P.H. v. Secretary of Health and Human Services
14-1112
Fed. Cl.Aug 22, 2017Background
- Petitioner Ashley Puroll filed a Vaccine Act claim on behalf of her son P.H., alleging rotavirus vaccine (Aug. 12, 2014) caused intussusception requiring surgery.
- P.H. underwent three abdominal surgeries from Aug. 2014–Oct. 2015 (resections totaling ~20 cm in the records), had postoperative C. difficile infection, chronic diarrhea, diaper dermatitis, and iron‑deficiency anemia requiring treatment and testing through 2017.
- Respondent conceded entitlement in a Rule 4 report; initial damages decision was issued, then withdrawn after respondent moved for reconsideration on procedural/discounting grounds.
- Parties briefed damages. Petitioner sought $250,000 (past pain and suffering) and $140,000 (projected); respondent proposed $100,000 total. Medicaid liens were quantified and claimed.
- The special master found P.H.’s course—multiple surgeries, infection, ongoing diarrhea and complications—warranted the Vaccine Program maximum for actual pain and suffering and awarded the statutory cap plus Medicaid lien satisfaction.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Entitlement to compensation | Vaccine caused intussusception and surgical complications; respondent conceded causation | Respondent conceded causation (no dispute) | Entitlement conceded and confirmed by the special master |
| Amount for past (actual) pain & suffering | Seek $250,000 (statutory cap) given multiple surgeries, infection, chronic sequelae | Opposed large award; proposed much lower total ($100,000) | Awarded maximum $250,000 for actual pain and suffering given severity, recurrence, and ongoing complications |
| Calculation for future (projected) pain & suffering and cap application | If future award needed, petitioner requested little discount (1%) or increase in past award to cap | Respondent argued statutory cap must be applied before discounting and future award should be discounted at 2% | Because past award reached the $250,000 statutory cap, future pain & suffering need not be considered; prior decision withdrawn and cap applied first |
| Medicaid lien satisfaction | Requested payment to satisfy identified Michigan Medicaid liens | Respondent did not contest lien satisfaction amounts | Special master awarded specified lump sums to satisfy parts of the State of Michigan Medicaid liens as listed in the decision |
Key Cases Cited
- Youngblood v. Secretary of Health & Human Services, 32 F.3d 552 (Fed. Cir.) (addresses application of statutory cap and net present value in Vaccine Program awards)
- Cloer v. Secretary of Health & Human Services, 654 F.3d 1322 (Fed. Cir.) (describes Vaccine Program goals of relative certainty and generosity in compensation)
- Bruesewitz v. Wyeth LLC, 131 S. Ct. 1068 (U.S.) (quoted for background on the Vaccine Program’s compensatory purpose)