Anderson v. Secretary of Health and Human Services, 02-1314

Background

Petitioners Bruce and Donna Anderson filed in 2002 under the National Vaccine Injury Compensation Program alleging R.A.’s MMR vaccine (Dec. 13, 1999) aggravated an underlying mitochondrial disorder and caused developmental regression culminating in ASD.
R.A. had a high fever within a week of MMR, seen in ER, diagnosed viral; contemporaneous pediatric records show normal development through early 2000, with developmental concerns first clearly noted at 18–21 months and more apparent by age 2.
Petitioners relied on later specialty evaluations (notably Dr. Shoffner in 2008) and testing (metabolic labs, muscle biopsy) to support a diagnosis of secondary mitochondrial dysfunction; results were inconsistent and often obtained years after alleged onset.
Petitioners’ expert (Dr. Huq) opined vaccine-triggered inflammatory/mitochondrial cascade caused ASD; he relied on case reports and small studies and on R.A.’s later abnormal labs and parental history.
Respondent’s expert (Dr. Cohen) rebutted, finding no convincing evidence of primary or secondary mitochondrial disease, criticizing lab variability, lack of standardized enzymology (citrate synthase normalization), and the absence of contemporaneous clinical signs or MRI changes consistent with mitochondrial disease.
Special Master Corcoran credited respondent’s expert, found Petitioners failed to prove R.A. had mitochondrial dysfunction or that MMR caused or aggravated his ASD, and denied compensation.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Did R.A. have underlying mitochondrial disease/dysfunction?	R.A. had secondary mitochondrial dysfunction supported by later metabolic tests, muscle biopsy, aminoaciduria, clinical multisystem signs, and expert diagnosis.	Testing was inconsistent, performed long after alleged onset, biopsy/enzymology not reliably standardized; clinical course and imaging do not support mitochondrial disease.	No — petitioners failed to prove mitochondrial disease by preponderance.
Did MMR vaccination cause or aggravate R.A.’s developmental disorder (Althen causation)?	MMR induced fever/immune activation that triggered/ worsened mitochondrial dysfunction producing encephalopathy and ASD.	No reliable mechanism or supporting contemporaneous evidence; literature and case studies cited are inapposite; temporal link is weak.	No — petitioners failed all Althen prongs; causation not established.
Are later specialty opinions (2008 Shoffner, later treaters) entitled to decisive weight?	Treating specialists’ conclusions support causation and diagnosis.	Opinions were formed years after the fact, relied on inaccurate history and inconsistent data; contemporaneous records are more probative.	Court gave less weight to post-hoc treaters; contemporaneous records carry more weight.
Is the temporal relationship between vaccination and onset medically acceptable?	Vaccine-related fever within a week triggered a slow inflammatory cascade leading to ASD months later.	No biologically reliable basis provided for a multi-month delay; contemporaneous records show no regression near vaccination.	No — timing unsupported; temporal correlation alone insufficient.

Key Cases Cited

Moberly v. Sec'y of Health & Human Servs., 592 F.3d 1315 (Fed. Cir.) (preponderance standard and substantial-factor causation requirement in Vaccine Program)
Capizzano v. Sec'y of Health & Human Servs., 440 F.3d 1317 (Fed. Cir.) (treatment of causation evidence)
Althen v. Sec'y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir.) (three-prong test for causation-in-fact in vaccine cases)
Andreu v. Sec'y of Health & Human Servs., 569 F.3d 1367 (Fed. Cir.) (standards for Althen prong one and weighing scientific evidence)
LaLonde v. Sec'y of Health & Human Servs., 746 F.3d 1334 (Fed. Cir.) (temporal relationship alone insufficient for causation)
Cucuras v. Sec'y of Health & Human Servs., 993 F.2d 1525 (Fed. Cir.) (contemporaneous medical records presumptively reliable)
Cedillo v. Sec'y of Health & Human Servs., 617 F.3d 1328 (Fed. Cir.) (use of Daubert factors and evaluation of scientific proof in Vaccine Program)