Mario Arturo Rodriguez v. HHS - MMR, transverse myelitis/quadriparesis (2005)

Mario Arturo Rodriguez, an infant, received the measles-mumps-rubella (MMR) vaccination on January 25, 2000. Eleven days later, he manifested transverse myelitis (TM) with quadriparesis.

Transverse myelitis is not an injury listed on the Vaccine Injury Table, so petitioner had to prove by a preponderance of the evidence that the MMR vaccination caused Mario's TM. The court reviewed the Chief Special Master's opinion, which denied relief, concluding that petitioner had failed to satisfy her burden of proof.

The court, citing the Federal Circuit's ruling in Althen v. Secretary of Health and Human Services, reversed the denial and remanded the case for a compensation determination.

The court found that petitioner satisfied her burden of proof under the Althen standard, which requires showing (1) a medical theory causally connecting the vaccination and the injury, (2) a logical sequence of cause and effect showing the vaccination was the reason for the injury, and (3) a proximate temporal relationship between vaccination and injury. The Chief Special Master found persuasive support from the Institute of Medicine, and prior special master decisions in Huston and Harris for the proposition that the MMR vaccine can cause TM, satisfying the first prong.

For the second and third prongs, the Chief Special Master found that Mario's TM onset occurred eleven days after vaccination, within the medically acceptable one-to-four-week window, and that the TM was monophasic, a form associated with vaccine triggering. Respondent's expert offered no alternative explanation other than coincidence.

The Chief Special Master also found that no better explanation for the TM existed in the record. Despite these findings, the Chief Special Master denied relief, requiring "direct evidence" linking the MMR to Mario's central nervous system, specifically the absence of an organism-specific antibody index (OSAI) test.

The court held that this requirement for an OSAI test was an impermissible elevation of the burden of proof, preventing the use of circumstantial evidence and negating the system created by Congress. The court concluded that, without this erroneous OSAI requirement, the Chief Special Master's other findings were sufficient to establish entitlement.

Petitioner's expert, Dr. Marcel Kinsbourne, testified to a reasonable medical certainty that the MMR caused Mario's TM.

The court denied petitioner's motion for oral argument and respondent's motion to strike as moot.