Thompson v. Secretary of Health and Human Services
15-1498
Fed. Cl.Jul 10, 2017Background
- Petitioners Candace Thompson and Stephen Powell filed under the National Vaccine Injury Compensation Program on behalf of their son A.H.P., alleging that vaccines given on December 11, 2012 (including DTaP, Hib, IPV, PCV, rotavirus) caused an acute/table encephalopathy or an encephalopathy that led to autism spectrum disorder (ASD).
- A.H.P. visited the ER the night of vaccination with fever and irritability and tested positive for influenza B; he improved within hours and was discharged the same night. No persistent altered consciousness consistent with a Table acute encephalopathy is documented.
- Contemporaneous pediatric records show no developmental concerns until roughly eight months after vaccination (fall 2013 onward), when speech delay and failed autism screening were documented; later evaluations diagnosed ASD and identified a NRXN1 interstitial deletion associated with neurodevelopmental disorders.
- Respondent moved to dismiss for lack of evidence of a Table encephalopathy and for failure to establish causation-in-fact; Petitioners relied largely on parental reports and sought time to pursue mitochondrial testing and expert opinions.
- Special Master Corcoran decided the case on the papers, concluding that the record lacks preponderant evidence of either a Table encephalopathy or a causal link between the vaccines and ASD, and dismissed the petition.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether A.H.P. suffered a Table acute encephalopathy after Dec. 11, 2012 vaccinations | Vaccination produced immediate post‑vaccine illness and parental observations show earlier neurologic/regressive signs | Records show rapid recovery in hours, no 24‑hour decreased consciousness or hospitalization required by Table QAI | Denied — record does not meet Table encephalopathy criteria; dismissal granted |
| Whether vaccines were a cause‑in‑fact of A.H.P.’s encephalopathy/ASD (Althen causation) | Vaccines (esp. DTaP) initiated an encephalopathic event that later produced ASD; parental reports and pending mitochondrial testing could support causation | No reliable medical theory tied to the facts; temporal gap (~8 months) too long; alternative genetic explanations (NRXN1) more likely | Denied — Althen prongs not satisfied given lack of proximate temporal relationship, factual predicate, and reliable theory |
| Weight to give contemporaneous medical records vs. later parental testimony | Parents argue they reported early regression to providers that was not recorded; affidavits would fill evidentiary gaps | Contemporaneous records are reliable and show no early regression; oral testimony conflicts with records and is less persuasive absent compelling corroboration | Held for records — contemporaneous medical evidence controls; parental after‑the‑fact assertions insufficient to overcome records |
| Whether the case should proceed to hearing or additional discovery (e.g., mitochondrial testing) | Petitioners requested time to obtain mitochondrial testing and expert reports to develop causation theory | Respondent opposed delay because the existing record is insufficient and further expert evidence would not cure foundational factual defects | Denied — no hearing or further delay; additional expert opinions would lack a reliable factual predicate and would not change outcome |
Key Cases Cited
- Moberly v. Sec’y of Health & Human Servs., 592 F.3d 1315 (Fed. Cir. 2010) (explains burden and causation standards in Vaccine Program)
- Capizzano v. Sec’y of Health & Human Servs., 440 F.3d 1317 (Fed. Cir. 2006) (treating-physician opinions and reliance on medical records discussed)
- Althen v. Sec’y of Health & Human Servs., 418 F.3d 1274 (Fed. Cir. 2005) (established three‑prong test for causation‑in‑fact in vaccine cases)
- Andreu v. Sec’y of Health & Human Servs., 569 F.3d 1367 (Fed. Cir. 2009) (addresses the evidentiary standard for medical theory under Althen prong one)
- Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525 (Fed. Cir. 1993) (contemporaneous medical records are accorded substantial weight)
- Paluck v. Sec’y of Health & Human Servs., 786 F.3d 1373 (Fed. Cir. 2015) (rare Federal Circuit affirmance involving vaccine aggravation of a documented mitochondrial disorder)