Ngo v. Secretary of Health and Human Services
16-1478
| Fed. Cl. | Nov 14, 2017Background
- Petition filed Nov. 9, 2016 by Philip Ngo on behalf of daughter A.N., alleging MMR vaccine (Nov. 18, 2013) caused autism spectrum disorder (ASD).
- Medical record set is limited (<100 pages): vaccination records, some labs, and later developmental evaluations; no birth/pregnancy records and no contemporaneous documentation of an immediate post‑vaccine encephalopathic reaction.
- First parental concern reported between 16–18 months (reduced babbling); formal autism evaluation at OHSU on Apr. 17, 2015 (age ~2½) documenting ASD symptoms (repetitive behaviors, limited speech/joint attention).
- Petitioner submitted a short letter asserting suppressed CDC evidence and two‑page statement citing studies linking vaccines to autism; no expert reports or treating physician opinions attributing A.N.’s ASD to MMR in the record.
- Respondent’s Rule 4(c) report recommended dismissal for lack of causation evidence; special master ordered Petitioner to show cause why case should not be dismissed.
- Special master concluded petitioner could not meet the Vaccine Act’s causation‑in‑fact requirements and dismissed the claim without a hearing.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether MMR caused A.N.’s ASD (non‑Table causation) | MMR vaccination precipitated autism; petitioner points to purported epidemiology and suppressed CDC evidence | No reliable evidence linking MMR to A.N.’s autism; petitioner has not met burden of proof | Dismissed: petitioner failed to prove causation‑in‑fact under Althen framework |
| Adequacy of the record to proceed / need for hearing | Petitioner requested time/effort to develop claims via filings (no expert reports submitted) | Respondent argued dismissal appropriate based on current record; special master found papers sufficient to decide | No hearing required; case resolved on the papers and dismissed |
| Temporal relationship between vaccination and onset | Petitioner asserted onset after vaccination (parental statements suggesting decline) | Respondent noted lack of contemporaneous medical evidence of onset within an acceptable timeframe | Held temporal gap (first documented concerns ~4–6 months post‑vaccine; evaluations later) insufficient to establish medically‑acceptable proximate temporal relationship |
| Whether petitioner distinguished this case from prior OAP decisions | Petitioner relied on general vaccine‑autism literature and conspiracy assertions | Respondent relied on extensive precedent rejecting MMR/autism theories from OAP | Held petitioner failed to distinguish facts/theory from prior adverse decisions; theory considered unreliable |
Key Cases Cited
- Moberly v. Sec'y of Health & Human Servs., 592 F.3d 1315 (Fed. Cir. 2010) (preponderance standard and but‑for/substantial factor causation principles)
- Capizzano v. Sec'y of Health & Human Servs., 440 F.3d 1317 (Fed. Cir. 2006) (importance of medical records and treating‑physician evidence)
- Althen v. Sec'y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (three‑prong test for causation‑in‑fact in Vaccine Program)
- Andreu v. Sec'y of Health & Human Servs., 569 F.3d 1367 (Fed. Cir. 2009) (standard for Athen prong one plausibility and evidentiary perspective)
- Pafford v. Sec'y of Health & Human Servs., 451 F.3d 1352 (Fed. Cir. 2006) (Athen prong one requirement that vaccine be a substantial factor)
- Bunting v. Sec'y of Health & Human Servs., 931 F.2d 867 (Fed. Cir. 1991) (medical certainty not required)
- Cedillo v. Sec'y of Health & Human Servs., 617 F.3d 1328 (Fed. Cir. 2010) (affirming rejection of MMR‑autism causation theory in OAP)