Stone v. Secretary of the Department of Health & Human Services
99 Fed. Cl. 187
Fed. Cl.2011Background
- Amelia Stone, born April 17, 2001, received a DTaP vaccination on August 27, 2001 and soon after suffered two severe seizures.
- Amelia was diagnosed with SMEI/Dravet Syndrome linked to an SCN1A gene mutation.
- Petitioners sought compensation under the Vaccine Act; respondent relied on Dr. Raymond’s testimony that the SCN1A mutation caused SMEI.
- The Special Master initially denied compensation; this Court reversed for misapplied causation standard; on remand, the Special Master denied compensation again.
- The Court reviews legal questions de novo and factual findings for arbitrariness or capriciousness, with credibility determinations of experts largely unreviewable.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| SCN1A mutation as sole substantial cause | Stone contends SCN1A is not the sole cause or may not fully explain SMEI | Stone argues SCN1A mutation is the sole cause; vaccine not causal | SCN1A mutation found to be sole substantial cause |
| DTaP vaccine as substantial cause | Stone argues vaccine contributed to SMEI | Government argues no substantial vaccine-related cause | DTaP not a substantial cause of Amelia’s SMEI |
| Initial vaccine-induced seizures causing brain damage | Initial seizures caused brain damage warranting compensation | No evidence initial seizures damaged the brain | No evidence initial seizures caused brain damage |
| Proper application of legal standards on remand | Special Master misapplied standards or burden | Standards applied correctly on remand | Special Master’s application of standards affirmed |
Key Cases Cited
- Broekelschen v. Sec’y of Health & Human Servs., 618 F.3d 1339 (Fed.Cir. 2010) (de novo review for questions of law; uphold findings of fact unless arbitrary or capricious)
- Cedillo v. Sec’y of Health & Human Servs., 617 F.3d 1328 (Fed.Cir. 2010) (upholds special master findings under Vaccine Act causation standards)
- Lampe v. Sec’y of Health & Human Servs., 219 F.3d 1357 (Fed.Cir. 2000) (credibility of expert testimony largely unchallengeable on appeal)
- Munn v. Sec’y of Health & Human Servs., 970 F.2d 863 (Fed.Cir. 1992) (discusses standard for evaluating evidence and credibility)
- SEB S.A. v. Montgomery Ward & Co., Inc., 594 F.3d 1360 (Fed.Cir. 2010) (wide latitude in admitting expert testimony; relation of expertise to issues)
- de Bazan v. Sec’y of Health & Human Servs., 539 F.3d 1347 (Fed.Cir. 2008) (uncertainty and causation standard in vaccine cases)