VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_12-vv-00285 Package ID: USCOURTS-cofc-1_12-vv-00285 Petitioner: Montez Petronelli Filed: 2016-05-12 Decided: 2016-06-07 Vaccine: influenza Vaccination date: Condition: Guillain-Barré Syndrome Outcome: compensated Award amount USD: 2969925 AI-assisted case summary: Montez Petronelli filed a petition on May 12, 2016, alleging a vaccine injury. The case proceeded to a damages hearing on February 10, 2016, before Special Master Thomas L. Gowen. Ms. Petronelli had received an influenza vaccine in October 2010 and subsequently developed Guillain-Barré Syndrome, which resulted in her complete disability from professional employment. The Special Master found that Ms. Petronelli, a former corporate attorney, would have returned to the practice of law had she not been injured. The decision details the calculation of damages awarded for past and future lost wages, past pain and suffering, past expenses, and various life care items. Petitioner's vocational expert, Dr. Staci Schonbrun, was found to be more credible than respondent's expert, Mr. Edward Bennett. Ms. Petronelli was awarded $2,225,000.00 for past and future lost wages, based on an estimated entry-level salary in 2011 and projected increases until her expected retirement age of sixty-four and a half. The award for past pain and suffering was $250,000.00. Past unreimbursable expenses totaled $8,344.64. Life care items awarded included Anthem Silver Pathway HMO premiums, co-pays for neurologist treatment, therapeutic massage, acupuncture, a cane, a scooter, a bath chair, a lift chair, a seat belt pull, a button hook/zipper pull, and home care services. The Special Master addressed complex issues regarding the rate of reduction to present value, tax offsets, wage growth, and fringe benefits. After considering expert reports from Dr. Patrick Kennedy for the respondent and George McLaughlin for the petitioner, and reviewing current U.S. Treasury bond rates, the Special Master determined a 1% discount rate for future wage loss and a 3.7% wage growth rate. A 10% fringe benefit rate was applied. The total award, after adjustments for tax offsets, fringe benefits, and reduction to present value, was $2,969,925.05. The Special Master ordered the award to be paid as a lump sum, finding Ms. Petronelli, as an adult with professional experience, capable of managing the funds. Petitioner was represented by Ronald C. Homer of Conway Homer & Chin-Caplan, P.C., and respondent was represented by Michael P. Milmoe of the United States Department of Justice. The decision was issued on June 7, 2016. Theory of causation field: Montez Petronelli received an influenza vaccine in October 2010 and subsequently developed Guillain-Barré Syndrome, leading to her complete disability. The Special Master found that Ms. Petronelli was substantially and permanently disabled secondary to the flu vaccine and Guillain-Barré Syndrome. The specific mechanism of causation was not detailed in the provided text, but the Special Master was persuaded that the injury was a result of the vaccine. The case proceeded to a damages hearing, and the Special Master awarded a total of $2,969,925.05, including past and future lost wages, past pain and suffering, past expenses, and life care items. Petitioner's vocational expert was Dr. Staci Schonbrun, and respondent's vocational expert was Mr. Edward Bennett. Economic experts included Dr. Patrick Kennedy for the respondent and George McLaughlin for the petitioner, who provided reports on issues of present value, tax offsets, wage growth, and fringe benefits. Special Master Thomas L. Gowen issued the decision on damages on June 7, 2016. Petitioner was represented by Ronald C. Homer, and respondent by Michael P. Milmoe. Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_12-vv-00285-cl-extra-2642863 Date issued/filed: 2013-10-25 Pages: 1 Docket text: Supplementary opinion from CourtListener cluster 2642863 -------------------------------------------------------------------------------- IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF THE SPECIAL MASTERS No. 12-285V Filed: October 25, 2013 Not for Publication **************************** MONTEZ PETRONELLI, * * Petitioner, * * Decision on the Record; Influenza Vaccine; v. * Guillain-Barré Syndrome; GBS * SECRETARY OF * HEALTH AND HUMAN SERVICES, * * Respondent. * **************************** Ronald Homer, Esq., Conway, Homer & Chin-Caplan, P.C., Boston, MA, for petitioner. Michael P. Milmoe, Esq., U.S. Dept. of Justice, Washington, DC, for respondent. RULING ON ENTITLMENT1 Vowell, Chief Special Master: On May 4, 2012, Montez Petronelli [“Ms. Petronelli” or “petitioner”] timely filed a petition for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10, et seq.2 [the “Vaccine Act” or “Program”]. The petition alleged that, as a result of her influenza vaccine on September 28, 2010, Ms. Petronelli suffers from a neurological demyelinating injury. The amended petition, filed on December 10, 2012, specified that petitioner suffers from Guillain-Barré syndrome [“GBS”]. The Vaccine Act provides that a special master may not make a finding awarding compensation based on the claims of a petitioner alone, unsubstantiated by medical 1 Because this unpublished ruling contains a reasoned explanation for the action in this case, I intend to post it on the United States Court of Federal Claims' website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899, 2913 (Dec. 17, 2002). In accordance with Vaccine Rule 18(b), petitioner has 14 days to identify and move to delete medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that the identified material fits within this definition, I will delete such material from public access. 2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa (2006). records or medical opinion. See § 13(a)(1). Petitioner has proffered both medical records and an expert medical opinion by Dr. Thomas Morgan causally linking her GBS to her influenza vaccination. For the reasons stated herein, I find that petitioner has established entitlement to compensation. I. Procedural History. Between May 4, 2012 and September 4, 2012, when this case was reassigned to me, Special Master Lord conducted the initial status conference and petitioner filed exhibits 1-7 and her Statement of Completion. See Order, issued June 13, 2012; Notice of Intent to file on CD, filed July 10, 2012; Statement of Completion, filed July 13, 2012. On September 13, 2012, I held a status conference with the parties. During the call, the parties expressed a desire to explore an informal resolution to this case. See Order, issued Sept. 13, 2012. Petitioner was ordered to file (1) medical records requested by respondent by October 15, 2012, (2) a status report when her demand was conveyed to respondent, and (3) her expert report by March 13, 2013. Petitioner filed exhibits 8 and 9 on October 9, 2012. She transmitted her demand to respondent on November 20, 2012. Petitioner’s Status Report, filed Nov. 30, 2012. Petitioner filed her affidavit and an amended petition on December 10, 2012. Although the parties continued to discuss settlement, petitioner filed her expert report on March 13, 2013. On April 8, 2013, the parties conveyed to the court that petitioner had received a response from respondent regarding her life care plan assessment, but that she had not yet received a comprehensive response to her settlement demand and therefore it was unclear if a settlement agreement could be reached. Joint Status Report, filed Apr. 8, 2013, at 1. The parties requested a status conference to discuss future proceedings. Id. On April 17, 2013, following the parties’ requested status conference, I ordered respondent to file her Rule 4(c) report, accompanied by any response to petitioner’s expert report she may elect to file, by no later than June 17, 2013. Order, issued Apr. 17, 2013. After receiving extensions to her original deadline, respondent filed her Rule 4(c) report [“Res. Report”] on July 9, 2013. In the report, respondent stated that she would “not offer an expert report in this case,” and that “other than [the] Rule 4(c) Report, and the attached literature, respondent will not expend further resources to defend this case.” Res. Report at 9. Respondent suggested I decide entitlement based on the current case record. Id. Petitioner filed a responsive pleading to respondent’s Rule 4(c) report on July 30, 2013. 