaccinations (i.e., 

instant screaming, uncontrollable crying, rejecting nursing, falling into a deep sleep, having 

“swelling and redness on both legs,” and developing a fever). (Tr. 16-17; Ex. 58, p. 1, ¶ 5.) 

Moreover, she relayed that C.A.P. “developed a cough, runny nose, and a rash that lasted for a 

week.” (Ex. 58, p. 1, ¶ 5.)23 In an affidavit, Mrs. Prokopeas averred that she called C.A.P.’s 

pediatrician’s office after that incident, but was assured that C.A.P.’s symptoms were normal, 

and that they would “pass within 48 hours.” (Ex. 58, p. 1, ¶ 5.) 

At the fact hearing, Mrs. Prokopeas testified that, on April 13, 2002,24 she took C.A.P. to 

the pediatrician, since he continued to suffer from the above-mentioned symptoms. (Tr. 17-19.) 

She stated that at that visit, C.A.P. still had a rash throughout his body, was coughing, and had a 

runny nose, but that his fever had resolved. (Id.)

25

 

c. C.A.P.’s third set of vaccinations and alleged ensuing symptoms 

 Recounting C.A.P.’s symptomatology after his vaccinations of July 22, 2002, Mrs. 

Prokopeas indicated by affidavit that his third set of vaccinations “seemed to do the most harm 

so far.” (Ex. 58, p. 1, ¶ 6.) She stated that C.A.P. had “[v]ery much the same symptoms” as he 

had after his first two rounds of vaccinations (i.e., instant screaming, uncontrollable crying, 

rejecting nursing, falling into a deep sleep, having swelling and redness on both legs, and 

developing a fever). (Tr. 20; Ex. 58, pp. 1-2.) She testified that C.A.P. had a fever of 103.9 

degrees Fahrenheit on the night of July 22, 2002 -- a temperature that she alleged lasted “for 

days.” (Ex. 58, pp. 1-2; Tr. 20-21.) 

 

23 At the “fact hearing,” Mrs. Prokopeas, after consulting her written notes, eventually 

stated that C.A.P. suffered those same symptoms that were listed in her affidavit filed on March 

12, 2012, testifying as follows: 

 

[L]ooking at my notes, in addition to that, I also noticed that he also started coughing –

well it didn’t happen right away, but later in the night, he started running – he had a 

runny nose, he was coughing, and he had a rash throughout his body. 

(Tr. 17.) As discussed further in Section VII(B)(1) below, throughout her fact hearing testimony, 

Mrs. Prokopeas appeared to be reading from her notes to refresh her memory of certain events. 

(E.g., Tr. 21-22; 29-30; 34.) 

24 As noted above in footnote 8, Mrs. Prokopeas was referring to the trip to C.A.P.’s 

pediatrician on April 30, 2002, which she believed occurred on April 13, 2002. (Tr. 17-19.) 

25 As further discussed in Section VII(B)(1)(b) of this fact ruling below, I note that in 

questioning Mrs. Prokopeas about C.A.P.’s visit to the pediatrician in April of 2002, Petitioners’ 

counsel asked several leading questions in an attempt to somehow relate C.A.P.’s condition to 

his vaccinations of April 9, 2002. (Tr. 18-19.) 

 
23

Mrs. Prokopeas testified that she called C.A.P.’s pediatrician’s office on July 23, 2002, 

and spoke with a nurse, reporting that C.A.P. had a fever, was miserable, could not open his 

eyes, rejected nursing, seemed to be “very weak,” and “appeared lifeless.” (Tr. 21-22.) 

Additionally, she recalled stating to the nurse that C.A.P.’s fever “had dropped slightly to 102 to 

103” degrees, as he was taking Motrin and Tylenol to control his fever. (Id.) 

 

She further testified that C.A.P.’s pediatrician called her back later that same day (i.e., on 

July 23, 2002), and that she told the pediatrician that C.A.P. had the “same symptoms” as when 

she spoke with the nurse earlier that day. (Tr. 22.) Notably, Mrs. Prokopeas testified that 

C.A.P.’s pediatrician’s note of the phone call of July 23, 2002, stating that C.A.P. was “playful,” 

and that he had “no other symptoms” beyond fever, was inaccurate. (Tr. 22; compare Ex. 34-2, 

p. 37.) In this regard, she averred that C.A.P. was “very sick” at that time, and thus, would not 

have been playful at the time of the pediatrician’s phone call. (Id.) 

 Mrs. Prokopeas also described taking C.A.P. to his pediatrician on July 24, 2002, because 

she was “increasingly concerned” that he was “very fussy” all day, “was crying,”

26 and was not 

being himself. (Tr. 23.) In her affidavit, Mrs. Prokopeas reported being told at that visit that 

C.A.P.’s symptoms were not related to his recent vaccinations, and that those symptoms would

eventually pass. (Ex. 58, p. 2.) 

Mrs. Prokopeas further asserted that on the night of July 24, 2002, C.A.P. “was getting 

even worse,” and he had started vomiting. (Tr. 24.) Thus, on July 25, 2002, Mrs. Prokopeas 

recalled taking C.A.P. to another pediatrician, Dr. Porter. (Tr. 24-28.) She testified that at that 

time, C.A.P.’s symptoms from the previous two days had continued, and that he had additionally 

developed diarrhea, and was vomiting. (Id.) She asserted that Dr. Porter’s assessment of C.A.P. 

was that he was suffering from a “virus,” but she was assured that “everything would be fine.” 

(Tr. 27; Ex. 58, pp. 1-2.) 

At the fact hearing, Mrs. Prokopeas asserted that, after his visit with Dr. Porter on July 

25, 2002, C.A.P. “seemed to have been getting better.” (Tr. 29-30.) She testified that starting on 

July 26, 2002, C.A.P.’s symptoms were “slowly getting better,” but that he continued to have 

diarrhea, vomiting, and a cough. (Tr. 28.) Additionally, she stated that he was “very fussy,” was 

not sleeping, and did not nurse well for “a few days.” (Id.) Notably, however, in her affidavit of 

March 12, 2012, Mrs. Prokopeas asserted that C.A.P.’s diarrhea symptoms were still ongoing 

“even three weeks later” after his vaccinations of July 22, 2002. (Ex. 58, p. 2.) 

Mrs. Prokopeas also testified about taking C.A.P. to his pediatrician on August 13, 2002, 

as he had a cough due to a cold, was not nursing, was fussy, was screaming, was unhappy, and 

was uncontrollable. (Tr. 29-30; Ex. 58, p. 2.) Mrs. Prokopeas recalled C.A.P.’s pediatrician 

 

26 At that point in the fact hearing, Petitioners’ counsel stated that C.A.P.’s pediatrician’s 

handwritten note from C.A.P.’s consultation of July 24, 2002, was partly illegible. (Tr. 23-24.) 

Similarly, Petitioners’ counsel stated that the pediatrician’s notation about C.A.P.’s sick visit of 

July 25, 2002, was also partly illegible. (Tr. 25.) For both of these medical records, Petitioners’ 

counsel suggested that he would get interpretations of those medical records prior to the fact 

hearing transcript being published in this case. (Tr. 25-26.) As of the release of the fact hearing 

transcript on August 1, 2016, however, Petitioners’ counsel did not submit any interpretations of 

those medical notes, nor have any such interpretations have been submitted thereafter. 
24

prescribing an over-the-counter medication to treat his “thrush,” which subsequently cleared 

“within a few days,” at which point C.A.P. started nursing again. (Id.) 

In summary, in her affidavits, Mrs. Prokopeas alleged that after his third round of 

vaccines, on July 22, 2002, C.A.P. experienced a variety of symptoms. (Ex. 58, p. 2.) 

Collectively, these symptoms included: crying, being miserable, only sleeping two hours per 

night, having intermittent “high fevers,” being difficult and demanding, having a “lack of eye 

contact,” and developing random outbursts for no apparent reason. (Id.) At the fact hearing, 

however, Mrs. Prokopeas recalled these symptoms as being less severe. (See Tr. 28-31.) In this 

regard, she averred that once C.A.P.’s thrush resolved after his sick visit of August 13, 2002, 

C.A.P. started nursing again, was not as fussy, was “sleeping a little better,” and that “[t]hings 

looked like he was getting a little better.” (Tr. 31.) 

d. C.A.P.’s vaccination of September 24, 2002, and alleged ensuing symptoms 

Mrs. Prokopeas stated that after C.A.P.’s Hepatitis B vaccination of September 24, 2002, 

C.A.P. experienced symptoms “almost identical” to those that he had experienced after his prior 

rounds of vaccinations. (Tr. 32-33; Ex. 58, p. 2.) She alleged that immediately after that 

vaccination, C.A.P. started crying, was screaming, was “very upset,” rejected nursing, was 

unhappy, and slept for “many hours.” (Id.) She further testified that those symptoms continued 

for a week, and she noticed him “getting worse,” prompting her to take C.A.P. to the pediatrician 

on September 30, 2002. (Tr. 34; Ex. 58, p. 2.) Mrs. Prokopeas recalled reporting to the 

pediatrician that C.A.P. was “just very, very sick,” additionally reporting the following 

symptoms: “congestion”; “runny nose”; “coughing”; “not nursing”; “screaming”; wanting to be 

held; and having diarrhea. (Tr. 34.) She additionally stated that at his sick visit of September 30, 

2002, C.A.P.’s pediatrician assessed him with having a cold, and assured her that C.A.P.’s 

symptoms would pass. (Ex. 58, p. 2.) 

e. C.A.P.’s care from November of 2002 

Mrs. Prokopeas stated that, due to C.A.P.’s alleged symptoms after his previously 

administered vaccinations, she decided to postpone his future vaccinations. (Ex. 58, p. 2.) 

Additionally, she stated that because of her decision not to administer further vaccinations to 

C.A.P., Dr. Porter -- C.A.P.’s pediatrician at that time -- refused to provide further care. (Id.) 

