In the United States Court of Federal Claims
ARTHUR CONTRERAS,
Petitioner, No. 19-vv-0491
v. Filed Under Seal: March 10, 2022
SECRETARY OF HEALTH Publication: May 19, 2022 1 AND HUMAN SERVICES,
Respondent.
Paul Adrian Green, Law Office of Paul Green, Pasadena, California for Petitioner.
Mary E. Holmes, United States Department of Justice, Civil Division, Torts Branch, Washington, D.C. for Respondent. With her on the briefs are Lara A. Englund, Assistant Director, Civil Division, Torts Branch; Heather L. Pearlman, Deputy Director, Civil Division, Torts Branch; C. Salvatore D’Alessio, Acting Director, Civil Division, Torts Branch; Brian M. Boynton, Acting Assistant Attorney General, United States Department of Justice, Washington, District of Columbia.
MEMORANDUM AND ORDER
On April 2, 2019, Petitioner Arthur Contreras (Petitioner) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986 (Vaccine Act or Act), alleging that the
Shingrix and Pneumococcal conjugate (PCV-13) 2 vaccines injured him. Petition for Vaccine
Compensation (ECF No. 1) (Pet.). After Respondent, the Secretary of the U.S. Department of
Health and Human Services (Respondent), filed a Rule 4(c) Report explaining that none of
1 This Memorandum and Order was filed under seal in accordance with Vaccine Rule 18(b), and the parties were afforded 14 days to propose redactions. As the parties did not propose any redactions, this Court is publicly reissuing this Memorandum and Order. The sealed and public versions of this Memorandum and Order are otherwise identical, except for the publication date and this footnote. 2 Petitioner refers to the vaccine as “Pneumvax” in his Petition. Pet. at 1; see infra at 3-4. Petitioner’s alleged injuries were included on the Vaccine Injury Table, Petitioner filed a Motion
to Dismiss (ECF No. 18) his petition, which the Special Master granted. See Decision Dismissing
Petition (ECF No. 19). Subsequently, Petitioner filed a motion seeking attorneys’ fees and costs,
which the Special Master granted in part. See Petitioner’s Motion for Attorney Fees and Costs
(ECF No. 22); Decision on Final Attorneys’ Fees and Costs (ECF No. 25) (Decision on Fees).
Pending before the Court is Respondent’s Motion for Review of the Special Master’s
decision awarding Petitioner attorneys’ fees and costs. Respondent’s Motion for Review (ECF
No. 27) (Mot.). Respondent contends that the Special Master erred in awarding any attorneys’
fees and costs in this action. See id. Specifically, Respondent argues that the Special Master
abused her discretion by (1) determining that Petitioner had a reasonable basis to claim that the
PCV-13 vaccine caused his injury, and (2) failing to address whether Petitioner had a reasonable
basis for alleging his injuries lasted more than six months, as required when considering an award
of attorneys’ fees and costs. See Respondent’s Memorandum in Support of Motion for Review
(ECF No. 28) (Resp. Mem.). Accordingly, Respondent urges this Court to vacate the Special
Master’s decision and deny Petitioner’s motion for attorneys’ fees and costs. See id. For the
reasons explained below, Respondent’s Motion for Review (ECF No. 27) is GRANTED.
BACKGROUND
I. Petitioner’s Medical History
On September 7, 2018, Petitioner received the Shingrix vaccine in his left arm and the
PCV-13 vaccine in his right arm. Exhibit 2 to Petitioner’s Petition for Vaccine Compensation
(ECF No. 1-3) (Pet. Ex. 2) at 49. Two days later, Petitioner visited an urgent care center
complaining of “middle back pain after [the] shingles vaccine.” Id. at 2. Specifically, he
complained of “sharp needle” pain on the left side of his back and under the shoulder blade. Id.