2 II. Evidentiary Record. Petitioner received an influenza vaccine on September 28, 2010. Petitioner’s Exhibit [“Pet. Ex.”] 2, p. 1. No medical records prior to the immunization or from the day of the immunization were filed by petitioner. On October 21, 2010, petitioner was seen by her primary care physician, Dr. Sraboni Banerjee. According Dr. Banerjee’s visit note, petitioner indicated she had been sick for six weeks, starting with a chest cold with no fever, sore throat, or cough, before progressing to a cough with nasal congestion and post nasal drainage. Petitioner indicated that her cough had started to resolve after four weeks, but then restarted during the past two weeks. Doctor Banerjee diagnosed her with sinusitis and prescribed amoxicillin. Pet. Ex. 2, pp. 38-39. At this visit, petitioner also complained of feeling very tired and numb, having tingling in her extremities, and muscle aches. Doctor Banerjee attributed her tingling to her sinusitis and conveyed to petitioner that her symptoms should improve within a couple of days. Id. at 39. Petitioner had a follow-up visit for her sinusitis on October 25, 2010. Her cough was mostly resolved, but she still complained of numbness and muscle pains and indicated they had gotten worse. Pet. Ex. 2, p. 43. She expressed frustration that she was feeling tired and was unable to read or cook. Id. Doctor Banerjee speculated that her tiredness and general achiness were associated with the tension and stress brought on by her upcoming GRE exam. Id. In the evening of October 25, 2010, petitioner fainted and was brought to the emergency room [“ER”] by her husband around midnight. She indicated she had a cough for two weeks that was almost resolved and had been experiencing worsening fatigue, numbness, and weakness. Pet. Ex. 1, p. 88. The ER physician ordered routine blood and lab tests. Id., pp. 96-97. Because Dr. Banerjee had sent blood to the lab following her appointment with him, there was confusion in the lab and testing of the blood sample sent by the ER physician was delayed. Id., p. 95. Petitioner elected to leave around 4:30 AM, prior to receiving her lab results, with the understanding that she would return if abnormal results were found. Id. Petitioner spoke with Dr. Banerjee on October 26, 2010. She reported that since returning home from the ER she was doing worse with increased leg weakness, difficulty walking and climbing stairs, and a loss of balance. She also indicated that she was getting winded very easily and was unable to lift her arms above her head. Concerned that she might be describing symptoms of GBS, Dr. Banerjee advised her to return to the ER immediately for further evaluation. Pet. Ex. 6, p. 13. She arrived at the Kaiser Permanente Santa Clara Medical Center [“SCMC”] around 3:39 PM and was evaluated by emergency room physician Dr. Haydn Hok Leung at 4:20 PM. Pet. Ex. 1, pp. 107-08. Ms. Petronelli relayed that she had a cough and myalgias for a couple of weeks, and that October 19, 2010 she noticed numbness in her toes which had progressively gotten worse and moved up her legs and also into 3 her arms. She also was experiencing shortness of breath. Pet. Ex. 1, p. 108. Petitioner was admitted to the hospital with diagnosis of possible GBS. Id., p. 112. A neurology resident at SCMC, Dr. Kelly Yeh, examined petitioner later that day. Doctor Yeh recorded that Ms. Petronelli had received a flu vaccine on September 28, 2010, and thereafter developed a cold consisting of a cough with mucous and a sore throat. Doctor Yeh also noted that during the previous week on October 19 th or 21st petitioner started to develop numbness, pins and needles, and coldness in her toes. The numbness then ascended up her feet, into her legs, and up to petitioner’s hands. Doctor Yeh documented that petitioner had not had any recent medical changes except for starting amoxicillin the previous week as treatment for her cold. Pet. Ex. 1, p. 120. Upon examination, Dr. Yeh observed petitioner had decreased sensation to light touch and pinprick which was worse in her toes bilaterally, but also present in her feet and legs, normalizing around petitioner’s knees. Petitioner also demonstrated a decreased sensation to touch and pinprick in her hands bilaterally to her mid-proximal forearm. Id., p. 121. Doctor Yeh assessed petitioner as having “ascending numbness/paresthesisas with absent reflexes, severe back pain and tenderness of face/extremities, also with weakness primarily of hip flexors/hamstrings, suggestive of Guillain-Barre Syndrome.” Pet. Ex. 1, p. 122. Doctor Yeh recommended frequent and serial pulmonary function tests, a lumbar puncture, and IVIG3 treatment. Id. Doctor Jai Hee Cho, a physician at SCMC, also briefly saw and examined petitioner. Doctor