She acknowledged that there are “no medical records for C.A.P. from 11 months to 20 months of 

age” (i.e., from November of 2002 to August of 2003) (Ex. 91, ¶ 3), although in a later statement 

she indicated that a family friend, Dr. Kotsanis, provided some care to C.A.P. during this period 

(Ex. 101, ¶ 4; see also Ex. 58, p. 2). In this regard, she further asserted that during that time 

period, she “accepted [C.A.P.’s] behavior as being a difficult child,” but that she “never thought 

we had a problem until he was 21 months old and still was not speaking.” (Ex. 58, p. 2) 

f. C.A.P.’s alleged developmental progress from seven months of age to 

twenty-four months of age 

At the fact hearing, Mrs. Prokopeas provided a narrative of C.A.P.’s developmental 

milestones from when he was seven months of age until he was twenty-four months of age. (Tr. 

35-39.) Specifically, she referred to a chart in his medical records (entitled “developmental 
25

screening checklist”) -- a chart that was used by the Pediatric Associates of Dallas to track 

C.A.P.’s development through the first seven months of his life. (Tr. 35-36; Ex. 34-1, pp. 15-17.)

27

 

At the fact hearing, Mrs. Prokopeas attempted to complete that developmental screening 

chart, commenting on C.A.P.’s developmental milestones starting from when he was seven 

months of age.28 (Tr. 36-39.) I list below, the “yes” or “no” answers given by Mrs. Prokopeas to 

the age-appropriate questions from that developmental checklist chart.29

i. C.A.P.’s developmental parameters at seven months of age 

Mrs. Prokopeas answered “yes” to both of the developmental checklist questions listed at 

seven months of age: “lift hands when sitting,” and “transfers objects from 1 hand to other.” (Tr. 

36; compare Ex. 34-1, p. 15.) 

ii. C.A.P.’s developmental parameters at eight months of age 

Mrs. Prokopeas answered “yes” to the question of whether C.A.P. “stays briefly on all 

fours when placed.” (Tr. 37; compare Ex. 34-1, p. 16.) She answered “no” to the following 

questions: “catches self to sides in sitting”; “sits at least five minutes”; and “rocks on all fours.”

(Id.) 

iii. C.A.P.’s developmental parameters at nine months of age 

Mrs. Prokopeas answered “yes” to the developmental parameter question of whether 

C.A.P. “gets in and out of sitting independently.” (Tr. 37; compare Ex. 34-1, p. 16.) However, 

she answered “no” to the following questions: “crawls on hands and knees”; “stands holding on 

when placed”; “understands simple words”; “Shakes toys”; “Drops things and looks for them”; 

“Says MaMa, DaDa.” (Id.) 

iv. C.A.P.’s developmental parameters at ten and eleven months of age 

For the chart’s developmental questions at ten months of age, she answered “no” to: 

“pulls up to standing,” and “plays Peek-A-Boo.” (Tr. 37; compare Ex. 34-1, p. 16.) She also 

answered a “no” to all of the following developmental questions listed at eleven months of age: 

“cruises”; “walks holding on to the furniture”; “practices different standing positions while 

 

27 Specifically, that checklist documented C.A.P.’s developmental progress at his various 

medical visits to that pediatric practice. (Ex. 34-1, pp. 15-17.) Petitioners’ counsel asserted at the 

fact hearing that C.A.P.’s developmental milestones chart was not updated after C.A.P. switched 

to a different pediatrician at seven months of age. (Tr. 36.) 

28 Mrs. Prokopeas attempted to complete the developmental checklist chart contained on 

pages 15 through 17 of Exhibit 34-1. (Ex. 34-1, pp. 15-17.) 

29 Petitioners’ counsel asked Mrs. Prokopeas to give “yes” or “no” answers to the listed 

age-appropriate questions from the developmental checklist chart reflected on Exhibit 34-1, 

pages 15 through 17. (Tr. 36-39.) 
26

holding on”; “lowers to sitting from standing”; “points/pokes with finger”; and “picks up small 

objects with thumb and forefinger.” (Id.) 

v. C.A.P.’s developmental parameters at twelve months of age

Mrs. Prokopeas answered “yes” to the following developmental parameter questions 

concerning C.A.P. at twelve months of age: “waves bye-bye”; and “gives and takes toys in play.” 

(Tr. 37; compare Ex. 34-1, p. 16.) She replied “no,” however, to the following developmental 

checklist questions: “prefers standing to sitting”; “walks with 1 hand held”; “has 3-10 word 

vocabulary”; “repeats performance if laughed at”; “puts things in containers”; and “drinks from 

cup.” (Id.)

vi. C.A.P.’s developmental parameters at fifteen months of age 

Mrs. Prokopeas answered “yes” to the checklist question of whether he “hugs and 

kisses.” (Tr. 37; compare Ex. 34-1, p. 16.) She replied “no” to the following questions: “walks 

independently”; “stands alone”; “indicates wants by gesturing/grunting”; and “builds tower of 3 

blocks.” (Id.) 

vii. C.A.P.’s developmental parameters at eighteen months of age 

Mrs. Prokopeas answered “yes” for the following developmental parameters at eighteen 

months of age: “climbs into chair”; “finger feeds”; and “points to 2-3 body parts.” (Tr. 38; 

compare Ex. 34-1, p. 16.) She replied “no” to the following questions: “walks backwards”; 

“takes clothes off”; “says 15-20 words”; “follows requests (i.e., get the ball)”; and “scribbles.” 

(Id.) 

viii. C.A.P.’s developmental parameters at twenty-four months of age 

Mrs. Prokopeas answered “yes” to the following questions: “runs”; “carries toys 

walking”; and “pulls toys.” (Tr. 37; compare Ex. 34-1, p. 16.) She replied “no,” however, to the 

following questions: “squats”; “kicks a ball”; “rides bike-no pedals”; “walks up and down stands 

holding rail”; “has 200 word vocabulary”; “uses 2 word sentences (i.e., ‘More Cookie’)”; “asks 

questions (i.e., ‘Where’s kitty?, ‘What’s that’)”; “asks for food or drink”; “names some 

pictures”; “builds tower of 6 blocks”; and “stays with one activity 6-7 minutes.” (Id.) 

 ix. C.A.P.’s developmental parameters at two and a half years of age

For his developmental checklist parameters at two and a half years of age, Mrs. 

Prokopeas answered a “no” to all of the following questions: “jumps with 2 feet off ground”; 

“knows full name”; “builds tower of 7+ blocks”; “point to body parts”; and “copies.” (Tr. 38; 

compare Ex. 34-1, p. 17.) 

2. Nick Chrissikos

 Nick Chrissikos submitted an affidavit on June 13, 2016, but did not testify at the fact 

hearing. (ECF No. 125, Ex. 100.) Mr. Chrissikos stated that he is a “very close family friend” of 

the Petitioners, and, in this capacity, he was able to report on C.A.P.’s alleged symptomatology 

after receiving each set of vaccinations in his first year of life. (Ex. 100, p. 1.) 
27

Mr. Chrissikos stated that, after receiving his first set of vaccinations on February 5, 

2002, C.A.P. had diarrhea, and was “running a fever.” (Id.) Similarly, Mr. Chrissikos reported

seeing C.A.P. the day after he received his second set of vaccinations on April 9, 2002, alleging 

that at that time, C.A.P. suffered from “a rash all over his body,” “a fever of over 101” degrees 

Fahrenheit, being “fussy,” and crying excessively. (Id.) 

Mr. Chrissikos also asserted that he observed C.A.P. soon after the vaccinations of July 

22, 2002. (Ex. 100, p. 1.) He recalled that C.A.P. had developed a fever of 103 degrees 

Fahrenheit, was “not nursing,” was “sleeping all day,” and was “screaming for no apparent 

reason while appearing lifeless.” (Id.) He further alleged that these symptoms were “getting 

worse” by July 25, 2002, and observed that these symptoms continued throughout August of 

2002. (Ex. 100, p. 2.) Mr. Chrissikos also stated that in August of 2002 C.A.P. was “still sick,” 

with a “high fever” and “vomiting” symptoms. (Id.) Notably, he claimed that C.A.P. had a “high 

fever” as late as September of 2002. (Id.) 

Moreover, Mr. Chrissikos stated that he observed C.A.P. after he was hospitalized in 

October of 2002,30 alleging that he “looked tired,” would not smile, and would not come to him 

when called. (Ex. 100, p. 2.) He also alleged that he observed C.A.P. on December 25, 2002, 

crying for no apparent reason, and refusing to sit still. (Id., ¶ 5.) 

Overall, Mr. Chrissikos alleged that “every time” he observed C.A.P., he was “fussy,” 

“did not look well,” “always had dark circles under his eyes,” and “seemed to have a fever all the 

time.” (Ex. 100, p. 2.) Similarly, Mr. Chrissikos stated that: 

[l]ooking back, I can clearly see on the days he was vaccinated, within a few hours, 

C.A.P. developed a high fever, screamed uncontrollably with a high pitch, and was 

lethargic and irritable. 

(Ex. 100, p. 3.) 

3. Naomi de la Torre 

Naomi de la Torre submitted an affidavit on June 13, 2016, but did not testify at the fact 

hearing. (Ex. 102.) Ms. de la Torre alleged that she was “very close” to Mrs. Prokopeas, and 

thus was able to observe C.A.P.’s condition from his early years of life. (Ex. 102, p. 1.) 

Ms. de la Torre alleged that she observed C.A.P. on March 20, 2002 -- i.e., several weeks 

after his first set of vaccinations of February 5, 2002. (Ex. 102, p. 1.) She described C.A.P. as 

being “extremely sick” at that time, asserting that C.A.P. was fussy, had a runny nose, was 

“running a fever,” and slept a majority of the day. (Id.) Similarly, she observed C.A.P. on July 

23, 2002 (i.e., the day after his vaccinations of July 22, 2002), describing him as having a fever,

as being unable to sit still, and as crying uncontrollably. (Id.) Thereafter, Ms. de la Torre alleged 

that she observed C.A.P. on July 25, 2002, describing C.A.P. at that time, as having “a rash all 

over his body,” crying uncontrollably, being “very upset,” and “burning up with a fever of 

 

30 Mr. Chrissikos was perhaps referring to C.A.P.’s emergency room visit of October 13, 

2002. (Compare Ex. 35, pp. 16-19; see also pp. 14-15, above.) 
28

103.9” degrees Fahrenheit. (Ex. 102, p. 1.) She alleged that C.A.P.’s high fever at that time 

lasted several days. (Id.) 

