Hughes v. Secretary of Health and Human Services
18-1895
Fed. Cl.Jul 6, 2021Background:
- Petitioner Sharon Hughes received an influenza vaccination in her right arm on October 30, 2017 and alleged a SIRVA with onset within 48 hours.
- She did not seek orthopedic care until May 2018, when she reported ~6 months of right shoulder pain; imaging showed mild labral fraying and she underwent arthroscopic subacromial decompression in July 2018.
- Respondent’s Rule 4(c) Report argued (1) petitioner had pre-existing right shoulder complaints from January 10, 2017 and (2) contemporaneous medical records do not support onset within 48 hours of the vaccine.
- A fact hearing was held May 18, 2021; petitioner, her husband, and two coworkers testified that soreness began the day of the shot and worsened within 48 hours.
- The Special Master credited the testimonial evidence over the apparent gap in contemporaneous records and found, by preponderant evidence, that onset occurred within 48 hours of the October 30, 2017 vaccination.
- The Special Master ordered respondent to file an amended Rule 4(c) report reflecting the fact ruling.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether onset of right shoulder pain occurred within 48 hours of the Oct. 30, 2017 flu vaccine | Hughes: soreness began same day; pain worsened the next day and within 48 hours interfered with work duties | Secretary: contemporaneous medical records (first orthopedic report May 2018) do not corroborate onset within 48 hours | Held: Onset found within 48 hours based on witness testimony and record as a whole |
| Whether pre-existing shoulder complaints bar finding of vaccine-related onset | Hughes: prior Jan 2017 complaint was trapezius/back-related, not shoulder joint pain | Secretary: there was a pre-existing right shoulder complaint on Jan 10, 2017 undermining causation | Held: Pre-existing complaint did not prevent finding of vaccine-related onset within 48 hours (onset question resolved in petitioner’s favor) |
Key Cases Cited
- Burns v. Sec'y of Health & Human Servs., 3 F.3d 415 (Fed. Cir. 1993) (special masters weigh testimony and records to resolve factual disputes)
- Cucuras v. Sec'y of Health & Human Servs., 993 F.2d 1525 (Fed. Cir. 1993) (contemporaneous medical records are presumed accurate)