2 The nurse practitioner who examined him noted he had a “macularpapular [sic] rash [on his] left
shoulder blade around [the] T7 region with one closed vesicle,” and that he experienced tenderness
in the affected area. Id. at 5. The nurse practitioner, Theresa Anderson, diagnosed Petitioner with
acute thoracic back pain and a “shingles outbreak.” Id. Given the timing of Petitioner’s vaccines
and the onset of his symptoms, she instructed Petitioner to follow up with his primary care
physician “and let them know about shingle outbreak after vaccine.” Id. at 10.
Petitioner followed the nurse practitioner’s advice and visited his primary care physician,
Dr. Tejas Patel, on September 11, 2018. Id. at 60-62. Petitioner complained that he had a “[r]ed
rash on [the] back and stomach [] over the weekend,” and he explained that after receiving his
vaccines he “began to have abdo[minal] pain, and a rash broke out.” Id. at 60-61. Dr. Patel
diagnosed him with herpes zoster (shingles) and prescribed him “Valtrex for 7 [days].” Id. at 61.
Petitioner made several follow-up visits to Dr. Patel over the next three months. On a
September 19, 2018 visit he reported suffering “severe pain,” especially at night, and “tingling
burning stabbing pain.” Id. at 59. Dr. Patel diagnosed Petitioner with post-herpetic neuritis and
did not note anything about Petitioner’s skin. Id. at 58-59. Petitioner again visited Dr. Patel on
October 3, 2018, and reported swelling on the left side of his abdomen. Id. at 55-57. Dr. Patel
maintained his diagnosis of postherpetic neuritis and prescribed additional pain medication. Id. at
57. Two weeks later, on October 17, 2018, Petitioner followed up with Dr. Patel complaining
about abdominal pain. Id. at 53-55. Dr. Patel noted a rash on Petitioner’s back, wrapping around
to his upper abdomen, that was healing. Id. at 55. Petitioner had another follow-up appointment
with Dr. Patel on November 9, 2018. Id. at 51. Petitioner received additional pain medication,
but Dr. Patel’s notes do not mention the status of Petitioner’s rash. Id. at 51-53. Finally, Petitioner
3 visited Dr. Patel on December 4, 2018, when Dr. Patel again noted post-herpetic neuritis but did
not document the status of Petitioner’s rash. Id. at 49-51.
After the December visit with Dr. Patel, Petitioner visited a neurologist, Dr. Ahed Hanna,
for evaluation of his post-herpetic neuritis. 3 See Exhibit 3 to Petitioner’s Petition for Vaccine
Compensation (ECF No. 1-4) (Pet. Ex. 3) at 5-6. Dr. Hanna’s notes from that January 2, 2019
visit document the onset of Petitioner’s “blisters and rash” that developed on the left side of his
abdomen along with “severe pain.” Id. at 5. Dr. Hanna notes that these symptoms developed after
Petitioner received “the zoster vaccine,” which is Shingrix; Dr. Patel’s notes do not mention the
PCV-13 vaccine. Id. Dr. Hanna further noted at that visit that Petitioner’s “rash has resolved but
he has scarring.” Id. Further, Petitioner was still experiencing “numbness, tingling and burning
on his side.” Id. Petitioner followed up with Dr. Hanna about postherpetic neuritis on January 7,
2019, and again on March 14, 2019, but Dr. Hanna’s notes do not document the status of
Petitioner’s scarring. Id. at 1-4. The medical records before the Special Master do not extend
beyond March 2019. See generally, Pet. Ex. 2; Pet. Ex. 3.
