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Vaccines are overwhelmingly safe, but in a few very rare instances, they can have unintended side effects. The National Vaccine Injury Act of 1986 provides a federal cause of action for parents whose children have been injured by vaccines.
The Paluck family sued the Secretary of Health and Human Services for compensation over a claim that an MMR vaccine caused infant K.P. to lapse into a "severe neurological disability." After the case bounced around the court system for a bit, the Court of Federal Claims vacated a special master's determination that K.P.'s deterioration wasn't caused by the vaccination. The Federal Circuit affirmed.
The infant in this case, K.P., was born in 2004. A year later, doctors noticed abnormal muscle tone and an abnormal reflex in his ankle. Cognitively, he was normal, but he couldn't sit or stand by himself. At this same appointment, he was given the MMR vaccine. In the weeks afterward, he developed a fever and became fussy. As the months went on, he gradually lost what language skills he had. K.P. was eventually diagnosed with an unspecified mitochondrial disorder.
His parents disagreed; they claimed his degeneration was the result of his vaccination. A special master didn't think so, however, finding that "K.P.'s neurological symptoms emerged too late to be causally linked to the vaccinations he received." In the special master's opinion, any symptoms that would result from the vaccine would happen in two weeks. The Court of Federal Claims reversed here, finding the limit arbitrary and capricious.
The special master got another shot at the case, saying on remand that K.P.'s illness didn't progress as the Palucks' experts said it would, so the vaccine couldn't be the cause of the degeneration. The Court of Federal Claims again reversed, finding that the Palucks had presented a plausible claim for causation.
Special Master, You So Crazy
The Palucks didn't deny that K.P. had a mitochondrial disorder, but contended that the MMR vaccine aggravated that existing condition. The Federal Circuit concluded that the Court of Federal Claims didn't abuse its discretion in setting aside the special master's findings. In particular, the court noted that the special master had misunderstood the Palucks' theory of causation, misconstrued the medical records, and made factual references unsupported by the record.
The special master said the progression of K.P.'s illness wasn't "linear," which appears to mean that it didn't comport exactly with the expert's model. That didn't make much sense to the Federal Circuit, given that "nothing in [the expert's] testimony mandated a 'linear' deterioration with no instances of slight or temporary improvement in symptoms."
Agreeing with the Court of Federal Claims that the special master's conclusions were unsupported, the Federal Circuit upheld the judgment that the master's findings should be set aside.