Overall, Ms. de la Torre alleged that C.A.P. had ongoing symptoms of “rash,”

“irritability,” “crankiness,” “inconsolability,” and “fever,” stating that she observed these 

symptoms “within a day of his vaccinations.” (Ex. 102, p. 2.) Moreover, she described C.A.P.’s 

condition after his twelve-month well-visit, alleging that he “appeared to be getting worse,” since 

he was not developing, not making eye contact, and perpetually fussy. (Id., ¶ 6.) She further 

alleged that, over time, C.A.P. generally had “no expression on his face,” stopped laughing, and 

stopped smiling. (Id., p. 3.) 

V 

SUMMARY OF PETITIONERS’31 EXPERT WITNESSES’ QUALIFICATIONS 

AND OPINIONS 

 In this case, Petitioners relied upon expert reports of two medical experts for the 

proposition that vaccinations harmed C.A.P. -- Joseph Bellanti, M.D. (Exs. 87 and 89), and JeanRonel Corbier, M.D. (Exs. 98-99).32

 These two experts, Drs. Bellanti and Corbier, each relied on 

multiple factual assumptions about C.A.P.’s medical history that are at variance with his medical 

records. Thus, at this point, I will briefly summarize both the qualifications and opinions of 

these two expert witnesses, as they relate to the present “fact ruling.” 

A. Petitioners’ expert Dr. Joseph Bellanti 

1. Qualifications 

Joseph Bellanti, M.D., earned his medical degree from the University of Buffalo School 

of Medicine in 1958. (Ex. 88, p. 3.) He subsequently completed his internship at Millard 

Fillmore Hospital in 1959, and his residency in pediatrics at Children’s Hospital of Buffalo in 

1961. (Id.) From 1961 to 1962, he was a special National Institute of Health (NIH) trainee in 

Immunology at the University of Florida, subsequently working as a research virologist at Walter 

Reed Army Institute of Research, from 1962 to 1964. (Id.) 

Dr. Bellanti has held a faculty position at Georgetown University School of Medicine 

since 1963, rising to the position of Professor of Pediatrics and Microbiology-Immunology in 

 

31 Respondent has also filed the expert reports of two highly qualified expert witnesses, but 

I have not summarized those reports in this Ruling, since they are for the most part not relevant 

to the factual rulings that I am making in this Ruling. However, I do note that, unlike the 

Petitioners’ two primary causation experts, Respondent’s experts relied upon the facts contained 

in the medical records, rather than upon the additional representations in the Petitioners’ joint 

affidavit filed as Ex. 58. 

32 Petitioners also submitted an expert report of Brett Abrahams, Ph.D., but that report only 

disputes a point in the report of Respondent’s expert. Dr. Abrahams does not opine that 

vaccinations harmed C.A.P. (See generally Ex. 96.) 
29

1970. (Ex. 88, p. 3.) Since 1975, Dr. Bellanti has concurrently served as the Director of the 

International Center for Interdisciplinary Studies of Immunology at Georgetown University. (Id.) 

Since 1980, he has also served as the Director of the Division of Immunology and Virology in 

the Department of Laboratory Medicine at Georgetown University. (Id.) Additionally, he holds 

an academic staff position in pediatrics at the Children’s Hospital National Medical Center, 

concurrently holding clinical positions in the pediatrics departments of Arlington Hospital and 

INOVA Fairfax Hospital. (Id., p. 1.) 

Dr. Bellanti is certified by the American Board of Pediatrics, and holds the accreditation 

of a “Diplomate” from the American Board of Allergy and Immunology, and from the National 

Board of Medical Examiners. (Ex. 88, p. 4.) 

Dr. Bellanti lists numerous accomplishments in his curriculum vitae. (See generally Ex. 

88.) He has held over a dozen leadership positions in various scientific societies, and presently 

serves on the editorial board of five scientific publications. (Id., pp. 5-6.) He has co-authored 

more than 200 research articles and more than 150 abstracts in peer-reviewed journals. (Id., pp. 

9-38.) He has also co-authored over 50 medical texts/book chapters (id., pp. 38-39), and has 

been invited to give numerous presentations internationally (id., pp. 9-11). 

2. Summary of Dr. Bellanti’s opinion 

Dr. Bellanti opined that a “causal relationship” existed between the vaccines administered 

to C.A.P. in his first year of life, and his current “neurologic and developmental abnormalities.” 

(Ex. 89, p. 2 of 3.) Specifically, he asserted that C.A.P.’s current developmental abnormalities 

are due to brain injuries caused by “repeated allergic (immune mediated) reactions to his 

vaccines received in 2002.” (Ex. 87, p. 3 of 5, parenthetical in original.) 

Notably, Dr. Bellanti based his opinion on parental testimony, describing symptoms 

allegedly suffered by C.A.P. immediately after he was administered each set of vaccinations 

during his first year of life. (Ex. 87, pp. 1-2 of 5.) In this regard, Dr. Bellanti asserted that C.A.P. 

“reacted similarly to each of his sets of vaccinations,” including the “final Hepatitis B

vaccination.” (Id., p. 3 of 5.) He opined that C.A.P.’s alleged post-vaccination symptoms after 

receiving each set of vaccinations, were, in fact, “reactions” to his administered vaccinations, 

deeming those “reactions” as “clearly” demonstrating that C.A.P. “was allergic to some 

components of the vaccines.” (Id.) 

Moreover, as to how C.A.P.’s particular condition was caused by the vaccinations 

administered to him in his first year of life, Dr. Bellanti seemed to simply rely on a temporal 

association. (Ex. 89, p. 3 of 3, ¶¶ 2 and 3.) In describing that alleged temporal association, Dr. 

Bellanti opined that C.A.P.’s case reflected “the striking history of a well child” who allegedly 

sustained “fever,” “high pitched cry,” and “developmental abnormalities” after his vaccinations. 

(Id.) 
30

B. Petitioners’ expert, Dr. Jean-Ronel Corbier 

1. Qualifications 

Jean-Ronel Corbier, M.D., earned his medical degree from Michigan State University, 

College of Human Medicine, in 1995. (Ex. 99, p. 6 of 10.) He completed his residency in 

pediatrics at Hurley Medical Center in 1997, later completing training in adult neurology at the 

University of Cincinnati in 1998. (Id.) In 2000, he completed a fellowship in pediatric neurology 

from the Children’s Hospital Medical Center in Cincinnati, Ohio. (Id.) Since 2000, Dr. Corbier 

has been in private practice as a pediatric neurologist. (Id., p. 8 of 10.) He is a member of 

several medical organizations, including the Child Neurology Society, American Academy of 

Neurology, the Medical Association of the State of North Carolina, and the American Board of 

Medical Specialists. (Id.) Dr. Corbier’s curriculum vitae reflects that he has authored three 

books, in addition to co-authoring one research article, and has one research publication 

pending.33 (Id., p. 9 of 10.) He has also been invited to give several presentations in his medical 

specialty. (Id.) 

2. Summary of Dr. Corbier’s opinion

Dr. Corbier opined that “it is more likely than not” that C.A.P. “was vaccine injured,” and

that his “immunizations led to a chronic brain disorder” -- a brain disorder he varyingly termed 

as “static encephalopathy” or “chronic encephalopathy.” (Ex. 98, p. 3 of 3; Ex. 99, pp. 4-5 of 

10.) Regarding C.A.P.’s alleged “static encephalopathy,” Dr. Corbier asserted that “[a]ll of 

[C.A.P.]’s problems” were essentially “the expression of his static encephalopathy” that 

“manifested within a day of his vaccinations.” (Ex. 99, p. 5 of 10.) At another point in his 

reports, Dr. Corbier termed C.A.P.’s alleged brain disorder as “Vaccine Induced Encephalitis,” 

defining that term as “an inflammation of the brain caused by vaccines.” (Ex. 98, p. 4.) 

Dr. Corbier’s reports, however, were unclear as to exactly what vaccinations allegedly 

caused C.A.P.’s encephalopathy. In his first expert report, Dr. Corbier seemed to point 

exclusively to C.A.P.’s vaccinations of July 22, 2002, asserting that the “records show a 

significant vaccine reaction” at that time, and opining that that alleged “vaccine reaction” caused 

C.A.P. to “become lethargic,” “lifeless,” and “febrile” within 72 hours of his vaccinations. (Ex. 

98, pp. 2 and 3 of 3.) In this regard, Dr. Corbier opined that after C.A.P.’s vaccinations of July 

22, 2002, at age “7-months,” C.A.P. suffered from a “series of neurological and immune 

problems,” which, by “15-18 months” of age, led to C.A.P. developing “clear regressive 

symptoms,” and becoming “encephalopathic.” (Id., p. 3 of 3.) 

In his supplemental expert report, however, Dr. Corbier instead seemed to substantially 

change his causation opinion. Instead of pointing to all of C.A.P.’s vaccinations of July 22, 

2002, he now pointed to the pertussis vaccinations (as part of the DTaP vaccinations) 

administered to C.A.P. on several occasions during his first year of life. (Ex. 99, pp. 3, 4 of 10.) 

In this regard, Dr. Corbier opined that the pertussis vaccinations caused C.A.P. to experience 

numerous symptoms, such as -- “irritability,” “high fever,” “lethargic state,” “decreased 

responsiveness,” “rash,” “fussiness,” and “decreased consciousness.” (Ex. 99, p. 4 of 10.) 

 

33 Dr. Corbier’s research article appears to have been pending as of December 4, 2015, the 

date on which his curriculum vitae was submitted in this case. 
31

Moreover, he deemed those alleged symptoms to be “evidence” of an “acute encephalopathy,” 

which, according to Dr. Corbier, occurred on the “same day” as C.A.P.’s administered DTaP 

vaccinations of “2/5/2002, 4/9/2002, 7/22/2002 and 9/24/2002.” (Id.) 

Dr. Corbier further opined that C.A.P.’s “acute encephalopathy” eventually progressed to 

a “chronic encephalopathy,” defining C.A.P.’s “chronic encephalopathy” to be “characterized by 

dysfunction in his cognitive and social skills.” (Ex. 99, p. 3 of 10.) Moreover, he alleged that 

certain of C.A.P.’s alleged symptoms -- “fever,” “irritability,” “decreased responsiveness,” and 

“rash” -- were observed within the “time period after immunization” during which children 

experience an “increased risk of encephalopathy.” (Id.) Thus, he ultimately opined that C.A.P.’s 

“chronic encephalopathy resulted from his pertussis vaccination.” (Id.) 

