Deribeaux v. Secretary of Health & Human Services
105 Fed. Cl. 583
Fed. Cl.2012Background
- Petitioners seek review of a Special Master’s denial of Vaccine Act compensation for Madison Deribeaux after evidence showed a genetic SCN1A mutation (Dravet’s syndrome) as a sole substantial factor unrelated to the DTaP vaccine.
- Madison experienced a febrile seizure shortly after DTaP on March 29, 2002, but later developed a chronic seizure disorder with developmental delays.
- Genetic testing in December 2005 revealed a de novo SCN1A mutation associated with Dravet’s Syndrome; petitioners argue vaccine-triggered events caused the injury.
- Initial entitlement finding favored petitioners, but during damages and subsequent proceedings new evidence led to a finding that the mutation independent of the vaccine caused the injury.
- The case was ultimately reviewed by the Court of Federal Claims, which upheld the Special Master’s denial and denied petitioners’ motion for review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Standard of proof for alternative causation | Deribeaux argues for a Restatement/Shyface standard | Deribeaux contends Althen framework applied | Althen standard applied; Restatement standard subsumed by Althen |
| Reliance on expert Dr. Raymond for causation | Lord substituted legal causation with medical opinion | Court may weigh persuasiveness of experts; Raymond persuasive | Court did not err in crediting Raymond and weighing expert opinions |
| Existence of a sole substantial factor unrelated to vaccine | Mutation not shown as sole factor; vaccine contributed | Mutation shown as sole substantial factor | Respondent demonstrated by preponderance that mutation was the sole substantial factor |
Key Cases Cited
- Althen v. Secretary of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (establishes three-prong test for off-Table causation)
- Shyface v. Secretary of Health & Human Servs., 165 F.3d 1344 (Fed. Cir. 1999) (Restatement-based substantial factor standard)
- Knudsen v. Secretary of Health & Human Servs., 35 F.3d 543 (Fed. Cir. 1994) (causation in fact standards under Vaccine Act)
- de Bazan v. Secretary of Health & Human Servs., 539 F.3d 1347 (Fed. Cir. 2008) (defines 'sole substantial factor' burden and substantiality)
- Stone v. Secretary of Health & Human Servs., 676 F.3d 1373 (Fed. Cir. 2012) (affirms Restatement-based causation standard in off-Table cases)
- Harris v. Secretary of Health & Human Servs., 102 Fed.Cl. 282 (Fed. Cl. 2011) (discusses expert weight and causation in GEFS+/DS context)