II. Procedural History
On April 2, 2019, Petitioner filed a claim for compensation under the Vaccine Act. See
Pet. He alleged that “concurrent Shingrix and Pneumvax vaccinations” caused several “injuries,
including shingles, maculopapular rash left shoulder, post-herpetic neuritis, and other postherpetic
nervous system involvement.” Id. at 1. While the Petition mistakenly referenced Pneumvax,
Petitioner’s medical records reflect that he received the PCV-13 vaccine, and there is no dispute
about which vaccines Petitioner received. Pet. at 1; Pet. Ex. 2 at 49. To support his claim,
3 Petitioner’s neurologist refers to this condition as “postherpetic neuralgia.” See, e.g., Pet. Ex. 3 at 1.
4 Petitioner attached his medical records and an affidavit to his Petition. See Pet. Ex. 2, Pet. Ex.3,
Pet. Ex. 4 (ECF No. 1-5). Although Shingrix is not eligible for compensation under the Vaccine
Act, PCV-13 is a vaccine covered by the Act. See Resp. Rule 4(c) Report (ECF No. 16) at 1 n.1.
On May 4, 2020, Respondent filed a Rule 4(c) report, contending that compensation would
be inappropriate in Petitioner’s case. Resp. Rule 4(c) Report at 2. Respondent argued that none
of Petitioner’s alleged injuries were included on the vaccine injury table for PCV-13, meaning that
Petitioner “is not entitled to a presumption of vaccine causation.” Id. at 5. Respondent also
asserted that Petitioner could not prove causation-in-fact because “Petitioner has not offered a
reputable scientific or medical theory establishing that PCV-13 can cause ‘shingles, maculopapular
rash left shoulder, post-herpetic neuritis, and other postherpetic nervous system involvement’
(general causation) or that it did so in his case.” Id. Accordingly, Respondent argued that
Petitioner failed to meet “his prima facie burden to show causation-in-fact, and this case should
be dismissed.” Id. at 7.
On July 6, 2020, Petitioner filed a status report responding to the government’s Rule 4(c)
report conceding “that the Shingrix vaccination that he received in his left arm is not a covered
vaccine under the National Vaccine Injury Compensation Program.” Petitioner’s Status Report
(ECF No. 17) at 1. Petitioner explained that while he believed he had a reasonable basis to file his
Petition because he suffered some of the adverse symptoms outlined in the PCV-13 package insert,
including “[r]edness, swelling, pain, or tenderness . . . and . . . as with any medicine, there is a very
remote chance of a vaccine causing severe allergic reaction, other serious injury, or death,” he
preferred “not to incur the cost of an expert to support his Petition by establishing causation in
5 fact / exacerbation.” Id. at 2 (quoting ECF No. 17-1). Thus, Petitioner conceded that “his case
should be dismissed.” Id.
Accordingly, on July 9, 2020, Petitioner filed a motion requesting the Special Master
dismiss his case. See Motion for a Decision Dismissing Petition (ECF No. 18). In that motion,
Petitioner conceded that “[a]n investigation of the facts and science supporting his case has
demonstrated . . . that he will be unable to prove that he is entitled to compensation in the Vaccine
Program.” Id. at 1. On July 10, 2020, the Special Master granted Petitioner’s motion and
dismissed the action. See Decision Dismissing Petition (ECF No. 19).
Following dismissal of his Petition, Petitioner filed a motion for attorneys’ fees and costs.
See Petitioner’s Motion for Attorney Fees and Costs (ECF No. 22). Petitioner alleged that he was
entitled to such fees and costs because he filed his Petition in good faith and with a reasonable
basis. See id. at 3-5. Specifically, Petitioner pointed to a PCV-13 vaccine information statement
(VIS) 4 – commonly referenced as a “package insert” – introduced for the first time along with his
motion for costs and attorneys’ fees, as providing a reasonable basis for his claim. Id. at 5; ECF
No. 17-1. Petitioner contended that a reasonable basis for an award of fees and costs existed
because the PCV-13 vaccine package insert listed “rash” as a potential “adverse reaction,” and
“[t]he injuries alleged in this case are shingles, a maculopapular rash on Petitioner’s left shoulder,
4 The National Vaccine Childhood Injury Act requires all vaccine providers to give the appropriate VIS to the patient, or legal guardian, prior to administering a dose of specific vaccines. 42 U.S.C. § 300aa-26. A VIS must include a description of the vaccine’s benefits, a description of the vaccine’s associated risks, and a statement about the availability of the National Vaccine Injury Compensation Program. Id.
