Erxleben v. Secretary of Health and Human Services, 14-385

Petitioner Reta Erxleben filed a Vaccine Program claim alleging dysphagia, vocal cord dysfunction, and laryngeal dystonia caused by an influenza vaccine administered on September 14, 2011.
The special master ordered petitioner to produce medical records and an expert causation opinion under the Althen framework; petitioner initially obtained an expert who later withdrew.
Respondent filed a Rule 4(c) report opposing compensation and submitted responsive expert reports.
Petitioner’s counsel attempted to retain new experts; the neurologist Dr. Marcel Kinsbourne reviewed the record but testified there is no evidence that paradoxical vocal cord motion (PVCM) is vaccine-caused or immune-mediated.
The court granted petitioner additional time to locate supportive expert opinion or literature; petitioner filed a pro se response and additional medical records but no expert report or supporting literature.
Because petitioner failed to provide a medical opinion or literature satisfying Althen’s prongs, the claim was dismissed for insufficient proof.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether petitioner proved causation-in-fact for a non-Table injury	Erxleben asserts the temporal proximity of symptoms to the flu vaccine indicates causation and advanced lay theories in a pro se filing	Respondent argues medical records and expert evidence do not support a vaccine causal mechanism or sequence	Dismissed: temporal association alone insufficient; no medical theory or expert opinion met Althen requirements
Whether petitioner met the Vaccine Act requirement for expert-supported evidence	Petitioner contended she searched for experts and provided medical history; sought more time to obtain support	Respondent maintained absence of supportive expert literature/analysis precludes entitlement	Dismissed: petitioner failed to produce a medical expert opinion or literature; self-written theory inadequate

Althen v. Sec'y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (establishes three-prong test for causation-in-fact: medical theory, logical sequence, and temporal relationship)