Dr. Corbier acknowledged, however, that C.A.P.’s “medical records did not document” 

“certain symptoms” that allegedly were suffered by C.A.P. (Ex. 98, p. 3 of 3.) Thus, Dr. Corbier 

admitted to relying on parental assertions of C.A.P.’s alleged medical history, in order to 

formulate certain factual assumptions upon which his expert opinion is based in this case. (Ex. 

98, p. 3 of 3; Ex. 99, p. 3 of 10.) 

VI

SCOPE OF RULING AND FACTUAL ISSUES TO BE DECIDED 

The record in this case includes, as relevant to this Ruling, a large volume of medical 

records, affidavits of Petitioners and their family friends, Mrs. Prokopeas’ testimony at the fact 

hearing, and the reports of two experts for the Petitioners. Petitioners’ two experts both base 

their causation opinions not primarily upon the medical records, but most heavily upon the 

additional symptoms allegedly displayed by C.A.P. during his first years of life, as set forth in 

the affidavits of the Petitioners and their friends, plus Mrs. Prokopeas’ hearing testimony. 

Petitioners, thus, at this time seek my ruling concerning the facts of C.A.P.’s early years of life. 

Specifically, I am asked to rule whether the additional facts alleged by C.A.P.’s parents and their 

friends concerning C.A.P. -- i.e., those facts that do not appear in C.A.P.’s contemporaneous

medical records -- are accurate descriptions of C.A.P.’s medical history. Because of the absence 

from the medical records of most of the symptoms alleged by the parents and family friends, 

Petitioners’ counsel requested that I conduct a fact hearing, and rule upon whether the parental 

and friend accounts can be credited. (ECF No. 116.) 

To summarize my factual finding below, I do not find, to be reliable, the written and oral 

testimony offered by C.A.P.’s parents and family friends, alleging that C.A.P. suffered additional 

post-vaccination symptoms after each set of vaccinations administered to C.A.P. in his first year 

of life -- i.e., alleged symptoms that are not already reflected in his contemporaneous medical 

records. I emphasize that I am not questioning the sincerity or honesty of the Petitioners, or the 

other affiants. I simply find the contemporaneous medical records, reflecting C.A.P.’s condition 

at the time his parents sought medical care during his first year of life, to be more reliable. 

To summarize my discussion below, I first set forth, in Section VII, my general reasons 

for relying on the contemporaneous medical records from C.A.P.’s first year of life over the 
32

written and oral testimony of the Petitioners and additional affiants, alleging that C.A.P. suffered 

additional post-vaccination symptoms after each set of vaccinations. Thereafter, in Section VIII, 

I set forth my reasons as to why I find two specific parental narratives of C.A.P.’s medical 

history, as relayed to C.A.P.’s medical care providers at Ex. 5, pp. 2-3, and Ex. 69, pp. 4-5, to be 

inconsistent with C.A.P.’s earlier contemporaneous medical records, and thus, I find them to be 

unreliable. Next, in Section IX, in order to provide clarity, I list some of the critical assertions of 

the Petitioners and their close family friends that I specifically reject. Thereafter, in Section X, I 

list the incorrect assumptions of fact found in Petitioners’ expert reports from Drs. Bellanti and 

Corbier. Finally, in Section XI, I issue a warning to Petitioners’ counsel to carefully assess the 

reasonableness of moving forward with this case. 

VII 

GENERAL REASONS FOR MY FINDING THAT C.A.P.’S MEDICAL RECORDS 

FROM HIS FIRST YEAR OF LIFE ARE MORE RELIABLE THAN LATER PARENTAL 

AND FRIEND STATEMENTS ALLEGING ADDITIONAL SYMPTOMS NOT 

REFLECTED IN THOSE MEDICAL RECORDS 

In the discussion below, I highlight several reasons as to why I find C.A.P.’s medical 

records from his first year of life, reflecting C.A.P.’s symptoms as contemporaneously reported 

by his parents to his medical care providers, to be much more reliable than the parental and 

friend narratives, made later in time, concerning his alleged post-vaccination symptomatology. 

Specifically, I reject the statements made by Petitioners and their friends in the course of this 

litigation, alleging additional symptoms purportedly suffered by C.A.P. after each set of 

vaccinations administered to him in his first year of life -- i.e., alleged symptoms that are not 

reflected in his contemporaneous medical records. 

A. The stark contrast between the contemporaneous medical records and the affidavits and 

fact hearing testimony of Petitioners and friends 

 The chief reason why I must credit the contemporaneous medical records over the 

proffered affidavits and the fact hearing testimony of Mrs. Prokopeas is simply that there was 

such a stark contrast between the contemporaneous medical records and the affidavits/fact 

hearing testimony. The affidavits and fact hearing testimony allege that C.A.P. suffered a 

number of very dramatic and serious symptoms, in close proximity to each of his 2002 

vaccinations. Yet those serious or dramatic symptoms were not recorded at all in the 

contemporaneous medical records. This stark contrast simply makes the parents’ and friends’ 

later recollections seem unbelievable. That is, if in fact C.A.P.’s symptoms took place as the 

parents and friends later alleged, then his parents, as concerned, caring parents, would certainly

have reported those symptoms during their many contacts with C.A.P.’s medical care providers 

throughout his first year of life. The absence of those symptoms in the contemporaneous 

medical records indicates that the parents and friends are not remembering C.A.P.’s symptoms 

accurately. Some examples of this stark contrast are detailed below. 
33

1. Example one: Alleged symptoms after vaccinations of February 5, 2002 

As the first example, Mrs. Prokopeas testified that “within a few minutes” of C.A.P.’s 

first set of vaccinations, on February 5, 2002, he began to scream and cry uncontrollably, 

followed by a “deep sleep for many hours.” (Ex. 58, p. 1; Tr. 11-14.) She alleged that even after 

C.A.P. woke up he was screaming and crying, rejected nursing, had lost his appetite, appeared 

“very weak,” and ran a fever of 103.9 degrees Fahrenheit overnight. (Tr. 14-15.) Mrs. Prokopeas 

added that she called C.A.P.’s pediatrician the next morning (i.e., on February 6, 2002), to report 

those symptoms. (Tr. 15.) Additionally, Mrs. Prokopeas alleged that C.A.P. rejected nursing for 

five days after February 5. (Ex. 58, p. 1, ¶ 4.) 

The contemporaneous medical records, however, present an entirely different story. The 

record of the visit of February 5 indicates that several vaccinations were given, but does not 

indicate any reaction at all to them. (Ex. 34, p. 34 of 39.) Further, while other phone calls on 

other days by C.A.P.’s parents to his pediatricians were explicitly recorded in the pediatrician’s 

records (e.g., Ex. 34-2, pp. 31, 36, 37; Ex. 10, p. 4 of 15), there is no mention in the medical 

records of any call on February 6, 2002. (Ex. 34-2, pp. 34-35.) Finally, during C.A.P.’s next 

regular visit on April 9, 2002, no mention is made of any unusual behavior by C.A.P. after the 

February 5 vaccinations. (Ex. 34-2, p. 35.) 

Thus, if after the February 5 vaccinations, C.A.P. really had screamed uncontrollably, run 

a fever of 103.9 degrees, and stopped nursing for five days, it seems extremely likely to me that 

C.A.P. would have been taken back to the pediatrician, and such symptoms would have been 

recorded in the medical records. 

2. Example two: Alleged symptoms after vaccinations of April 9, 2002 

Mrs. Prokopeas also asserted that after receiving his vaccinations of April 9, 2002, C.A.P. 

experienced symptoms “very similar” to those that he had after his first set of vaccinations (i.e., 

screaming, uncontrollable crying, rejecting nursing, falling into a deep sleep, and developing a 

fever). (Tr. 16-17; Ex. 58, p. 1, ¶ 5.) She stated that she called C.A.P.’s pediatrician after that 

incident, but was assured that C.A.P.’s symptoms were normal. (Ex. 58, p. 1, ¶ 5.) 

However, again the contemporaneous records of C.A.P.’s pediatrician contradict Mrs. 

Prokopeas’ testimony. The record of April 9, 2002, does not indicate any immediate reaction by 

C.A.P. to his vaccinations (Ex. 34-2, p. 35 of 39), and there is no mention anywhere in the 

contemporaneous medical records of any symptoms in C.A.P. around this time period, or of any 

phone call or visit by C.A.P.’s parents to the practice on or soon after April 9. Further, on the 

same page as the record of the pediatric visit of April 9, 2002, there is a note concerning another 

pediatric visit later that month. (Ex. 34-2, p. 35 of 39.) The date of that visit was miswritten on 

the medical chart, recorded as “04/300/2.” But it seems clear that the actual visit date was April 

30, 2002, with the second “slash” having been accidentally misplaced -- the apparent intent was 

to write “04/30/02.” And that record of April 30, 2002, makes no mention of any symptoms by 

C.A.P. in the several days after the vaccinations on April 9, 2002, much less the serious, 

dramatic symptoms reported by Petitioners in this litigation. The April 30 notation states only 

that C.A.P. had suffered from a cough, a runny nose, and a “rash throughout body,” for one week 

prior to the April 30 visit, or since April 23, 2002. 
34

3. Example three: Alleged symptoms after vaccinations of July 22, 2002 

Describing C.A.P.’s alleged symptomatology after his vaccinations of July 22, 2002, 

Mrs. Prokopeas indicated that his third set of vaccinations “seemed to do the most harm so far.” 

(Ex. 58, p. 1, ¶ 6.) She stated that C.A.P. had “[v]ery much the same symptoms” as he had after 

his first two rounds of vaccinations (i.e., screaming, uncontrollable crying, rejecting nursing, 

falling into a deep sleep, and developing a fever). (Tr. 20; Ex. 58, pp. 1-2.) She testified that 

C.A.P. had a fever of 103.9 degrees Fahrenheit on the night of July 22 -- a temperature that she 

alleged lasted “for days.” (Ex. 58, pp. 1-2; Tr. 20-21.) 

Mrs. Prokopeas testified that she called C.A.P.’s pediatrician’s office on July 23, 2002, 

and spoke with a nurse, reporting that C.A.P. had a fever, was miserable, could not open his 

eyes, rejected nursing, seemed to be “very weak,” and “appeared lifeless.” (Tr. 21-22.) She 

further testified that when C.A.P.’s pediatrician called her back later that same day, she told the 

pediatrician that C.A.P. had the “same symptoms” as earlier that day. (Id.) 

