Backman v. Secretary of Health and Human Services
16-458
| Fed. Cl. | Dec 8, 2017Background
- Petitioner Betty D. Backman filed a Vaccine Act claim alleging left-shoulder injury (SIRVA-type) after receiving an influenza vaccine on November 12, 2014.
- Respondent challenged entitlement, arguing petitioner failed to prove the vaccine was given in the left arm, failed to show onset within 48 hours, and failed to prove vaccine caused the injury (Althen causation).
- Medical records included a 2003 MRI showing a prior left rotator cuff tear with tendon calcification; petitioner submitted affidavits and updated primary-care and therapy records.
- A fact hearing was held (petitioner plus lay witnesses); respondent did not call witnesses. The Special Master took testimony and issued oral factual findings from the bench.
- The Special Master found by credibility and record evidence that the flu shot was given in petitioner’s left arm, pain began almost immediately (before she left the pharmacy), and the delay in reporting to a doctor was plausibly explained by concurrent acute bronchial illness.
- Based on the factual findings and the SIRVA criteria (as interpretive guidance), the Special Master ruled petitioner met the elements and is entitled to compensation.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Site of injection | Shot was administered in left arm; petitioner testified accordingly | Record insufficient to prove left-arm administration | Found shot was administered in left arm (credibly proven) |
| Onset/timing of symptoms | Pain began almost immediately, before leaving pharmacy (petitioner affidavit & testimony) | No contemporaneous medical record proving onset within 48 hours | Found onset was almost immediate (credibly proven) |
| Causation (Althen) | Vaccine caused shoulder injury (causal link supported by timing and lack of competing explanation) | No medical theory or logical sequence shown; petitioner failed Althen burden | After resolving factual issues, Special Master concluded petitioner met SIRVA criteria and entitlement established (causation satisfied for compensation) |
| Preexisting condition / delay in care | Prior shoulder MRI (2003) exists, but calcification’s cause is uncertain; delay due to acute bronchial illness | Prior rotator cuff tear and tendon calcification indicate chronic condition; delay undermines claim | Prior calcification acknowledged but not dispositive; delay plausibly explained and not fatal to claim; evidence supports entitlement |
Key Cases Cited
- Althen v. Secretary of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (establishes the three-prong test for proving causation-in-fact in Vaccine Program cases)