Moriarty v. Secretary of Health & Human Services
643 F. App'x 997
| Fed. Cir. | 2016Background
- Eilise Moriarty (born 1996) had preexisting developmental delays; received an MMR dose on Jan 2, 2001 and began having seizures within days, culminating in hospitalizations and an EEG consistent with epilepsy.
- Treating doctors diagnosed new-onset seizure disorder; later noted intractable seizures that became seizure-free on a ketogenic diet; treating neurologist labeled it static encephalopathy of unknown etiology and intractable seizures resolved by diet.
- The Moriartys filed a Vaccine Act petition alleging vaccination-caused injury (initially autism-related, later amended to seizure disorder/encephalopathy); special-master hearing occurred in 2013 with expert testimony from petitioner’s Dr. Shafrir and respondent’s Dr. MacDonald.
- Special master denied compensation, finding petitioner failed Althen prong one (medical theory) and prong two (logical sequence), though prong three (temporal relationship) was satisfied; Court of Federal Claims affirmed.
- On appeal, the Federal Circuit vacated and remanded, finding the special master improperly refused to consider petitioner’s second expert report and the medical articles cited therein (notably Weibel), contrary to the Vaccine Act’s requirement to consider the record as a whole.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the special master may ignore expert reports/articles not discussed at hearing | Moriarty: Special master must consider entire record including Dr. Shafrir’s second report and cited literature; those sources support a biologically plausible MMR→autoimmune epileptic encephalopathy theory | Gov: Special master considered testimony and reports; need not credit or parse every cited article absent expert oral explanation | Held: Special master erred by refusing to consider written expert report and cited articles; statute and Vaccine Rule require consideration of all relevant medical/scientific evidence of record |
| Whether petitioner proved Althen prongs 1 & 2 given the record | Moriarty: Record (reports + articles) supplies a medical theory and logical sequence linking MMR to encephalopathy/seizures; overlap between prongs makes relief plausible | Gov: Expert Dr. MacDonald: no evidence MMR causes autoimmune epileptic encephalopathy; clinical picture inconsistent with immune-mediated encephalopathy | Held: Court did not decide merits of Althen prongs on appeal; vacated and remanded so special master can reconsider prongs 1 and 2 after evaluating the full record |
Key Cases Cited
- Althen v. Sec'y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir.) (three‑part test for causation in off‑Table Vaccine Act cases)
- Moberly v. Sec'y of Health & Human Servs., 592 F.3d 1315 (Fed. Cir.) (standard of review and discussion of special‑master factfinding)
- Hazelhurst v. Sec'y of Health & Human Servs., 604 F.3d 1343 (Fed. Cir.) (special master must consider relevant evidence; presumption of consideration does not apply when decision shows otherwise)
- Bradley v. Sec'y of Health & Human Servs., 991 F.2d 1570 (Fed. Cir.) (deference to special master credibility findings when witness was observed)