However, again the contemporaneous records paint quite a different picture. Those 

records indicate a call from Mrs. Prokopeas on July 23, 2002, reporting a fever of 102-103 

degrees, and that C.A.P. had been “fussy,” but that he was feeling better after taking Motrin, and 

was “eating ok.” (Ex. 34-2, p. 36 of 39.) The records indicate a second phone call that day 

between Mr. Prokopeas and the office, recording that C.A.P. still had a fever of 102-103 degrees, 

but that he was also “playful,” and had no other symptoms beside the fever. (Id., p. 37.) The 

records further reflect that C.A.P. was taken back to his pediatrician on July 24, with a fever of 

up to 103 degrees, with his parents then describing him as “not himself.” (Id.) C.A.P. was also 

taken to another pediatrician, Dr. Porter, on July 25, with a brief history of fever, vomiting, and 

diarrhea; but at that visit C.A.P. was also reported to have breastfed three times that day with no 

further diarrhea, and Dr. Porter observed C.A.P. to be “happy” and “playful.” (Ex. 10, p. 4 of 

15.) 

In other words, the medical records tell a distinctly different story from that told by 

Petitioners’ proffered affidavits and testimony, concerning the time period immediately after the 

vaccinations of July 22, 2002. There was no mention whatsoever in the medical records of the 

screaming, uncontrollable crying, or an extended refusal to nurse, as alleged by Petitioners in this 

Program proceeding. Instead, in the phone call records of July 23, C.A.P. is described as “eating 

ok,” and as having no other symptoms except for fever. (Ex. 34-2, p. 36 of 39.) And in the 

records of July 24 and 25, C.A.P. is described not as miserable, but as “playful” (Ex. 34-2, p. 37 

of 39; Ex. 10, p. 4) and “happy” (Ex. 10, p. 4). 

4. Example four: Symptoms after vaccination of September 24, 2002 

Mrs. Prokopeas stated that after C.A.P.’s Hepatitis B vaccination of September 24, 2002, 

C.A.P. experienced symptoms “almost identical” to those that he had experienced after his prior 

rounds of vaccinations. (Tr. 32-34; Ex. 58, p. 2.) She alleged that immediately after that 

vaccination, C.A.P. started crying, was screaming, was “very upset,” rejected nursing, was 

unhappy, and slept for “many hours.” (Id.) She further testified that those symptoms continued 

for a week, and she noticed him “getting worse,” prompting her to take C.A.P. to the pediatrician 

on September 30, 2002. (Tr. 34; Ex. 58, p. 2.) Mrs. Prokopeas recalled reporting to the 
35

pediatrician that C.A.P. was “just very, very sick,” additionally reporting that he was not nursing 

and was screaming. (Tr. 34.) 

However, the actual record of the visit on September 30 states only that C.A.P. had 

congestion and a runny nose for three days, plus sneezing, vomiting, teething, and poor sleep. 

(Ex. 10, p. 3 of 15.) No mention was made of screaming, uncontrollable crying, or fever. (Id.) 

5. Summary concerning this “stark contrast”

As these four examples demonstrate, the very stark contrast between (1) the allegations of 

the Petitioners’ proffered affidavits and testimony, and (2) the actual contemporaneous medical 

records, are a strong reason why I find the contemporaneous medical records to be much more 

reliable than the allegations of the parents and friends made in this litigation. 

6. Additional reason for finding the stark contrast to be problematic 

This is especially true since the medical records, taken as a whole, indicate that C.A.P.’s 

parents were not shy about communicating with C.A.P.’s health care providers by telephone, or 

through office visits, during C.A.P.’s first year of life. See “patient phone call records” of: 

December 27, 2001 (Ex. 34-2, p. 31); July 23, 2002 (Ex. 34-2, p. 36); July 23, 2002 (Ex. 34-2, p. 

37.); and August 13, 2002 (Ex. 10, p. 4 of 15). See also C.A.P.’s office visits of: December 11, 

2001 (Ex. 34-2, p. 30); December 20, 2001 (id., p. 32); December 27, 2001 (id., pp. 31-32); 

January 8, 2002 (id., p. 33); February 5, 2002 (id., p. 34); April 9, 2002 (id., p. 35); April 30, 

2002 (id., p. 35); July 22, 2002 (id., p. 36); July 24, 2002 (id., p. 37); July 25, 2002 (Ex. 10, p. 4 

of 15); August 14, 2002 (id.); September 24, 2002 (id., p. 3 of 15); and September 30, 2002 (id.). 

Therefore, since C.A.P.’s parents were quick to report by phone relatively minor symptoms of 

C.A.P., and to bring him in to the doctor with relatively minor ailments, it seems extremely 

unlikely that they would have failed to bring C.A.P. in, or even to report the symptoms during 

C.A.P.’s next visit, if in fact C.A.P. actually displayed the dramatic and serious symptoms 

reported in the affidavits and testimony of the parents and friends. 

B. Other reasons for rejecting the Petitioners’ and friends’ allegations of symptoms that are 

not reported in the contemporaneous medical records 

1. Mrs. Prokopeas’ fact hearing testimony suffered from several flaws, and was 

unpersuasive overall.

As part of my reasons for my general conclusion set forth in this Section VII, I note 

specifically that I cannot credit the fact hearing testimony, of Mrs. Prokopeas, for additional 

reasons as well. Her testimony suffered from extensive flaws, rendering her entire testimony to 

be unpersuasive overall. Specifically, Mrs. Prokopeas’ testimony (1) appeared to be mainly a 

recitation of her written notes, and (2) was compromised by Petitioners’ counsel’s strategy of 

asking leading questions throughout the fact hearing -- both of which led me to question whether 

Mrs. Prokopeas, by the time of hearing (14 years after the vaccinations in question), had an 

accurate, independent recollection of C.A.P.’s early months of life. 
36

a. Mrs. Prokopeas’ fact hearing testimony appeared to be a recitation of her 

written notes.

I highlight that for the majority of her fact hearing testimony, Mrs. Prokopeas appeared to 

be reading from prepared written notes that she had with her on the witness stand. Hence, 

instead of relying on her memory to offer an accounting of C.A.P.’s alleged post-vaccination 

symptoms, Mrs. Prokopeas’ oral testimony was, in essence, a reading of her prepared notes. 

(E.g., Tr. 11-12 (reading from a “piece of paper”); Tr. 14 (Mrs. Prokopeas stating that “looking 

at my records,” C.A.P. had a fever of “103.9” degrees Fahrenheit after his vaccinations of 

February 5, 2002); Tr. 17 (after Mrs. Prokopeas stated that she was “looking at my notes,” she 

proceeded to testify about C.A.P.’s symptoms after his vaccinations of April 9, 2002); Tr. 26-27

(Mrs. Prokopeas appeared to be reading from her notes while testifying about C.A.P.’s 

symptoms after his vaccinations of July 22, 2002); Tr. 28-29 (Mrs. Prokopeas appeared to be 

reading from her notes while testifying about C.A.P.’s alleged lack of eye contact after his 

vaccinations of July 22, 2002); Tr. 33-34 (Mrs. Prokopeas appeared to be reading from her 

prepared notes while testifying about C.A.P.’s symptoms after his vaccination of September 24, 

2002).) 

I further note that at the fact hearing, Petitioners’ counsel acknowledged that at least one 

of those prepared records relied upon by Mrs. Prokopeas during her testimony was Exhibit 58 --

i.e., Petitioners’ joint affidavit. (Tr. 26-27.) Moreover, I then requested that Mrs. Prokopeas 

discontinue reading from that affidavit, encouraging her to rely instead upon her memory to 

testify about C.A.P.’s post-vaccination symptoms during his first year of life. (Tr. 26-27.) 

However, even after I made several requests that she discontinue reading from her prepared 

notes (e.g., Tr. 27-29), Mrs. Prokopeas failed to comply, and continued reading from those notes 

(Tr. 33-34). Thus, for that reason alone, I found Mrs. Prokopeas’ testimony at the fact hearing to 

be unpersuasive, and I cannot give it any substantial weight.34 

b. Petitioners’ counsel asked leading questions throughout the fact hearing. 

Another reason why I afford little weight to Mrs. Prokopeas’ testimony during the fact 

hearing is that Petitioners’ counsel used a strategy of asking leading questions throughout that 

hearing. In this regard, Petitioners’ counsel was blatantly obvious in asking leading questions in 

order to elicit certain testimony to substantiate critical factual assumptions relied upon in the 

Petitioners’ expert reports submitted in this case. I highlight two examples below. 

In one such instance, Petitioners’ counsel asked repeated leading questions. (Tr. 18-19.) 

Specifically, Petitioners’ counsel asked the following leading questions while questioning Mrs. 

Prokopeas about C.A.P.’s visit to the pediatrician in April of 2002:

 

34 I am sympathetic to the fact that fourteen years after the events in question, Mrs. 

Prokopeas could not reasonably be expected to remember all details of the events in question. 

But since the entire purpose of the fact hearing was to buttress, by oral testimony, the 

previously-filed affidavits, then it seemed pointless to me for Petitioners’ counsel to simply have 

the witness read from the very affidavit that her testimony was intended to support. (Of course, I 

fault Petitioners’ counsel, not Mrs. Prokopeas, for this flawed trial strategy.) 
37

Q: Okay. And that’s your recollection, that you took him in because he was having these 

symptoms after the vaccinations, is that correct? 

 

A: Well, I took him in because he still had the same symptoms. He was coughing; he had 

a runny nose. It had been close to a week now. He didn’t have a fever, but he did have the 

rash throughout his body. 

Q: And that was – that rash had started shortly after the vaccinations; is that correct?

A: Yes. All of this has been going on since Tuesday. Since the day he was vaccinated. 

(Tr. 18-19, emphasis added.) 

Similarly, Petitioners’ counsel asked another clearly leading question in an attempt to 

elicit testimony by Mrs. Prokopeas, specifically regarding C.A.P.’s alleged loss of eye contact 

after his vaccinations of July 22, 2002 -- i.e., a critical alleged fact at variance with C.A.P.’s 

contemporaneous medical records from his first year of life. In this regard, Petitioners’ counsel 

attempted to elicit an answer from Mrs. Prokopeas to the following question at the fact hearing: 

Q: Did you notice anything after those vaccines with regard to his eye contact and his 

responding to you?