6 post-herpetic neuritis, and other postherpetic nervous system involvement.” Id. at 4-5; Exhibit C
(ECF No. 22-4) at 1.
The Special Master granted in part Petitioner’s motion for attorneys’ fees and costs over
the Respondent’s objections. See Decision on Fees at 1-2. First, the Special Master held that
Petitioner brought his claim in good faith. See id. at 7. Second, the Special Master held that
although “[t]he filings in this case are minimal,” they “include enough evidence to establish [a]
reasonable basis” for Petitioner’s claim. Id. Accordingly, the Special Master held that Petitioner
was entitled to certain attorneys’ fees and costs but did not grant Petitioner the full amount of
requested fees. See id. at 8-10. While the Petitioner requested $18,540.00 in costs and fees, the
Special Master awarded $16,269.00, as Petitioner’s counsel billed time attributable to learning
about the Vaccine Program, which is normally considered non-compensable time. Id. at 8.
The Special Master’s decision relied principally on two points: that (1) “Petitioner
developed a rash after receiving vaccinations on September 7, 2018,” and (2) “[t]he PCV-13
vaccine package insert states that a rash can be an adverse reaction after vaccination.” Id. The
Special Master dismissed the medical records’ attribution of Petitioner’s rash to shingles because
“the package insert does not limit rash development to one that is unassociated with a specific
condition.” Id. Additionally, the Special Master held that the urgent care nurse practitioner’s note
in Petitioner’s medical records recommending “that he ‘F/U with [his primary care physician] and
let them know about shingle[s] outbreak after vaccine’ . . . suggests that Petitioner’s urgent care
medical provider questioned the connection between Petitioner’s shingles outbreak and the
vaccines he received.” Id. at 8 (quoting Pet. Ex. 2 at 10). The Special Master concluded that the
urgent care nurse practitioner’s note in his medical records and the PCV-13 package insert
7 “constitutes more than a mere scintilla of evidence in support of the petition.” Decision on Fees
at 8.
On November 1, 2021, Respondent filed the present Motion for Review of the Special
Master’s decision to award costs and attorneys’ fees to Petitioner. Mot. at 1. Petitioner responded
substantively to Respondent’s Motion for Review, and in doing so introduced new evidence,
comprising photos and emails related to Petitioner’s scarring, to buttress his claim that he had a
reasonable basis to file his Petition. See Petitioner’s Memorandum in Opposition to Respondent’s
Motion for Review (ECF No. 30-1) (Pet.’s Mem.); Exhibit D (ECF No. 30-6). Respondent moved
to exclude Petitioner’s new evidence as untimely. See Motion to Exclude Petitioner’s Untimely
Evidence (ECF No. 32). On December 15, 2021, this Court granted Respondent’s motion to
exclude and struck the new evidence pursuant to United States Court of Federal Claims Vaccine
Rule 8(f), as such documents and photos were not part of the record below and were not before
the Special Master when she considered Petitioner’s motion for attorneys’ fees and costs. See
Order Granting Respondent’s Motion to Exclude Petitioner’s Untimely Evidence (ECF No. 35).
Respondent’s Motion for Review is now ripe for consideration.
STANDARD OF REVIEW
This Court has jurisdiction to review a special master’s decision under the Vaccine Act.
See 42 U.S.C. § 300aa-12(e)(1). When reviewing a special master’s decision, this Court may:
(A) uphold the findings of fact and conclusions of law of the special master and sustain the special master’s decision,
(B) set aside any findings of fact or conclusion of law of the special master found to be arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law and issue its own findings of fact and conclusions of law, or
(C) remand the petition to the special master for further action in accordance with the court’s discretion.
