Porter v. Secretary of Health and Human Services
663 F.3d 1242
| Fed. Cir. | 2011Background
- Ms. Porter and Ms. Rotoli filed Vaccine Act petitions alleging hepatitis B vaccine caused autoimmune hepatitis (AIH).
- Porter received three hepatitis B vaccine doses in 1992–1993; post-vaccination liver enzymes elevated and AIH diagnosed in 1993–1995.
- Rotoli received five hepatitis B vaccine doses between 1994–1995; later AIH diagnosed with fibrosis on biopsy in 1995.
- Special Master denied both petitions, finding no causation and, for Porter, also concluding minocycline was a more likely cause.
- Claims Court reversed, applying Andreu, and awarded compensation based on credibility findings; government appealed.
- Federal Circuit reverses Claims Court, affirming the Special Master’s determinations and remanding to deny recovery for both petitioners.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Claims Court erred by wholesale invalidation of facts based on credibility | Porter contends Andreu/Moberly permit credibility assessments by the Special Master but not to immunize errors. | Porter argues credibility findings are proper if grounded in record evidence and not the sole basis for reversal. | Legal error to set aside all findings for credibility-based reasons. |
| Whether Althen three-prong test was correctly applied to off-Table AIH | Porter shows medical theory linked to AIH and proximate temporal relation within medically acceptable window. | Government contends the theories are insufficient and rely on credibility/other flaws. | Special Master’s rejection based on improper reasoning was erroneous; causation satisfied. |
| Whether minocycline as an alternate cause was properly evaluated | Government failed to carry burden to negate alternative cause; Porter argues misapplication of burden and reliance on demeanor. | Special Master properly considered minocycline as an alternate cause based on record. | Porter’s alternative-cause analysis flawed; need to reassess burden and evidence. |
| Whether the temporal relationship requirement was applied correctly | Exact onset date is impracticable; medical timeframe acceptable; Dr. Bellanti’s testimony supports timing. | Special Master correctly demanded a precise onset date for establishing interval. | The requirement of a precise onset date was improper; medically acceptable timeframe suffices. |
Key Cases Cited
- Andreu v. Sec'y of Health & Human Servs., 569 F.3d 1367 (Fed. Cir. 2009) (credibility determinations cannot mask legal errors; causation framework remains)
- Moberly v. Sec'y of Health & Human Servs., 592 F.3d 1315 (Fed. Cir. 2010) (special masters may assess reliability of expert testimony; credibility context is appropriate)
- Broekelschen v. Sec'y of Health & Human Servs., 618 F.3d 1339 (Fed. Cir. 2010) (expert testimony importance; demeanor findings are generally not dispositive)
- Lombardi v. Sec'y of Health & Human Servs., 656 F.3d 1343 (Fed. Cir. 2011) (deferential review of special master factual findings)
- Doe v. Sec'y of Health & Human Servs., 601 F.3d 1349 (Fed. Cir. 2010) (credibility findings and evidence evaluation under Vaccine Act)
- Capizzano v. Sec'y of Health & Human Servs., 440 F.3d 1317 (Fed. Cir. 2006) (epidemiologic proof not required; causation by plausible theory permitted)