(Tr. 28, emphasis added.) At that point, I explicitly asked Petitioners’ counsel to discontinue

asking leading questions critical to substantiating Petitioners’ expert reports submitted in this 

case. (Tr. 28-29.) However, Petitioners’ counsel continued to ask such leading questions to elicit 

answers from Mrs. Prokopeas. (E.g., Tr. 33.) 

Thus, this behavior -- i.e., Petitioners’ counsel’s repeated leading questioning at the fact 

hearing -- added another reason for me to discount the accuracy of the testimony of Mrs. 

Prokopeas at the fact hearing. 

c. Phone log of C.A.P.’s pediatrician 

Moreover, I highlight that Mrs. Prokopeas alleged that she made a telephone call to 

C.A.P.’s pediatrician on February 6, 2002, to complain of C.A.P.’s symptoms after his 

vaccinations of February 5, 2002. (Tr. 15.) Similarly, she also testified to making a telephone 

call to the pediatrician on April 9, 2002, to complain of C.A.P.’s symptoms after his vaccinations 

earlier that day. (Ex. 58, p. 1, ¶ 5.) However, the records from C.A.P.’s pediatrician at the time --

i.e., Pediatric Associates of Dallas -- do not reflect that his parents made contact with the office 

on those dates. (See Ex. 34-2 generally.) In this regard, I note that the records from Pediatric 

Associates of Dallas reflect that that pediatrician’s office kept relatively detailed records of 

parental phone calls, prior to and after the dates upon which C.A.P.’s parents alleged they called 

the pediatrician’s office. (See “patient phone call records” of December 27, 2001 (Ex. 34-2, p. 

31)); July 23, 2002 (Ex. 34-2, pp. 36-37) (two separate call notes); and August 13, 2002 (Ex. 10, 

p. 4 of 15). Thus, I find that it would be unlikely that a staff member from that pediatrician’s 

office would not have documented the alleged phone calls on February 6 and April 9, 2002, if in 

fact Mrs. Prokopeas had made those calls. 
38

d. Inconsistencies between affidavits and fact hearing testimony 

I additionally note that were several internal inconsistencies between Mrs. Prokopeas’ 

written statements in the joint affidavit (Ex. 58) and her fact hearing testimony. I discuss a few 

of those instances below. 

i. C.A.P.’s alleged high fever after his vaccinations of February 5, 

2002, and allegations of a phone call made to his pediatrician on 

February 6, 2002 

At the fact hearing, Mrs. Prokopeas asserted that after C.A.P.’s vaccinations of February 

5, 2002, (1) C.A.P. ran a fever of 103.9 degrees that night, and (2) she called C.A.P.’s 

pediatrician the morning of February 6, 2002, to report his fever symptoms. (Tr. 14-15.) I note, 

however, that that oral testimony was inconsistent with written testimony provided by Mrs. 

Prokopeas in her previously-filed affidavits. 

For example, none of the affidavits submitted by Mrs. Prokopeas previously alleged that 

C.A.P. had any type of high fever, much less a temperature of 103.9 degrees, after his 

vaccinations of February 5, 2002. (See Ex. 58, p. 1 of 5 (discussing C.A.P.’s condition after his 

vaccinations of February 5, 2002).) Additionally, another of her allegations at the fact hearing,

that she phoned the pediatrician’s office on February 6, 2002, was never mentioned in any of her 

previous affidavits. (See generally Exs. 58, 91, and 101.) 

ii. Allegations regarding the severity of certain of C.A.P.’s 

symptoms after his vaccinations of July 22, 2002 

In one of her affidavits, Mrs. Prokopeas asserted that C.A.P. experienced numerous 

symptoms after his vaccinations of July 22, 2002. (Ex. 58, p. 2.) Specifically commenting on 

some of those symptoms -- vomiting, fever, failure to nurse, and diarrhea -- Mrs. Prokopeas 

stated that those symptoms were “still going on even three weeks later” (i.e., three weeks after 

his vaccinations of July 22, 2002). (Id., emphasis added.) Moreover, Mrs. Prokopeas also 

described additional symptoms as occurring in late July or August, including crying, being 

miserable, only sleeping two hours per night, having intermittent “high fevers,” being difficult 

and demanding, having a “lack of eye contact,” and developing “random outbursts” for no 

apparent reason. (Id.) 

At the fact hearing, however, Mrs. Prokopeas’ described C.A.P.’s symptoms after his 

vaccinations of July 22, 2002, as being far less severe than those stated in her affidavit. (See Tr. 

20-31 generally.) Notably, at the hearing, Mrs. Prokopeas did not describe C.A.P. having a lack 

of eye contact,35 or having random outbursts in the period following his vaccinations of July 22, 

2002. (Id.) Moreover, regarding C.A.P.’s symptoms of vomiting, inability to nurse, and diarrhea, 

Mrs. Prokopeas did not state at the fact hearing that those symptoms were continuously ongoing 

 

35 At this point in the fact hearing, I admonished Petitioners’ counsel for attempting to ask a 

leading question, regarding C.A.P.’s alleged lack of eye contact immediately after his 

vaccinations of July 22, 2002, in an attempt to elicit testimony from Mrs. Prokopeas concerning 

that critical allegation of fact in this case. (Tr. 28-29.) However, Mrs. Prokopeas did not give an 

answer to that leading question. (Id.) 
39

for three consecutive weeks after his vaccinations of July 22, 2002, as the Petitioners had alleged 

in their joint affidavit. (Tr. 29-30; compare Ex. 58, p. 2.) In this regard, although Mrs. 

Prokopeas testified about C.A.P. having symptoms on or about July 25, 2002, she also testified 

that, after his sick visit on July 25, C.A.P. “seemed to have been getting better” (Tr. 29-30) 

(although apparently he did “have some” symptoms again in the days prior to August 13, 2002 

(Ex. 10, p. 4 of 15).) 

C. Summary of Section VII 

For all of the reasons outlined above in this Section VII, I find that C.A.P.’s medical 

records from his first year of life, reflecting C.A.P.’s symptoms as contemporaneously reported 

by his parents to his medical care providers for the purposes of seeking treatment, to be far more 

reliable than the parental and friend narratives of his alleged post-vaccination symptomatology 

made later in time, for the purposes of advancing this litigation. In this regard, I do not find 

sufficient indicia of reliability in the written and oral testimony of Mr. and Mrs. Prokopeas, and 

their friends, to credit their testimony over the evidence found in the contemporaneous records. 

Thus, I generally reject allegations made by Petitioners and their close family friends of 

additional post-vaccination symptoms purportedly suffered by C.A.P. after each set of 

vaccinations -- i.e., alleged symptoms that are not reflected in C.A.P.’s contemporaneous 

medical records from his first year of life. 

VIII 

I REJECT TWO SPECIFIC RETROSPECTIVE PARENTAL NARRATIVES GIVEN TO 

C.A.P.’S MEDICAL CARE PROVIDERS CONCERNING HIS PURPORTED MEDICAL 

HISTORY IN HIS EARLY MONTHS OF LIFE 

In regard to the issue of determining an accurate medical history of C.A.P.’s first months 

of life, I add that while I credit the contemporaneous medical records, I do not credit two specific 

parental narratives given much later to C.A.P.’s medical care providers, concerning his medical 

history from his early months of life. Those two unacceptable narratives are: (1) the medical 

history reported by the Petitioners to Dr. Kotsanis during C.A.P.’s telephonic phone consultation 

of January 6, 2004 (Ex. 5, pp. 2-4); and (2) the medical history reported by Mr. Prokopeas to Dr. 

Brasted during C.A.P.’s psychological evaluation of October 11, 2004 (Ex. 69, pp. 4-5). 

At the outset, I point out that in this case, as in most Program cases, I generally afford the 

most weight to those medical histories that represent the contemporaneous recitation of 

symptoms then taking place. In this case, however, the two particular medical histories listed 

above do not contemporaneously describe symptoms then happening, or that happened in the 

previous several days, but instead describe symptoms that allegedly happened more than a year

beforehand.36

 And those two histories are so drastically inconsistent with the contemporaneous 

medical records, as well as with the majority of the other medical histories contained in C.A.P.’s 

medical records, that I cannot rely upon those two histories as accurate. In the discussion below, 

 

36 Respondent’s expert, Dr. Judith Miller, also seemed skeptical of Dr. Kotsanis’ report, for 

the same reason. (Ex. H, pp. 7-8 of 9.) 
40

I highlight the specific problems I have with each of those two purported medical histories, and 

why I ultimately find them to be unreliable. 

A. Parental narrative of C.A.P.’s medical history relayed to Dr. Kotsanis in the phone 

consultation of January 6, 2004

1. The parental narrative of C.A.P.’s medical history, provided by Petitioners to Dr. 

Kotsanis in January of 2004, is drastically at variance with the contemporaneous 

accounts of C.A.P.’s symptomatology, given by Petitioners to his medical care 

providers during his first year of life. 

After carefully comparing the parental narrative of C.A.P.’s medical history given to Dr. 

Kotsanis37 in January of 2004 with their other histories made to C.A.P.’s medical care providers 

during his early years of life, I find that the medical history reported by the parents to Dr. 

Kotsanis in January of 2004 is drastically at variance with the large majority of the medical 

histories contained throughout C.A.P.’s medical records, as well as with all the medical records 

made during C.A.P.’s first year of life. 

In January of 2004, Petitioners recounted to Dr. Kotsanis a history of C.A.P.’s 

developmental milestones, reporting that “C.A.P. had met all his developmental milestones until 

July 2002, but that they started noticing problems after his vaccinations administered that 

month.” (Ex. 5, pp. 2-3, emphasis added.) Thus, in January of 2004, C.A.P.’s parents reported

that they first noticed issues with C.A.P.’s development as early as July of 2002 (i.e., when 

C.A.P. was approximately seven months of age). However, that accounting of the approximate 

timeframe of when the Petitioners started noticing C.A.P.’s developmental problems is 

inconsistent with prior and subsequent accounts given by the Petitioners to various other medical 

care providers. 

First, in statements made by Petitioners to C.A.P.’s various medical care providers prior 

to January of 2004 -- i.e, from October 2003 to December 2003 -- the parents reported that they 

started noticing problems with C.A.P.’s development (specifically with his verbalization skills), 

after C.A.P.’s head injury in September or October of 2003. (E.g., Ex. 67, p. 3; Ex. 54-1, p. 3; 

Ex. 54-1, p. 4; Ex. 54-2, pp. 43-44.) 

