V.C. v. HHS - Hepatitis A, autism spectrum disorder (2014)
Case summary [AI summaries can sometimes make mistakes]
On May 12, 2009, Kim and Richard Castaldi filed a petition for compensation under the National Vaccine Injury Compensation Program on behalf of their minor son, V.C., alleging that the hepatitis A vaccine administered on May 8, 2006, caused V.C.'s autism spectrum disorder (ASD). Respondent, the Secretary of Health and Human Services, moved to dismiss the case as untimely, arguing that symptoms of ASD manifested more than 36 months prior to the petition's filing date.
Chief Special Master Denise K. Vowell presided over the case.
A fact-finding hearing was held on December 14, 2011. The Special Master issued a ruling on facts pertaining to onset on April 26, 2012, and a final decision on June 25, 2014, which was reissued on July 29, 2014.
The Special Master dismissed the petition on two independent grounds: it was untimely filed, and the petitioners failed to establish vaccine causation. The Special Master found that V.C. exhibited symptoms of ASD, including speech and language regression and motor skill deficits, prior to May 12, 2006.
This conclusion was based on a review of medical records from V.C.'s pediatrician, Dr. Pilar Escobar, as well as evaluations from Sooner Start, Dr.
Marc Hille, Dr. Laurie Kukas, Dr.
Harley Morgan, and Dr. Kathleen Koljack.
The Special Master found Mrs. Castaldi's testimony regarding the onset and severity of V.C.'s symptoms to be unreliable, citing inconsistencies with contemporaneous medical records and her own prior statements.
Specifically, her testimony about V.C. having a 500-word vocabulary at the time of vaccination and a specific incident on May 19, 2006, was deemed not credible. The Special Master also considered the expert reports of Dr.
Richard Hastings for the petitioners and Dr. Max Wiznitzer for the respondent.
Dr. Hastings, with a Ph.D. in anatomy and a degree in osteopathic medicine, offered a conclusory opinion that the hepatitis A vaccine caused V.C.'s ASD but did not provide a mechanism of injury.
Dr. Wiznitzer, a specialist in childhood autism with multiple board certifications, opined that V.C.'s symptoms, including speech regression and motor incoordination, manifested prior to May 12, 2006.
The Special Master gave greater weight to Dr. Wiznitzer's opinion due to his specialized expertise.
The Special Master concluded that the petition was untimely because the first symptom or manifestation of onset occurred more than 36 months before May 12, 2009. Even if the petition had been timely, the Special Master found that petitioners failed to establish causation, as Dr.
Hastings' report lacked a medical theory connecting the vaccine to the alleged injury and was insufficient under the standard set forth in Althen v. Sec'y, HHS.
The Special Master's decision was reviewed by Judge Eric G. Bruggink of the Court of Federal Claims, who denied the motion for review on December 19, 2014, and reissued the opinion on January 6, 2015, finding no legal error in the Special Master's conclusions regarding untimeliness and lack of causation.
The case was dismissed without compensation. Subsequently, on January 15, 2015, Chief Special Master Vowell approved a stipulation for final attorneys' fees and costs, awarding $18,000.00 to petitioners' counsel, Andrew Downing of Hennelly & Steadman, P.C., and Vann Cott & Talamante, PLLC, covering the period from May 1, 2013, to the present, in addition to a prior interim award.
Theory of causation
Petitioners alleged that the hepatitis A vaccine administered on May 8, 2006, caused V.C.'s autism spectrum disorder (ASD). The case was dismissed by Chief Special Master Vowell on two independent grounds: untimeliness and failure to establish causation. Regarding untimeliness, the Special Master found that V.C. exhibited symptoms of ASD, including speech and language regression and motor skill deficits, prior to May 12, 2006, the date 36 months before the petition was filed. This conclusion was based on medical records from Sooner Start (July 2006), Dr. Hille (November 2006), Dr. Morgan (April 2007), and Dr. Koljack (July 2007), which indicated symptom onset around March or April 2006, shortly after V.C.'s second birthday. Respondent's expert, Dr. Max Wiznitzer, also opined that V.C.'s regression began in March-April 2006 and that his vision problems, noted before May 8, 2006, were likely an early manifestation of motor incoordination indicative of ASD. The Special Master found Mrs. Castaldi's testimony regarding symptom onset and severity to be unreliable due to inconsistencies with contemporaneous records and her own prior statements, particularly concerning V.C.'s vocabulary size and a specific incident on May 19, 2006. Regarding causation, petitioners' expert, Dr. Richard Hastings (Ph.D. anatomy, DO), provided a conclusory report stating the vaccine caused ASD but offered no specific mechanism of injury, failing to meet the Althen standard for off-Table injuries. Dr. Wiznitzer's expert opinion supported the finding of earlier symptom onset. The Special Master's decision was affirmed by Judge Bruggink, who found no legal error in the dismissal for untimeliness and lack of established causation. Attorneys for petitioners were Andrew Downing and Vann Cott & Talamante, PLLC. Attorneys for respondent were Darryl Wishard, Stuart F. Delery, Rupa Bhattacharyya, Vincent J. Matanoski, and Gabrielle M. Fielding. Chief Special Master Vowell issued the final decision on June 25, 2014. Judge Bruggink denied the motion for review on December 19, 2014 (reissued January 6, 2015). Final attorneys' fees and costs of $18,000.00 were awarded on January 15, 2015.