Johnson v. Secretary of Health and Human Services
20-1092
| Fed. Cl. | Jun 14, 2021Background
- Paula Johnson filed a Vaccine Program petition (No. 20-1092V) alleging Guillain-Barré syndrome (GBS) caused by an influenza vaccine administered on September 11, 2018.
- Petitioner’s first reported neurological symptoms (sudden lower-extremity numbness) began on December 12, 2018 — 92 days post-vaccination — per contemporaneous records and her affidavit.
- Hospital workup (including lumbar puncture) showed normal CSF protein, but clinicians diagnosed possible GBS and treated with five doses of IVIG; she underwent inpatient rehab and continued outpatient therapy for ongoing deficits.
- The Vaccine Injury Table requires GBS onset within 3–42 days of flu vaccination for a presumptive (Table) claim; non-Table causation-in-fact claims typically must show onset within a medically acceptable window (commonly six–eight weeks).
- The special master issued an order to show cause because the record indicated onset at 92 days, outside both the Table window and the longest medically accepted timeframe for vaccine-induced GBS.
- Petitioner did not submit additional records or persuasive explanation in response; the special master found the contemporaneous records preponderantly established 12/12/2018 onset and dismissed the claim for failure to prove causation.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether onset occurred within the Vaccine Table window (3–42 days) | Johnson asserts onset on Dec 12, 2018 (92 days after vaccination) | Respondent contends onset is outside the Table window | Held: Onset was Dec 12, 2018 (92 days); outside Table window — not a Table claim |
| Whether onset timing supports a causation-in-fact (Althen) claim | Johnson relied on existing records and affidavit; requested ruling on the record | Respondent argued 92-day onset is beyond medically acceptable timeframe for vaccine-induced GBS | Held: 92-day onset is too remote; no evidence to rebut that such latency is medically acceptable — causation-in-fact not shown |
| Whether petitioner overcame the presumptive accuracy of contemporaneous medical records | Johnson offered affidavit but no additional contemporaneous records contradicting onset date | Respondent relied on contemporaneous records establishing symptom onset date | Held: Contemporaneous records and affidavit preponderantly establish onset date; petitioner did not present clear, cogent evidence to overcome the records' accuracy |
Key Cases Cited
- Burns v. Sec'y of Health & Human Servs., 3 F.3d 415 (Fed. Cir. 1993) (special master weighs and assigns weight to evidence, including records and testimony)
- Cucuras v. Sec'y of Health & Human Servs., 993 F.2d 1525 (Fed. Cir. 1993) (contemporaneous medical records are presumptively accurate)
- Althen v. Sec'y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (framework for proving causation-in-fact in Vaccine Program cases)