 

37 I once again highlight that Dr. Kotsanis’ role in providing care for C.A.P. is unclear in 

this case. Moreover, Ex. 25, p. 52 reveals that Dr. Kotsanis is a founding member of Defeat 

Autism Now (“DAN”), an organization that promotes “alternative” theories concerning autism. 

(Ex. 25, p. 52.) In this regard, I note that in his phone consultation note of January 6, 2004, Dr. 

Kotsanis recorded that “[i]n the summer/fall of 2002,” C.A.P.’s parents attended one of Dr. 

Kotsanis’ “public lectures” during which he advised them to “do a comprehensive pediatric 

evaluation with a pediatrician that is aware of possible postvaccination injury.” (Ex. 5, p. 3.) 

Thus, at the very least, it seems that as early as 2002, Dr. Kotsanis was actively advocating for 

Petitioners to seek out pediatricians who believed in the idea of “possible postvaccination injury” 

in relation to autistic children, and may have played some role in the parents’ decisions to 

withhold future vaccinations. (Id.) 
41

Second, in several accounts given by C.A.P.’s parents after January of 2004, they once 

again reported that they started noticing problems with C.A.P.’s development after his head 

injury in September or October of 2003. (E.g., Ex. 16, p. 1; Ex. 9, p. 1.) For instance, in an 

audiological evaluation of February 2004, Mrs. Prokopeas reported that her concerns about 

C.A.P.’s development had “began in October of 2003, when [C.A.P.] had an injury to his 

forehead.” (Ex. 16, p. 1, emphasis added.) Similarly, in a psychological evaluation of July of 

2004, Mrs. Prokopeas gave the following accounting of C.A.P.’s developmental history:

This past November [of 2003] [C.A.P.]’s parents noted a substantial change in his 

behavior. He began fussing and crying much more than previously had been the case, his 

eye contact, reported as previously typical, became briefer and less consistent, he 

responded less consistently to people speaking to him, and his attention span shortened 

considerably, as well as he became more insistent upon things and activities being as he 

preferred. 

(Ex. 9, p. 1, emphasis added.) 

Thus, in the time period surrounding the phone consultation of January 6, 2004, I can 

point to six separate instances during which the Petitioners relayed to C.A.P.’s various medical 

care providers that they first started noticing problems with C.A.P.’s development after his head 

injury in September or October of 2003. (E.g., Ex. 67, p. 3; Ex. 54-1, p. 3; Ex. 54-1, p. 4; Ex. 54-

2, pp. 43-44; Ex. 16, p. 1; Ex. 9, p. 1.) In this regard, I highlight that the approximate timeline 

provided by Petitioners to Dr. Kotsanis in January of 2004, specifically regarding when the 

parents first started noticing C.A.P.’s developmental problems, is drastically inconsistent and at 

variance with the majority of such timelines provided to other of C.A.P.’s medical care 

providers. 

Thus, for the reasons stated above, I find Petitioners’ observations to Dr. Kotsanis in 

January of 2004, concerning C.A.P.’s developmental history, to be so inconsistent with the 

majority of the other medical histories relayed by them, that I do not rely on the medical history 

found on Ex. 5, pages 2-3. 

B. C.A.P.’s purported medical history reported by Mr. Prokopeas during C.A.P.’s 

psychological evaluation in October of 2004

I additionally note that the medical history provided by Mr. Prokopeas during C.A.P.’s 

psychological evaluation of October 2004, was also substantially different from the majority of 

the medical histories contained in the record of this case. Specifically, on October 11, 2004, 

C.A.P. underwent a psychological evaluation by William Brasted, Ph.D. (Ex. 69.) At that time, 

Mr. Prokopeas reported an oral history of C.A.P.’s development to Dr. Brasted. In relevant part, 

Dr. Brasted recorded the following about C.A.P.’s developmental history: 

At 9-12 months, the family noticed that [C.A.P.] was not achieving developmental 

milestones within normal limits. He [sic] speech appeared delayed. At 9 months of age, 

[C.A.P.] appeared to have a reaction to his immunization shots. He began having temper 

tantrums and banging his head at 12 to 14 months of age and was easily irritated. 
42

(Ex. 69, p. 4 of 5, emphasis added.) In other words, in October of 2004, Mr. Prokopeas relayed 

to Dr. Brasted that the parents noticed C.A.P.’s developmental problems as early as September 

of 2002 -- a time frame which is drastically inconsistent with the majority of the observations 

provided to other of C.A.P.’s medical care providers. In fact, the large majority of the medical 

histories given by Petitioners in the medical records submitted in this case reflect that the parents 

started noticing problems with C.A.P.’s development after his head injury in September or 

October of 2003. (E.g., Ex. 67, p. 3; Ex. 54-1, p. 3; Ex. 54-1, p. 4; Ex. 54-2, pp. 43-44; Ex. 16, p. 

1; Ex. 9, p. 1.) 

Moreover, as alleged in Dr. Brasted’s evaluation of October 2004, Mr. Prokopeas’ report 

that C.A.P.’s alleged temper tantrums and head-banging started as early as when C.A.P. was “12 

to 14 months” of age, is greatly at variance with other medical histories provided of C.A.P. (Ex. 

69, pp. 4-5.) In fact, in numerous medical histories provided to C.A.P.’s medical care providers

prior to C.A.P.’s evaluation in October of 2004, C.A.P.’s parents make no mention of his temper 

tantrums and head-banging symptoms as having started as early as when he was twelve months 

of age. (E.g., Ex. 67, p. 3; Ex. 54-1, p. 3; Ex. 54-1, p. 4; Ex. 54-1, pp. 29-31; Ex. 54-2, pp. 43-44; 

Ex. 16, p. 1; Ex. 9, p. 1; Ex. 18, p. 7.) 

Similarly, in medical histories contained in C.A.P.’s medical records subsequent to his 

evaluation of October 2004, his parents again reported a version of C.A.P.’s medical history that 

contradicts Mr. Prokopeas’ statements in October of 2004. For instance, on November 8, 2004, 

C.A.P. was examined by Dr. Tardo for a possible autism diagnosis. (Ex. 75, p. 2.) At that time, 

Dr. Tardo recorded an oral history of C.A.P.’s development, as reported to her by Mrs. 

Prokopeas. (Id.) In that history, Mrs. Prokopeas made no mention of C.A.P.’s head-banging 

symptoms. (Id.) Moreover, during Dr. Tardo’s evaluation of November 8, 2004, Mrs. Prokopeas 

reported that she became concerned about C.A.P.’s development “when he was approximately 

20 months of age,” but that she initially thought that C.A.P. was “just a late talker.” (Id., 

emphasis added.) 

Because of the inconsistencies mentioned above, I find Mr. Prokopeas’ observations to 

Dr. Brasted in October of 2004, concerning C.A.P.’s neurodevelopmental medical history, to be 

drastically inconsistent with the majority of the other medical histories relayed by the Petitioners 

in the medical records submitted in this case. Thus, I do not rely on the medical history found on 

Ex. 69, pages 4-5 of 5. 

C. Summary of Section VIII 

As highlighted above, upon my close examination of C.A.P.’s medical records, I do not 

credit two specific medical histories reported to C.A.P.’s medical care providers concerning 

C.A.P’s medical history concerning his early months of life. I find Petitioners’ observations (1) 

to Dr. Kotsanis in January of 2004, as reflected in Ex. 5, pp. 2-3, and (2) to Dr. Brasted in 

October of 2004, as reflected in Ex. 69, pp. 4-5 of 5, to be drastically inconsistent with the 

majority of the other medical histories reported by them in the medical records submitted in this 

case. Hence, I do not find those two medical histories to be reliable. 

 
43

IX 

SPECIFIC FACT FINDINGS 

 In this section, for the purpose of providing clarity to the record of this case, I summarize 

some of the critical allegations made by C.A.P.’s parents that I specifically reject in this ruling 

on the facts, for reasons explained above in Sections VII and VIII of this Ruling. 

A. C.A.P.’s alleged additional symptoms after his vaccinations of February 5, 2002 

 Specifically, I do not find that on February 5, 2002, C.A.P. screamed and cried 

uncontrollably, followed by a deep sleep. I also do not find that C.A.P.’s parents contacted his

pediatrician’s office on February 6, 2002, as later alleged by the Petitioners. 

B. C.A.P.’s alleged additional symptoms after his vaccinations of April 9, 2002 

I reject the Petitioners’ allegations that soon after his vaccinations of April 9, 2002, 

C.A.P. suffered symptoms similar to those he allegedly experienced after his February 5 

vaccinations, such as screaming and crying uncontrollably, and rejecting nursing. I reject Mrs. 

Prokopeas’ testimony that the date of C.A.P.’s second visit to the pediatrician in April of 2002, 

was on April 13 -- I find that it was April 30. 

C. C.A.P.’s alleged additional symptoms after his vaccinations of July 22, 2002. 

I reject the Petitioners’ allegation that shortly after his vaccinations of July 22, 2002, 

C.A.P. had uncontrollable screaming and crying, and failed to nurse. I reject that C.A.P.’s 

sleeping difficulties began soon after his vaccinations of July 22, 2002. I also reject Petitioners’ 

allegations that C.A.P.’s lack of eye contact began in the time period immediately after his 

vaccinations of July 22, 2002. Further, I credit the notation in the record of the second phone 

call of July 23, 2002, that C.A.P. was “playful,” and that he had no additional symptoms at that 

time other than his fever. 

D. Symptoms allegedly occurring after vaccination of September 24, 2002 

I reject the Petitioners’ contention that after the vaccination of September 24, 2002, 

C.A.P. had any symptoms other than the minor symptoms reported in the record of the visit of 

September 30, 2002. 

E. C.A.P.’s parents’ developmental concerns 

I reject Petitioners’ allegations that they first noticed developmental problems with 

C.A.P. at any time prior to his head injury in September or October of 2003.

F. The medical history recorded by Dr. Kotsanis during his telephone consultation of January 

6, 2004 

I reject, as inaccurate, the medical history recorded by Dr. Kotsanis in January of 2004, 

as contained in Ex. 5, pp. 2-3. 
44

G. C.A.P.’s psychological evaluation of October 11, 2004 

I specifically reject the medical history recorded by Dr. Brasted in October of 2004, as 

contained in Ex. 69, pp. 4-5 of 5. 

