Pertussis Vaccine: Court Finds No Justification for Association with Permanent Brain Damage

The Lancet ◽  
1988 ◽  
Vol 331 (8589) ◽  
pp. 837 ◽  
Author(s):  
Diana Brahams
PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. A54-A54
Author(s):  
Student

1. The preliminary issue to be determined by the court is, can pertussis vaccine cause permanent brain damage in young children? The question relates to pertussis vaccine manufactured in the United Kingdom and applies to all children whether or not they were neurologically normal before vaccination. The burden of proof rests on the Plaintiff and the standard of proof is that of the balance of probability. It must be shown that it is more likely than not that the vaccine can cause permanent brain damage. 2. The medical and expert opinion is deeply divided on the issue. 3. The question is not answered by showing that there is a respectable and responsible body of medical opinion that the vaccine can, albeit rarely, cause permanent brain damage, or that this view is/may be more widely held than the contrary. 4. Similarly the advice contained in the contra-indications against pertussis vaccination . . . cannot be relied upon as though it were evidence . . . that the vaccine in fact causes permanent brain damage. 5. Reports of . . . encephalopathy resulting in . . . brain damage or death where the onset occurs shortly after DTP vaccination, raises the hypothesis that the vaccine may cause brain damage or death. It does not prove the hypothesis. Such reports do not take account of events occurring by chance, for which no explanation can be found. What they do establish is that encephalopathy resulting occasionally in permanent brain damage or death does sometimes occur in close temporal proximity to pertussis vaccination. 6. I have reviewed the evidence and reasoning of the Plaintiffs and Defendants' expert witnesses . . . . I have found myself more impressed both by the cogency and quality of the evidence and reasoning of the experts called on behalf of the Defendants. 7. When I embarked on consideration of the preliminary issue, I was impressed by the case reports and what was evidently a widely held belief that the vaccination could, albeit rarely, cause permanent brain damage. I was ready to accept that this belief was well founded. But over the weeks that I have listened to and examined the evidence and arguments, I have become more and more doubtful that this is so. I have now come to the clear conclusion that the Plaintiff fails to satisfy me on the balance of probability that pertussis vaccine can cause permanent brain damage in young children. It is possible it does, the contrary cannot be proved. But in the result the Plaintiff's claim must fail.


2006 ◽  
Vol 105 (6) ◽  
pp. 1081-1086 ◽  
Author(s):  
Frederick W. Cheney ◽  
Karen L. Posner ◽  
Lorri A. Lee ◽  
Robert A. Caplan ◽  
Karen B. Domino

Background The authors used the American Society of Anesthesiologists Closed Claims Project database to determine changes in the proportion of claims for death or permanent brain damage over a 26-yr period and to identify factors associated with the observed changes. Methods The Closed Claims Project is a structured evaluation of adverse outcomes from 6,894 closed anesthesia malpractice claims. Trends in the proportion of claims for death or permanent brain damage between 1975 and 2000 were analyzed. Results Claims for death or brain damage decreased between 1975 and 2000 (odds ratio, 0.95 per year; 95% confidence interval, 0.94-0.96; P < 0.01). The overall downward trend did not seem to be affected by the use of pulse oximetry and end-tidal carbon dioxide monitoring, which began in 1986. The use of these monitors increased from 6% in 1985 to 70% in 1989, and thereafter varied from 63% to 83% through the year 2000. During 1986-2000, respiratory damaging events decreased while cardiovascular damaging events increased, so that by 1992, respiratory and cardiovascular damaging events occurred in approximately the same proportion (28%), a trend that continued through 2000. Conclusion The significant decrease in the proportion of claims for death or permanent brain damage from 1975 through 2000 seems to be unrelated to a marked increase in the proportion of claims where pulse oximetry and end-tidal carbon dioxide monitoring were used. After the introduction and use of these monitors, there was a significant reduction in the proportion of respiratory and an increase in the proportion of cardiovascular damaging events responsible for death or permanent brain damage.


1970 ◽  
Vol 33 (5) ◽  
pp. 498-505 ◽  
Author(s):  
R. Zupping

✓ Acid-base and gas parameters of CSF, jugular venous and arterial blood were measured in 45 patients with brain injury in the first 12 days after trauma or operation. CSF metabolic acidosis together with respiratory alkalosis and hypoxemia in the cerebral venous and arterial blood were the most characteristic findings. A close correlation between the severity of brain damage and the intensity of the CSF metabolic acidosis and arterial hypocapnia was revealed. It was concluded that brain hypoxia and acidosis play an important role in the development of cerebral edema and permanent brain damage.


BMJ ◽  
1973 ◽  
Vol 4 (5893) ◽  
pp. 673-673 ◽  
Author(s):  
P Juul-Jensen ◽  
M Schou

2016 ◽  
Vol 10 (1) ◽  
pp. 2-11 ◽  
Author(s):  
Carolina de Medeiros Rimkus ◽  
Martijn D. Steenwijk ◽  
Frederik Barkhof

Cognitive decline is a frequent but undervalued aspect of multiple sclerosis (MS). Currently, it remains unclear what the strongest determinants of cognitive dysfunction are, with grey matter damage most directly related to cognitive impairment. Multi-parametric studies seem to indicate that individual factors of MS-pathology are highly interdependent causes of grey matter atrophy and permanent brain damage. They are associated with intermediate functional effects (e.g. in functional MRI) representing a balance between disconnection and (mal) adaptive connectivity changes. Therefore, a more comprehensive MRI approach is warranted, aiming to link structural changes with functional brain organization. To better understand the disconnection syndromes and cognitive decline in MS, this paper reviews the associations between MRI metrics and cognitive performance, by discussing the interactions between multiple facets of MS pathology as determinants of brain damage and how they affect network efficiency.


Author(s):  
Bruce Becker

This is a case report of a very preventable near-death event involving a 6-year-old female who had a syncopal event due to hyperthermia in an overheated hot tub and drowned. She was resuscitated but due to the combination of anoxia and hyperthermia has been left with permanent brain damage.


2019 ◽  
Vol 396 ◽  
pp. 12-17 ◽  
Author(s):  
Coline Duwicquet ◽  
Julien Biberon ◽  
Philippe Corcia ◽  
Bertrand De Toffol ◽  
Nadège Limousin

Sign in / Sign up

Export Citation Format

Share Document