Livingston v. Secretary of Health and Human Services

CourtUnited States Court of Federal Claims
DecidedOctober 14, 2021
Docket17-1619
StatusPublished

This text of Livingston v. Secretary of Health and Human Services (Livingston v. Secretary of Health and Human Services) is published on Counsel Stack Legal Research, covering United States Court of Federal Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Livingston v. Secretary of Health and Human Services, (uscfc 2021).

Opinion

In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS

********************* ERICA LIVINGSTON, * * No. 17-1619V Petitioner, * Special Master Christian J. Moran * v. * * Filed: September 14, 2021 SECRETARY OF HEALTH * AND HUMAN SERVICES, * Attorneys’ fees and costs, interim * award, expert hourly rate Respondent. * ********************* Mark T. Sadaka, Law Offices of Sadaka Associates, LLC, Englewood, NJ, for petitioner; Julia M. Collison, United States Dep’t of Justice, Washington, D.C., for respondent.

PUBLISHED DECISION AWARDING ATTORNEYS’ FEES AND COSTS ON AN INTERIM BASIS1

Seeking compensation pursuant to the National Childhood Vaccine Injury Act, 42 U.S.C. § 300aa–10 through 34 (2012), Ms. Livingston claims that she suffered from a reactivation of the Epstein-Barr virus (“EBV”) and Sjogren’s syndrome after receiving an influenza (“flu”) vaccine on November 5, 2014. Pet., filed Oc. 27, 2017, Preamble. Ms. Livingston’s counsel of record is Mr. Mark T. Sadaka.

1 The E-Government Act, 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government Services), requires that the Court post this decision on its website. This posting will make the decision available to anyone with the internet. Pursuant to Vaccine Rule 18(b), the parties have 14 days to file a motion proposing redaction of medical information or other information described in 42 U.S.C. § 300aa-12(d)(4). Any redactions ordered by the special master will appear in the document posted on the website. On March 16, 2021, Ms. Livingston moved for an award of attorneys’ fees and costs on an interim basis, requesting $51,654.15 in fees and $23,023.32 in costs, for a total of $74,677.47. Pet’r’s Mot., at 4. The Secretary has opposed, at least in part. As explained below, fees and costs will only be evaluated through April 21, 2020. Calibrated to this date, Ms. Livingston’s motion requests $44,188.14 in fees and $14,884.87 in costs, for a total of $59,073.01.

For the reasons that follow, Ms. Livingston is awarded $50,973.01, for work performed through April 21, 2020.

I. Procedural History Relevant events in Ms. Livingston’s case concern her claims for entitlement and her request for attorneys’ fees and costs. These are outlined below.

A. Procedural History relating to Entitlement

Ms. Livingston’s October 27, 2017 petition alleged a flu vaccine caused her to suffer from a reactivation of the EBV, subsequently causing Sjogren’s syndrome. Ms. Livingston filed medical records periodically through February 26, 2018. After the Secretary determined that the records were sufficient, he filed his Rule 4 Report on October 9, 2018. The Secretary argued that compensation was not appropriate because (1) Ms. Livingston had not established a specific compensable injury, and (2) a reliable medical theory was lacking. Resp’t’s Rep. at 12-14.

To develop her case, Ms. Livingston filed an expert report from Dr. Yehuda Shoenfeld on July 1, 2019 as exhibit 23.2 Dr. Shoenfeld presented a theory in which the flu vaccination (Nov. 5, 2014) caused a latent Epstein-Barr virus to reactivate (Dec. 22, 2014), and the reactivation of the Epstein-Barr virus led to the development of small fiber neuropathy (Jan. 12, 2015), and the development of small fiber neuropathy caused the development of Sjogren’s syndrome (June 2, 2015). Dr. Shoenfeld’s theory relies on the presence of pentapeptide homologies expressed by influenza virus, EBV, and humans that he deems to be significant. See id. at 39, 54.

2 Exhibit 23 was stricken at petitioner’s request, and then refiled as “Corrected Expert Report” on April 20, 2020, remaining labeled as exhibit 23. 2 The parties discussed Dr. Shoenfeld’s theory in subsequent status conferences. Due to deficiencies in his report, during the July 15, 2019 status conference, the undersigned ordered Dr. Shoenfeld to answer questions in a supplemental report. The undersigned asked: (1) whether the proposed homology between influenza virus and EBV derived from a BLAST search; (2) what time would medical science anticipate (a) flu vaccine to reactivate EBV, (b) EBV to cause small fiber neuropathy, and (c) small fiber neuropathy to cause Sjogren’s; and (3) whether any epidemiological evidence shows the frequency of EBV reactivating from a dormant state.

Ms. Livingston then filed voluminous medical literature associated with the initial report, along with the ordered supplemental report on September 13, 2019. See exhibit 106. However, Dr. Shoenfeld did not comply with the instructions in the July 16, 2019 order. During the following status conference on October 9, 2019, the undersigned again ordered Dr. Shoenfeld to answer the questions in a supplemental report. Ms. Livingston filed Dr. Shoenfeld’s next report on November 25, 2019. Exhibit 110. The report and Ms. Livingston’s theory were again discussed in a status conference on December 11, 2019. The discussions in these status conferences mostly focused on the theory that the flu vaccine reactivated a latent EBV infection.

Subsequently, the Secretary filed reports from Dr. J. Lindsay Whitton and Dr. Brendan Antiochos on February 7, 2020. Dr. Whitton argues Ms. Livingston’s blood work (“the pattern of EBV-specific antibodies, plasma that was negative for EBV DNA, and normal lymphocyte count”) is consistent with a past EBV infection and very strongly indicates she did not experience an EBV reactivation. Exhibit A at 11-13, 26. Dr. Whitton further argues the remainder of Dr. Shoenfeld’s theory is moot because he opines that Sjogren’s was caused by EBV reactivation. Id. at 13. Dr. Antiochos also argues there is no evidence of EBV reactivation in this case. Exhibit C at 3-5. Dr. Antiochos further comments that there is not a single case report of Sjogren’s following vaccine administration. Id. at 21.

Importantly, both experts criticize Dr. Shoenfeld’s reliance on the existence of short homologies as proof of cross-reactive immune responses. Dr. Whitton explains that the presence of short homologies is nothing unusual given the vast numbers of proteins containing multiple pentameters, and further argues that these findings are immunologically meaningless. Exhibit A at 19-23. Dr. Antiochos argues the same, undermining Dr. Shoenfeld’s reliance on the mere presence of

3 homologies by demonstrating the frequency of such homologies. See exhibit C at 6-12.

In a February 20, 2020 status conference, the undersigned questioned whether Ms. Livingston could maintain her current cause of action and stated that the Secretary’s experts’ collective opinions seem convincing. Mr. Sadaka then suggested that Dr. Shoenfeld might have an alternative opinion that the flu vaccination directly caused Ms. Livingston to suffer Sjogren’s syndrome, despite not disclosing this opinion in his three previous reports. The request to consult with Dr. Shoenfeld and possibly retain a rheumatologist was permitted. The following February 21, 2020 order highlighted a weakness in Ms. Livingston’s case, and the undersigned stated that the reasonable basis to maintain the case is questionable.

Ms. Livingston next filed two more reports from Dr. Shoenfeld, responding to the Secretary’s experts, on April 21, 2020. Exhibits 118 and 119. Ms. Livingston also filed a status report stating that she has retained a rheumatologist. Her initial deadline to file the rheumatologist’s report was June 22, 2020.

After granting four motions for enlargement of time, the undersigned deferred ruling on Ms.

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