X 

PETITIONERS’ EXPERTS RELIED ON NUMEROUS MISASSUMPTIONS OF FACT IN 

FORMULATING THEIR RESPECTIVE EXPERT OPINIONS 

Based on my factual findings above, I necessarily also find that Petitioners’ experts relied 

on numerous misassumptions of fact in formulating their respective expert reports. I detail each 

experts’ critical misassumptions of fact below. 

A. Dr. Bellanti’s misassumptions of fact 

 In his expert report of July 8, 2013, Dr. Bellanti set forth the factual assumptions upon 

which he based his expert opinion in this case. (Ex. 87, pp. 1-3) Specifically, Dr. Bellanti 

heavily relied on the joint affidavit of Mr. and Mrs. Prokopeas, filed as Exhibit 58, to assume 

certain facts concerning C.A.P.’s condition after each set of vaccinations administered to C.A.P. 

during his first year of life. (E.g., Ex. 87, p. 1, ¶¶ 2, 4; Ex. 87, p. 2, ¶¶ 1, 3-7.)38 

Additionally, in his expert report of July 8, 2013, Dr. Bellanti relied upon Dr. Kotsanis’ 

recorded medical history contained in Exhibit 5, deeming that recorded medical history as being 

“an excellent history of what was going on at that time.” (Ex. 87, p. 2, ¶ 8.) Moreover, Dr. 

Bellanti stated the following regarding the medical history recorded by Dr. Kotsanis in January 

of 2004: 

The history he recorded (Ex. 5, at 1-3) is entirely consistent with the narrative of 

[C.A.P.]’s parents. 

(Ex. 87, p. 3, parenthesis in the original.) 

As discussed in Section VII above, however, I specifically reject Petitioners’ written and 

oral statements in this case, testifying to additional post-vaccination symptoms allegedly suffered 

by C.A.P. -- alleged symptoms that are not reflected in C.A.P.’s contemporaneous medical 

records -- during his first year of life. Moreover, as also discussed above, I also specifically 

 

38 See Ex. 87, p. 1, ¶ 4 (assuming as fact parental assertions of C.A.P.’s condition after his 

vaccinations of February 5, 2002); Ex. 87, p. 2, ¶ 1 (assuming as fact parental assertions of 

C.A.P.’s condition after his vaccinations of April 9, 2002); Ex. 87, p. 2, ¶¶ 3-4 (assuming as fact 

parental assertions of C.A.P.’s condition immediately following his vaccinations of July 22, 

2002); Ex. 87, p. 2, ¶ 5 (assuming as fact parental assertions as to the start of certain of C.A.P.’s 

symptoms, including his lack of eye contact, following his vaccinations of July 22, 2002); Ex. 

87, p. 2, ¶ 6 (assuming as fact parental assertions of C.A.P.’s condition after his vaccination of 

September 24, 2002). 
45

reject the medical history recorded by Dr. Kotsanis in January of 2004, as contained in Ex. 5, pp. 

2-3. 

Thus, I emphasize that the majority of the factual assumptions reflected in both of the 

expert reports of Dr. Bellanti submitted in this case (Exs. 87 and 89) are clearly erroneous.

39

 

B. Dr. Corbier’s misassumptions of fact 

 Dr. Corbier relied on the assumptions that shortly after his vaccinations of February 5, 

2002, C.A.P. “lost his appetite and slept for long hours at a time” (Ex. 98, p. 2 of 3), and that 

soon after his vaccinations of July 22, 2002, C.A.P. became “lifeless” and “lethargic,” and was 

“crying inconsolably” (Ex. 98, pp. 2-3 of 3). Dr. Corbier also assumed that C.A.P. had 

“irritability” and a “lethargic state” after each of his vaccination sets on February 5, April 9, and 

July 22. (Ex. 99, p. 3 of 10.) 

 However, as I have set forth above, I find that those were erroneous assumptions of fact, 

upon which Dr. Corbier based his opinion. 

C. Summary of my conclusions concerning Dr. Bellanti’s and Dr. Corbier’s expert opinions 

For the reasons described in detail above, I find that the expert opinions of Drs. Bellanti 

and Corbier in this case are based upon numerous flawed assumptions, with those erroneous 

assumptions being strongly contradicted by C.A.P.’s medical records. Hence, I find that the 

expert opinions of both Drs. Bellanti and Corbier40 are fatally flawed, and thus, wholly 

unreliable.

41

 

39 I note that, in serving as an expert witness for petitioners in prior Vaccine Act cases, Dr. 

Bellanti has a history of basing his causation opinion on clearly faulty factual assumptions. In a 

prior case before me in which Dr. Bellanti served as Petitioners’ expert witness, Brook v. HHS, 

No. 04-405V, 2015 WL 3799646 (Fed. Cl. Spec. Mstr. May 14, 2015), I found that Dr. Bellanti’s 

causation opinion in that case was “premised on assumptions that run contrary to the clinical 

history presented by the medical records.” 2015 WL 3799646 at *11, emphasis in original. 

40 Dr. Corbier also opined that C.A.P. suffered a “Table Injury encephalopathy” after his 

vaccinations of July 22, 2002. (Ex. 99, p. 4 of 10.) However, after studying the medical records 

of July 23, 24, and 25, 2002, it is absolutely clear that C.A.P. did not suffer such a Table Injury. 

(That conclusion by Dr. Corbier, indeed, was, in my view, quite absurd.) 

41 “To the extent that it relies on the testimony of the petitioners’ witnesses as to the 

occurrence and timing of events, [expert medical opinion] must stand or fall with the fact 

testimony.” (Murphy v. HHS, 90-882V, 1991 WL 74931, at *3 (Fed. Cl. Spec. Mstr. April 25, 

1991) (aff’d, 23 Cl. Ct. 726 (1991), aff’d, 968 F.2d 1226 (Fed. Cir. 1992), cert. denied, 113 S. Ct. 

463 (1992).) Thus, because I decline to credit Petitioners’ testimony with regard to C.A.P. 

allegedly suffering from additional post-vaccination symptoms after each set of vaccinations, 

including allegations that some of those post-vaccination symptoms constituted severe reactions 

to his vaccinations in the immediate time period following his vaccinations, I likewise decline to 

accept Drs. Bellanti’s and Corbier’s opinions based upon that testimony.
46

XI 

WARNING TO PETITIONERS’ COUNSEL CONCERNING “REASONABLE BASIS”

In several cases before myself and other special masters hearing cases involving children 

with diagnoses on the autism spectrum, petitioners’ experts have relied upon parental testimony, 

as opposed to the minor child’s medical records, in formulating factual assumptions upon which 

they based their expert opinions. In many of those cases, parental testimony offered in the 

course of litigation, alleging that the child suffered certain severe post-vaccination symptoms not 

reflected in his/her medical records, is the exclusive or predominant evidence supporting the 

factual assumptions of the petitioners’ experts. But in many of those cases, as in this case, a 

careful examination of the record of the case has revealed that the child’s medical records 

strongly contradicted the petitioners’ assertions that their child suffered any kind of serious 

symptoms soon after his/her vaccinations in question. See, e.g., Hardy v. HHS, supra; Brook v. 

HHS, supra; Hooker v. HHS, supra; Dempsey v. HHS, supra; Hashi v. HHS, No. 08-307V, 2015 

WL 4626089 (Fed. Cl. Spec. Mstr. June 1, 2015). In certain of those cases, I have found that 

petitioners’ proffered expert opinions were so divorced from the actual facts contained in the 

child’s medical records, that in effect petitioners’ case, as presented, was simply frivolous. See, 

e.g., Hardy v. HHS, supra; Hooker v. HHS, supra.

This case clearly fits such a fact pattern, as explained above. Therefore, I hereby notify 

Petitioners’ counsel in this case, that if Petitioners choose to continue to pursue any further 

proceedings in this case, after this point in time, I would be unlikely to conclude that there was a 

“reasonable basis” for such further proceedings, and therefore would be unlikely to compensate 

Petitioners for any further attorneys’ fees and/or costs incurred concerning this petition. (I think 

it likely that any special master that might succeed me in this case would probably reach the 

same conclusion.) 

Further, I strongly advise petitioners’ counsel in all pending Vaccine Act cases that such 

counsel should carefully scrutinize, for credibility, any cases in which an expert witness, opining 

that vaccines caused or aggravated a minor child’s ASD or other neurologic disorder, bases an 

expert opinion in a case in substantial part on parental allegations of the child undergoing certain 

severe post-vaccination symptoms; if, as in this case, such alleged symptoms are not reflected in 

the contemporaneous medical records of the child, I (or any special master) will be unlikely to 

find that the use of such expert was reasonable, and thus compensable. 

XII 

CONCLUSION 

Petitioners’ counsel is hereby ordered to carefully study these findings of fact. Expert 

opinion inconsistent with these findings of fact is not likely to be persuasive. See Burns v. HHS, 

3 F.3d 415, 417 (1993) (holding that the special master did not abuse his discretion in refraining 

from conducting a hearing when the petitioner’s expert “based his opinion on facts not 

 
47

substantiated by the record”); Brooke Group Ltd. v. Brown & Williamson Tobacco Corp., 509 

U.S. 209, 242 (1993) (“When an expert opinion is not supported by sufficient facts to validate it 

in the eyes of the law, or when indisputable record facts contradict or otherwise render the 

opinion unreasonable, it cannot support a jury’s verdict.”); Perreira v. HHS., 33 F.3d 1375, 1376 

n.6 (Fed. Cir. 1994) (“An expert opinion is no better than the soundness of the reasons 

supporting it.”); see also Bradley v. HHS, 991 F.2d 1570, 1574 (Fed. Cir. 1993) (the assumption 

of an expert about the accuracy of a fact witness’s testimony does not “substantiate” the fact

witness’s testimony).

Moreover, I also strongly urge Petitioners’ counsel to comprehensively study C.A.P.’s 

medical records, and this ruling on the facts, as discussed in Section X of this Decision above, 

prior to proceeding further with this case. 

IT IS SO ORDERED.

 /s/ George L. Hastings, Jr. 

 George L. Hastings, Jr. 

 Special Master