Pafford v. Secretary Of Health And Human Services

451 F.3d 1352 (Fed. Cir. 2006)

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Nature of the Case

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Facts

On March 24, P received a series of vaccinations for DTaP, a fourth OPV, and a second MMR. P had developed a faint maculopapular rash approximately seventeen days after receiving her third DTP and OPV vaccinations and her first MMR vaccination. Two weeks prior to March 24, she was seen for inflamed tonsils with white patches on them and a fever of 101-102 degrees Fahrenheit. She tested negative for strep. On March 24, it was noted that the tonsillitis had cleared. On April 4, she developed a fever and complained of neck pain. The fever resolved itself, but the neck pain continued. By April 7, she had developed a diffuse, pink, macular rash, whitish spots on her tongue and complained of limb pain. She was diagnosed with a vaccine-induced rash and recommended that she avoid exposure to others for five days. On April 13, she was taken to a local hospital emergency room with a fever, vomiting, pain on being touched and a rash on her hands, legs, chest, and upper abdominal area. A doctor noted that 'the rash was very viral in character and I did not feel it was related to her immunizations but suggested a CBC to see if it supported the viral picture.' She tested positive for a bacterial infection known as 'mycoplasma' which was determined to be the cause of her symptoms. She was released, and on April 20 there was a recurrence of her symptoms. She was diagnosed with systemic onset Juvenile Rheumatoid Arthritis, also known as Still's disease. P sued under the National Childhood Vaccine Injury Act, 42 U.S.C. §§ 300aa-1 to 34, in the Court of Federal, Claims alleging that the vaccinations on March 24 were the cause. A special master denied her claims. The special master determined that a vaccine can cause Still's disease but that P had not sufficiently demonstrated that in her case the vaccine did cause the development of Still's disease. The Court of Federal Claims Judge issued an opinion sustaining the Special master's decision. P filed a motion for reconsideration alleging 'legal error with regard to standards of proof and the allocation of burdens' which was denied on March 8, 2005. This appeal resulted.