Caves v. Secretary of Department of Health & Human Services
100 Fed. Cl. 119
Fed. Cl.2011Background
- Petitioner received influenza vaccine on Nov 18, 2005; within weeks developed transverse myelitis (TM).
- Initial hospitalization showed no acute intracranial pathology; MRI later indicated conus edema without clear etiology.
- Shands and Raulerson Hospital treated TM; MRI/CT and steroid therapy followed; inferior vena cava filter placed due to immobility.
- Treating physicians documented temporal association with vaccination but did not conclusively diagnose vaccine-caused TM.
- Petitioner filed Vaccine Act petition (2007); special master denied compensation after Althen prongs analysis.
- Court denies review and sustains the special master’s decision, holding proof failed on prongs one and two of Althen.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Daubert analysis was misapplied | Caves claims Daubert used too rigidly | Daubert factors appropriately gauge reliability | Daubert framework used properly as a reliability tool |
| Weight afforded to treating physicians’ statements | Treating doctors supported causation | Statements show only temporal association | Special master did not err in giving little weight to those statements |
| Elimination of alternative causes as circumstantial evidence | Elimination supports causation | Elimination alone insufficient | Not sufficient to prove causation under Althen prong two |
| Temporal relationship as evidence for Althen prongs | Temporal proximity supports causation | Temporal relation alone is insufficient | Temporal relation alone insufficient for prongs one and two |
Key Cases Cited
- Althen v. Sec'y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (establishes three-prong causation framework for off-Table claims)
- Cedillo v. Sec'y of Health & Human Servs., 617 F.3d 1328 (Fed. Cir. 2010) (Daubert analysis may be used to assess expert reliability in Vaccine Act cases)
- Moberly v. Sec’y of Health & Human Servs., 592 F.3d 1315 (Fed. Cir. 2010) (proximate temporal relationship alone insufficient for causation)
- Capizzano v. Sec'y of Health & Human Servs., 440 F.3d 1317 (Fed. Cir. 2006) (epidemiology not mandatory; triad of Althen prongs)
- Grant v. Sec'y of the Dep’t of Health & Human Servs., 956 F.2d 1144 (Fed. Cir. 1992) (causation proof requires substantial evidence beyond temporal link)