8 Id. § 300aa-12(e)(2). On this Court’s review, the arbitrary and capricious standard applies to
factual determinations, the abuse of discretion standard applies to discretionary rulings, and the
“not in accordance with the law” standard applies to legal determinations. Munn v. Sec'y of Dep't
of Health & Hum. Servs., 970 F.2d 863, 874 n.10 (Fed. Cir. 1992).
As special masters have discretion to award attorneys’ fees and costs to an unsuccessful
petitioner, this Court reviews such awards under an abuse of discretion standard. Chuisano v.
United States, 116 Fed. Cl. 276, 283 (2014); see Saxton v. Sec'y Dep't Health & Hum. Servs., 3
F.3d 1517, 1520 (Fed. Cir. 1993) (explaining that “the special master ‘may’ award reasonable fees
and costs if the petition was brought in good faith and upon a reasonable basis; the statute clearly
gives him discretion over whether to make such an award”). This Court may find an abuse of
discretion if “(1) the [special master’s] decision is clearly unreasonable, arbitrary, or fanciful; (2)
the decision is based on an erroneous conclusion of the law; (3) the [special master’s] findings are
clearly erroneous; or (4) the record contains no evidence upon which the [special master] rationally
could have based its decision.” Hendler v. United States, 952 F.2d 1364, 1380 (Fed. Cir. 1991).
DISCUSSION
The Special Master erred in awarding costs and attorneys’ fees without first analyzing
whether Petitioner established that he had a reasonable basis to claim his injury lasted more than
six months. The Vaccine Act grants special masters the discretion to award costs and attorneys’
fees to unsuccessful claimants when the special master “determines that the petition was brought
in good faith and there was a reasonable basis for the claim for which the petition was brought.”
42 U.S.C. § 300aa-15(e)(1). Even where a petitioner has a reasonable basis for his claim and files
his petition in good faith, a special master still retains discretion to deny a request for attorneys’
fees. James-Cornelius v. Sec’y of Health & Human Serv., 984 F.3d 1374, 1379 (Fed. Cir. 2021).
9 This Court “relies on ‘an objective standard determined by the totality of the circumstances,’”
when evaluating whether a petitioner had a “reasonable basis” for his claim. Cottingham v. Sec'y
of Dep't of Health & Hum. Servs., 971 F.3d 1337, 1344 (Fed. Cir. 2020) (quoting Chuisano, 116
Fed. Cl. at 286). “[T]he quantum of objective evidence needed to establish reasonable basis for a
claim . . . is ‘lower than the preponderant evidence standard required to prove entitlement to
compensation,’ but ‘more than a mere scintilla.’” James-Cornelius, 984 F.3d at 1379 (quoting
Cottingham, 971 F.3d at 1346).
It is well-established that a petitioner seeking costs and fees must demonstrate that a
“reasonable basis” existed for each element of his claim. See Cottingham, 971 F.3d at 1345-46;
Goodgame v. Sec'y of Dep't of Health & Hum. Servs., 157 Fed. Cl. 62, 68 (2021) (explaining that
“the Vaccine Act provides specific requirements that are useful in determining whether a petitioner
has established a reasonable basis”). Thus, a petitioner filing a petition under the Vaccine Act
must have a reasonable basis for claiming he:
(1) received a vaccine listed on the Vaccine Injury Table;
(2) received the vaccination in the United States, or under certain stated circumstances outside of the United States;
(3) sustained (or had significantly aggravated) an injury as set forth in the Vaccine Injury Table (42 C.F.R. § 100.3(e)) or that was caused by the vaccine;
(4) experienced the residual effects of the injury for more than six months, died, or required an in-patient hospitalization with surgical intervention; and
(5) has not previously collected an award or settlement of a civil action for damages for the same injury.
Cottingham, 971 F.3d at 1345-466 (citing 42 U.S.C. § 300aa-11(c)(1)).
