Greene v. Hhs

CourtCourt of Appeals for the Federal Circuit
DecidedDecember 28, 2020
Docket20-1544
StatusUnpublished

This text of Greene v. Hhs (Greene v. Hhs) is published on Counsel Stack Legal Research, covering Court of Appeals for the Federal Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Greene v. Hhs, (Fed. Cir. 2020).

Opinion

Case: 20-1544 Document: 36 Page: 1 Filed: 12/28/2020

NOTE: This disposition is nonprecedential.

United States Court of Appeals for the Federal Circuit ______________________

ROY GREENE, Petitioner-Appellant

v.

SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent-Appellee ______________________

2020-1544 ______________________

Appeal from the United States Court of Federal Claims in No. 1:11-vv-00631-MMS, Chief Judge Margaret M. Sweeney. ______________________

Decided: December 28, 2020 ______________________

ROY GREENE, Spring, TX, pro se.

HEATHER LYNN PEARLMAN, Vaccine/Torts Branch, Civil Division, United States Department of Justice, Washing- ton, DC, for respondent-appellee. Also represented by JEFFREY B. CLARK, C. SALVATORE D'ALESSIO, CATHARINE E. REEVES. ______________________ Case: 20-1544 Document: 36 Page: 2 Filed: 12/28/2020

Before NEWMAN, O’MALLEY, and TARANTO, Circuit Judges. Opinion for the court filed PER CURIAM. Dissenting opinion filed by Circuit Judge O’MALLEY. PER CURIAM. Roy Greene sought compensation under the National Childhood Vaccine Injury Act of 1986 (Vaccine Act), 42 U.S.C. §§ 300aa-1 to -34, based on his claim that the teta- nus-diphtheria (Td) vaccine he received in July 2009 caused his brachial neuritis. The special master first con- cluded that Mr. Greene did not meet a precondition for in- voking a presumption of causation under the relevant provision of the Vaccine Injury Table, a ruling not at issue here. The special master then considered whether, without the aid of the Table presumption, Mr. Greene had proved that the vaccine caused his condition. The special master found that Mr. Greene did not prove actual causation and so was not entitled to recover under the Vaccine Act. The United States Court of Federal Claims (Claims Court) af- firmed the special master’s denial of recovery. Applying the required deferential standard of review to the special master’s findings, we affirm. I On July 22, 2009, Mr. Greene received treatment at Clear Lake Regional Medical Center for a puncture wound on his hand. As part of that treatment, he received a Td vaccination. About six weeks later, Mr. Greene began ex- periencing symptoms of brachial neuritis. 1

1 The Vaccine Injury Table identifies brachial neuri- tis, in relevant part, as “dysfunction limited to the upper extremity nerve plexus (i.e., its trunks, divisions, or cords),” marked upon onset by “severe aching pain in the shoulder and upper arm.” 42 C.F.R. § 100.3(c)(6). Case: 20-1544 Document: 36 Page: 3 Filed: 12/28/2020

