W.C. v. Secretary of Health & Human Services
2013 U.S. App. LEXIS 1069
| Fed. Cir. | 2013Background
- Petitioner W.C. claimed his influenza vaccination on 12/13/2004 caused or significantly aggravated preexisting, subclinical multiple sclerosis (MS).
- Special master denied compensation; finding MS predated vaccination and vaccine could not have caused the disease or its significant aggravation.
- Court of Federal Claims affirmed; this court reviews for arbitrariness or capriciousness under the Vaccine Act framework.
- MS described as an autoimmune CNS disease with relapsing-remitting course and MRI-evident lesions; causation analysis relies on Althen prongs for off-table claims.
- Off-table burden requires proof of causation by preponderance, including medical theory, logical sequence, and proximate temporal relationship per Althen and Loving framework.
- Petitioner preserved alternative theory that vaccination significantly aggravated preexisting MS, analyzed under Loving framework.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether vaccine caused MS onset | Petitioner relies on molecular mimicry between flu vaccine and myelin basic protein. | MS preexisted vaccine, making causation unlikely; timing and MRI data undermine causation. | No; Althen prongs not satisfied; vaccine did not cause onset given preexisting MS. |
| Whether vaccine significantly aggravated preexisting MS | Under Loving, vaccination could cause significant aggravation if medical theory links vaccine to worsening. | Loving framework requires proof of causation with a medical theory; evidence insufficient. | No; evidence failed to show vaccine-induced significant aggravation by preponderance. |
| Whether the Althen causation analysis could be bypassed by the special master | Special master used preliminary MS diagnosis to bypass Althen analysis. | Broekelschen supports pre-ALthen preliminary issue; harmless error. | Harmless error; nonetheless, Althen analysis was properly applicable and not satisfied. |
| Whether the court correctly applied Loving/Whitecotton framework for off-table aggravation | Whitecotton framework should govern off-table aggravation analysis. | Loving framework governs off-table aggravation; requires a medical theory and causation chain. | Court affirmed denial; Loving framework rightly applied. |
Key Cases Cited
- Althen v. Sec’y of Health & Human Servs., 418 F.3d 1274 (Fed.Cir.2005) (three-prong test for off-table causation)
- Moberly v. Sec’y of Health & Human Servs., 592 F.3d 1315 (Fed.Cir.2010) (preponderance standard for causation)
- Whitecotton v. Sec’y of Health & Human Servs., 81 F.3d 1099 (Fed.Cir.1996) (four-factor approach to significant aggravation)
- Loving v. Sec’y of Health & Human Servs., 86 Fed.Cl. 135 (Fed.Cl.2009) (six-factor Loving framework for off-table aggravation)
- Broekelschen v. Secretary of Health & Human Servs., 618 F.3d 1339 (Fed.Cir.2010) (preliminary diagnosis issue; requires context-specific analysis)
- Lampe v. Sec’y of Health & Human Servs., 219 F.3d 1357 (Fed.Cir.2000) (arbitrary and capricious standard of review)
- Pafford v. Sec’y of Health & Human Servs., 451 F.3d 1352 (Fed.Cir.2006) (not in accordance with law standard of review)