Snyder v. Secretary of Health & Human Services
102 Fed. Cl. 305
Fed. Cl.2011Background
- N.S. developed SMEI epilepsy beginning in 2005 after DTaP vaccinations and later was found to have a SCN1A gene mutation.
- Petitioners allege the DTaP vaccine contributed to N.S.’s seizures and developmental delay; government asserts SMEI was caused solely by SCN1A mutation.
- Special Master Moran denied compensation in Snyder v. Sec’y of HHS, No. 07-59V, 2011 WL 3022544 (Spec.Mstr.Fed.Cl. July 21, 2011).
- Petitioners’ experts argued gene-environment interaction between SCN1A mutation and pertussis component of DTaP; government experts argued SMEI is purely genetic.
- Court reverses and remands for compensation and costs, finding the vaccine can be a substantial factor in causation under Althen.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does the DTaP vaccine causally contribute to SMEI with a SCN1A mutation? | Snyder alleges vaccine acts as environmental trigger. | Wiznitzer/Raymond deny vaccine causation, SCN1A mutation sole cause. | Yes; vaccine can be a substantial factor under Althen. |
| Was the SCN1A mutation the sole cause of N.S.’s SMEI, precluding vaccine causation? | Mutations may require environmental trigger; vaccine could influence outcome. | Mutation alone explains SMEI; no vaccine role. | No; government failed to prove SCN1A alone caused SMEI beyond reasonable doubt. |
| Did the Special Master err in evaluating alternate causation under §300aa-13(a)(1)(B)? | Alternatives insufficiently proven; causal links need not be scientifically certain. | Alternative causes proven, negating vaccine causation. | Yes; reversal for proper application of Althen and Knudsen standards. |
| Did the court apply the correct standard of proof for causation-in-fact under Althen? | Medical literature not required to prove causation to certainty. | Need for stronger epidemiological certainty. | Yes; preponderance standard suffices, and the evidence supports vaccine as a substantial factor. |
| Should the case be remanded for an award of compensation and costs? | Remand appropriate if causation-in-fact is proven. | If no causation, no compensation. | Remanded; petitioners entitled to compensation and costs. |
Key Cases Cited
- Althen v. Sec'y of HHS, 418 F.3d 1274 (Fed. Cir. 2005) (three-part causation test for vaccine-injury claims; preponderance suffices)
- Capizzano v. Sec'y of HHS, 440 F.3d 1317 (Fed. Cir. 2006) (causation need not be scientifically certain; substantial factor standard)
- Knudsen ex rel. Knudsen v. Sec’y of HHS, 35 F.3d 543 (Fed. Cir. 1994) (heavy burden on government to prove alternative causation when causation-in-fact shown)
- Andreu v. Sec’y of HHS, 569 F.3d 1367 (Fed. Cir. 2009) (rejects requiring epidemiologic certainty; supports preponderance standard)
- Loving v. Sec’y of HHS, 86 Fed.Cl. 135 (Fed. Cl. 2009) (remand/standardized approach to significant aggravation analysis in vaccine cases)