Rickett v. Secretary of Health & Human Services
468 F. App'x 952
Fed. Cir.2011Background
- Rickett, with FM family history, received three Hepatitis B vaccines (Mar 10, 1998; Apr 8, 1998; Sept 22, 1998) and later claimed FM symptoms were vaccine-caused.
- Post-first vaccine, Rickett alleged persistent diarrhea; expert linked to IBS but no IBS diagnosis or medical visit until Mar 9, 1999.
- Second vaccine allegedly preceded arm/shoulder pain; medical records show right/left pain timing may predate the second vaccination, with full ROM and no focal tenderness.
- Rickett later reported widespread pain, diarrhea, sleep problems, and headaches; treating physicians were inconclusive about a vaccine-FM link.
- Special Master denied in 2010, finding no Althen causation-in-fact due to lack of a consistent temporal relationship and unreliable challenge-rechallenge theory.
- Judge Miller affirmed in 2010, noting inconsistencies between records and affidavit/testimony, and that Lee-based reasoning did not control this case.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Reliance on records vs. testimony | Rickett argues records should not be outweighed by his testimony. | Government argues records are more trustworthy when inconsistent with testimony. | Eso held that records can justify weight over conflicting testimony. |
| Effect of inconsistency on Bellanti's testimony | Rickett contends Bellanti’s challenge-rechallenge opinion is valid despite reliance on his testimony. | Government argues inconsistent testimony undermines Bellanti’s causal theory. | Special Master’s discounting of Bellanti’s testimony was permissible given inconsistencies. |
| Lee theory applicability to this case | Rickett claims a medical theory analogous to Lee should apply. | Government contends Lee is distinguishable and not controlling here. | Lee is distinguishable; theory not controlling in Rickett’s case. |
| Causation-in-fact under Althen prongs | Rickett asserts a causal link via a medical theory, a logical sequence, and proper temporal relationship. | Government contends the evidence fails to satisfy all Althen prongs, especially timing. | Rickett failed to meet Althen Prong Three; overall causation-in-fact not established. |
Key Cases Cited
- Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525 (Fed. Cir. 1993) (medical records determine onset; avoid unsubstantiated petitioner testimony)
- Althen v. Sec’y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (establishes three-prong causation-in-fact standard)
- Capizzano v. Sec’y of Health & Human Servs., 440 F.3d 1317 (Fed. Cir. 2006) (not requiring epidemiology or absolute certainty to prove causation)
- Knudsen v. Sec’y of Health & Human Servs., 35 F.3d 543 (Fed. Cir. 1994) (causation in the Vaccine Act can be demonstrated with circumstantial evidence)