Lisa Munn, Personal Representative of the Estate of Chelsea Vukelich v. The Secretary of the Department of Health and Human Services

970 F.2d 863, 92 Daily Journal DAR 10867, 1992 U.S. App. LEXIS 16700, 1992 WL 170547
CourtCourt of Appeals for the Federal Circuit
DecidedJuly 23, 1992
Docket91-5020
StatusPublished
Cited by474 cases

This text of 970 F.2d 863 (Lisa Munn, Personal Representative of the Estate of Chelsea Vukelich v. The Secretary of the Department of Health and Human Services) 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
Lisa Munn, Personal Representative of the Estate of Chelsea Vukelich v. The Secretary of the Department of Health and Human Services, 970 F.2d 863, 92 Daily Journal DAR 10867, 1992 U.S. App. LEXIS 16700, 1992 WL 170547 (Fed. Cir. 1992).

Opinions

PLAGER, Circuit Judge.

In this case we are being asked whether the loss sustained by the family of Chelsea Vukelich as a result of her tragic death in childhood qualifies for compensation under the National Vaccine Injury Compensation Program (the Program).1 The Claims Court, upon review of the decision of the special master, has said no. Before we exercise our appellate review authority, we must first clarify the nature and scope of that authority.

Specifically, we must address the role Congress has left to the Court of Appeals following the sui generis trial-and-appellate-review obligations given to the Claims Court by the 1989 amendments to the Program. The question deserves careful examination. It bears not only on the case before us today, but on the large number of vaccine compensation cases to be decided by the Claims Court in the years ahead, and which may be appealed to this court. The question has been addressed in recent eases before this court, but significant aspects remain unsettled, aspects important to the resolution of this case.2 Once the scope of our review is clarified, we can determine, in light of that scope, whether the injury at issue qualifies as a compensa-ble injury under the Program.

Petitioner, Lisa Munn, as personal representative of the estate of Chelsea Vukelich (Chelsea), sought compensation under the Program for the death of Chelsea. Chelsea, age 4 months, received her second DTP (diphtheria-tetanus-pertussis) inoculation 3 on December 1, 1986. On December 5, she died. Petitioner sought $250,000 as compensation for a vaccine-related death, as well as attorney fees and expenses. Compensation was denied by a special master of the United States Claims Court in Munn v. Secretary of the Dep't. of Health and Human Servs., No. 89-71V (Cl.Ct. May 15, 1990) (hereafter Opinion of Special Master). A judge of the Claims Court, after conducting on motion by the petitioner the review required by the statute, affirmed the denial in Munn v. Secretary of the Dep’t. of Health and Human Servs., 21 Cl.Ct. 345 (1990). This appeal followed.

I. BACKGROUND

A. Factual Background

Chelsea was born on July 26, 1986 with no apparent abnormalities. She appeared healthy before and shortly after October 21, 1986 when she received her first DTP vaccination and her first dose of oral polio vaccine. She later developed a cough and fever. On November 17, her mother took her to the doctor where the coug^ was diagnosed as possible early otitis media, and amoxicillin was prescribed. Chelsea went for a follow-up visit on December 1 still suffering from what her mother described as a slight cold and cough. Chelsea was given her second DTP inoculation during that visit.

Chelsea slept more than usual and ate less than usual following the inoculation. This was similar to her reaction to the first inoculation. She awoke late on December 2 acting cranky and having a deep cough. She ate less than usual and screamed “a high-pitched screech” that night, as if in [865]*865pain. Her mother took Chelsea to the emergency room on December 3 where her mother described her as “crying — trouble breathing — feels warm.” Opinion of Special Master at 5. Chelsea was diagnosed as suffering from acute febrile illness of unknown etiology. Her mother was told to return that evening for a follow-up examination. At the evening examination, Chelsea’s mother was told that everything was all right.4

On December 4, Chelsea was quiet all day. She appeared weak and did not want to eat. She slept all night. She seemed improved on the morning of the fifth but in the early afternoon, she was not responsive and holding her was described as “like holding a bag of rags.” Id. at 6. Chelsea was gray and had a fever. By late afternoon, Chelsea seemed better and she was dressed to go to a baby sitter. She was asleep when she arrived at the baby sitter’s home. She was found unconscious later that evening and rushed to the same hospital emergency room that had seen her on December 3. Chelsea arrived at the hospital at 9:25 p.m. in full cardiac arrest. She was pronounced dead at 10:00 p.m. The autopsy found that Chelsea died from Kleb-siella pneumonia.

B.The Statutory Framework

Subehapter XIX of Chapter 6A, Title 42 United States Code, enacted in 1986 (though the Program as such was not in effect until October 1988), established the National Vaccine program within the Department of Health and Human Services. The program was established “to achieve optimal prevention of human infectious diseases through immunization and to achieve optimal prevention against adverse reactions to vaccines.” 42 U.S.C. § 300aa-1. Subchapter XIX also established the National Vaccine Injury Compensation Program “under which compensation may be paid for a vaccine-related injury or death.” 42 U.S.C. § 300aa-10(a).

In general, a person seeking payment from the government under the Compensation Program may establish entitlement on either of two bases. The one, much the easier as an evidentiary matter, is to show that the injury or condition is one of those listed in the Vaccine Injury Table (Table), 42 U.S.C. § 300aa-14; that the manifestation of the injury occurred within the time frame given in the Table; and that the other requirements of § 300aa-13(a)(1) have been met. See Schwartz & Mahshigian, National Childhood Vaccine Injury Act of 1986: An Ad Hoc Remedy or a Window for the Future?, 48 Ohio St.L.J. 387, 390 (1987). The Program presumes causation for a Table injury. In other words, if the injury is within the requirements described, it is presumed to have been caused by the vaccine. H.Rep. No. 908, 99th Cong., 2d Sess. 18, reprinted in 1986 U.S.C.C.A.N. 6287, 6344, 6359.

If the injury or condition is not listed in the Table, or if its symptoms or manifestations are not seen within the timé frames specified, recovery under the Program may still be had. But now a more difficult evidentiary showing is required. The claimant must prove by a preponderance of the evidence that the vaccine, and not some other agent, was the actual cause of the injury. Given the vagaries of human illnesses, particularly in young children, that is not always an easy burden to carry.

For the administration of DTP, the Table lists the following occurrences and a related time period for first symptom or manifestation of onset or of significant aggravation after vaccine administration:

A. Anaphylaxis or anaphylactic shock— 24 hours
B. Encephalopathy (or encephalitis) — 3 days
C. Shock-collapse or hypotonic-hypore-sponsive collapse — 3 days
D. Residual seizure disorder in accordance with [§ 300aa-14(b)(2) ] — 3 days
[866]*866E. Any acute complication or sequela (including death) of an illness, disability, injury, or condition referred to above which illness, disability, injury, or condition arose within the time period prescribed. ...

42 U.S.C.

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970 F.2d 863, 92 Daily Journal DAR 10867, 1992 U.S. App. LEXIS 16700, 1992 WL 170547, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lisa-munn-personal-representative-of-the-estate-of-chelsea-vukelich-v-the-cafc-1992.