GREENE v. HHS 3

In 2011, Mr. Greene filed this action in the Claims Court against the Secretary of Health and Human Ser- vices, seeking relief under the Vaccine Act, § 300aa-11, and alleging that the Td vaccine he received caused his brachial neuritis. Initially, Mr. Greene asserted both (1) a claim un- der the Vaccine Injury Table, 42 C.F.R. § 100.3(a)(I)(B), which provides for a presumption of causation when bra- chial neuritis symptoms begin within twenty-eight days of the Td vaccination date, and (2) a non-Table claim, for which Mr. Greene had to establish actual causation of the brachial neuritis. In 2015, after an evidentiary hearing, the special master found that Mr. Greene’s symptoms of brachial neuritis began no earlier than forty-one days after vaccination—more than the twenty-eight days specified in the Table, and on that basis dismissed Mr. Greene’s Table claim. Greene v. Sec’y of Health & Human Servs., No. 11- 631V, 2015 WL 9056034, at *1 (Fed. Cl. Spec. Mstr. July 31, 2015). Mr. Greene continued to pursue his theory of actual causation under our three-part approach laid out in Althen v. Secretary of Health & Human Services, 418 F.3d 1274 (Fed. Cir. 2005). In support of his claim, Mr. Greene filed several expert reports, including two from Dr. Thomas W. Wright, and, at the special master’s direction, a report from Dr. Marcel Kinsborne. The Secretary moved for a ruling in its favor on the record, which the special master granted in May 2017. Mr. Greene sought reconsideration under Vaccine Rule 10(e), attaching a second report from Dr. Kinsborne and eighteen scientific articles, as well as a letter from Dr. Vera Byers. The special master granted reconsideration, but again denied entitlement, explaining that the “record does not support [his] allegation that his Td vaccine more likely than not caused his brachial neuritis.” Greene v. Sec’y of Health & Human Servs., No. 11-631V, 2017 WL 5382856, at *7 (Fed. Cl. Spec. Mstr. Sept. 26, 2017). On appeal, how- ever, the Claims Court vacated the decision, as having Case: 20-1544 Document: 36 Page: 4 Filed: 12/28/2020

rested on an incorrect legal standard, and remanded for further proceedings. Greene v. Sec’y of Health & Human Servs., 136 Fed. Cl. 445, 453–54 (2018). On remand, the special master denied the Secretary’s motion for a ruling on the record, but authorized the Sec- retary to file an expert report, which the Secretary had not previously done. Greene v. Sec’y of Health & Human Servs., No. 11-631V, 2018 WL 3238611, at *1 (Fed. Cl. Spec. Mstr. May 7, 2018). The Secretary submitted a report from Dr. Eric Lancaster, to which Mr. Greene responded with his own reports from Dr. Kinsborne, as well as a new report from Dr. Lawrence Steinman. In August 2019, the special master held a hearing to evaluate Mr. Greene’s claim of ac- tual causation. Greene v. Sec’y of Health & Human Servs., No. 11-631V, 2019 WL 4072110, at *1 (Fed. Cl. Spec. Mstr. Aug. 2, 2019). At the hearing, Mr. Greene’s experts, Drs. Steinman and Kinsborne, compared brachial neuritis to Guillain- Barré syndrome (GBS). They cited scientific literature for the proposition that both GBS and brachial neuritis are au- toimmune conditions with a common pathogenesis. And they testified that—because six weeks was a reasonable time of onset for GBS—brachial neuritis could also develop in that timeframe. Id. at *3–10. The Secretary’s expert, Dr. Lancaster, rejected the analogy between GBS and brachial neuritis, testifying that GBS differs from brachial neuritis in several important re- spects. Id. at *11. Specifically, he stated that brachial neu- ritis tends to be an “axonal” injury with a “localized nature of the inflammation,” whereas GBS is primarily considered a “demyelination” injury that tends to be multifocal or bi- lateral. Id. Next, Dr. Lancaster testified that Mr. Greene’s medical records were consistent with brachial neuritis, ra- ther than GBS, stating that the “electrodiagnostic test re- sults . . . suggested to him the presence of ‘severe axonal injury.’” Id. at *12. Dr. Lancaster also observed that no Case: 20-1544 Document: 36 Page: 5 Filed: 12/28/2020

GREENE v. HHS 5

one who treated Mr. Greene for brachial neuritis had indi- cated that his condition may have been caused by his Td vaccine, and he opined that there may have been other trig- gers for the condition, such as an injury Mr. Greene suf- fered in early September 2009. Id. On August 2, 2019, the special master found that Mr. Greene had not met his burden of proving actual causation. Id. at *22. The special master stated that forty-one days was not a medically acceptable timeframe for the vaccine to have caused the brachial neuritis. Id. at *21. In his de- cision, he explained that Dr. Lancaster’s testimony persua- sively undermined the reliance on GBS by Mr. Greene’s experts for their opinions about Mr. Greene’s brachial neu- ritis. Id. at *19–20.

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