10 Respondent argues that Petitioner lacked a reasonable basis for elements three and four of
his claim. See Resp. Mem. at 12. Specifically, it argues that the Special Master abused her
discretion by (1) determining that Petitioner had a reasonable basis for his claim that the PCV-13
vaccine caused Petitioner’s rash, and (2) failing to address the statutory requirement mandating
that Petitioner experienced residual effects of his injury for more than six months. Id. Petitioner
argues that (1) the Special Master correctly held that the PCV-13 vaccine package insert, along
with medical records, demonstrated Petitioner’s claim was reasonable, and (2) the Special Master’s
failure to explicitly address the statutory durational requirement was rational “because the medical
records indicate that Petitioner’s rash resulted in residual scarring and, typically, residual scarring
lasts more than six months.” 5 Pet.’s Mem. at 16. This Court agrees with Respondent that the
Special Master erred by failing to address the Act’s durational requirement; namely, whether
Petitioner had a reasonable basis to claim his injury lasted more than six months. See 42 U.S.C. §
300aa-11(c)(1)(D)(i). As this error alone justifies vacatur and remand, the Court need not address
at this time whether Petitioner had a reasonable basis to claim the PCV-13 vaccine caused
his injuries.
The Special Master’s conclusion that “[b]ecause Petitioner’s medical records demonstrate
he developed a rash postvaccination and the PCV-13 vaccine package insert states that a rash can
be an adverse reaction to the vaccine . . . [p]etitioner has establish[ed] a reasonable basis to support
his claim” constitutes an abuse of discretion because it does not address all five statutorily required
elements of Petitioner’s claim for fees and costs. Decision on Fees at 8; see Cottingham, 971 F.3d
5 This is a severity element that may also be satisfied with proof that the petitioner seeking fees (i) died or (ii) required an in-patient hospitalization with surgical intervention. 42 U.S.C. § 300aa- 11(c)(1)(D)(i). However, it is undisputed on the record before this Court that neither of those circumstances are applicable here. The Court accordingly refers to this severity element as a durational requirement.
11 at 1345-466 (citing 42 U.S.C. § 300aa-11(c)(1)). In this case, Petitioner’s claim cannot have a
reasonable basis unless objective evidence supports his contention that the claimed injury lasted
for more than six months. See Cottingham, 971 F.3d at 1345-466; 42 U.S.C. § 300aa-
11(c)(1)(D)(i). Here, the Special Master erred in failing to analyze whether Petitioner established
a reasonable basis for the Act’s durational requirement. The Special Master’s failure to address
this requirement is particularly troubling because Petitioner’s medical records before this Court do
not appear to clearly demonstrate that Petitioner meets this statutorily-mandated requirement. In
fact, the last mention of a rash or scarring in Petitioner’s medical records occurred in January 2019,
only four months after Petitioner received the PCV-13 vaccine. See Pet. Ex. 3 at 5-6.
Despite this observation, this Court’s holding does not foreclose the possibility that on
remand the Special Master could find a reasonable basis for Petitioner’s claim. It may be that
support exists for Petitioner’s contention that the presence of a rash or scarring four months after
vaccination indicates that the injury would also have been present six months after vaccination. It
is also possible that other evidence properly before the Special Master would support Petitioner’s
claim that injuries caused by the PCV-13 vaccine persisted for more than six months. Or it may
be that no such evidence meeting the statute’s durational requirement exists. However, each
scenario requires fact-finding that the Special Master did not undertake in the first instance.
Accordingly, this Court finds it appropriate to remand Petitioner’s case to provide the Special
Master an opportunity to consider the statute’s durational requirement and fully address whether
Petitioner has met the reasonable basis threshold for bringing his claim.
12 CONCLUSION
For the reasons above, Respondent’s Motion for Review (ECF No. 27) is GRANTED.
The Special Master’s Decision on Attorneys’ Fees and Costs (ECF No. 25) is VACATED, and
the case is REMANDED to the Special Master for further proceedings consistent with this Order.
IT IS SO ORDERED.
s/Eleni M. Roumel ELENI M. ROUMEL Judge
March 10, 2022 Washington, D.C.