Cho “agree[d] with the findings and the plan of care as documented in [Dr. Yeh’s] note.” However, in recounting petitioner’s history of presenting illness in her consult note, Dr. Cho indicated that petitioner had a mild upper respiratory infection [“uri”] prior to receiving her influenza shot and that the symptoms worsened after the vaccination. Pet. Ex. 1, p. 123. Petitioner’s lumbar puncture showed elevated protein levels and normal white blood count and glucose, confirming the diagnosis of GBS. Pet. Ex. 1, p. 195. She received five days of IVIG treatments at SCMC before being discharged to another Kaiser Permanente facility for rehabilitation. Id., pp. 229-232, 236-37. Petitioner was discharged from the rehabilitation facility on December 1, 2010. Pet. Ex. 5, pp. 6-7. She received home health care, which included physical and occupational therapy until January 24, 2011, when she was transitioned to out-patient therapy. See Pet. Ex. 7, pp. 7-18. An EMG/NCV4 study was performed in May 2011. The study showed that petitioner still had “evidence of a demyelinating sensorimotor polyneuropathy in the 3 “IVIG” stands for intravenous immunoglobulin. Neil M. Davis, MEDICAL ABBREVIATIONS, 15th Edition, at 178 (2011). 4 EMG (electromyography) studies look at the electrical activity within muscles and NCV (nerve conduction or electroneurography) studies examine the integrity of the peripheral nerves. Kathleen D. Pagona & Timothy J. Pagona, MOSBY’S MANUAL OF DIAGNOSTIC AND LABORATORY TESTS [“MOSBY’S LABS”] at 571-77 (3d. ed. 2006). The two studies are commonly performed at the same time in patients complaining of weakness. 4 upper and lower extremities.” Pet. Ex. 3, pp. 38-39. When compared with the study conducted in December 2010, Pet. Ex. 1, pp. 256-57, the study showed significant improvement. Pet. Ex. 3, pp. 38-39. In September 2011, petitioner was seen by neurologist Dr. Cho and reported that she still required a cane to walk through large stores, such as Costco, and could not go to parks without her wheelchair. Id., p. 64. Doctor Cho noted that although the “lack of functional improvement is a concern, there is no objective evidence that there has been a relapse,” and thus she was not concerned about CIDP.5 Pet. Ex. 3, p. 65. III. Discussion. A. Legal Standards to Establish Entitlement to Compensation. In order to prevail under the Program, a petitioner must prove either a “Table” 6 injury or that a vaccine listed on the Table was the cause in fact of an injury (an “off- Table” injury). Because GBS is not a Table injury for any vaccine appearing on the Vaccine Injury Table, petitioner must produce preponderant evidence that a covered vaccine is responsible for her injury. When a petitioner alleges an off-Table injury, eligibility for compensation–the prima facie case–is established when the petitioner demonstrates, by a preponderance of the evidence, that: (1) she received a vaccine set forth on the Vaccine Injury Table; (2) that she received the vaccine in the United States; (3) that she sustained or had significantly aggravated an illness, disease, disability, or condition caused by the vaccine; and (4) that the condition has persisted for more than six months.7 To satisfy her burden of proving causation in fact, petitioner must establish each of the three Althen factors by preponderant evidence: (1) a medical theory causally connecting the vaccination and the injury; (2) a logical sequence of cause and effect showing that the vaccination was the reason for the injury; and (3) a proximate temporal relationship between vaccination and injury. Althen v. Sec’y, HHS, 418 F.3d 1274, 1278 (Fed. Cir. 2005); see de Bazan v. Sec’y, HHS, 539 F.3d 1347, 1351-52 (Fed. Cir. 2008); Caves v. Sec’y, HHS, 100 Fed. Cl. 119, 132 (2011), aff. per curiam, 463 Fed. Appx. 932, 2012 WL 858402 (Fed. Cir. 2012) (specifying that each Althen factor must be established by preponderant evidence). 5 By definition, GBS is monophasic, meaning it occurs only once. In contrast, CIDP reoccurs. In initial presentation, patients with CIDP are often difficult to distinguish from patients with GBS, as the initial symptoms are very similar. However, GBS typically responds to either plasma exchange or IVIG; patients with GBS who receive steroids typically do not improve or may get worse. Patients with CIDP generally improve on steroids. A. Ropper & M. Samuels, ADAMS AND VICTOR’S PRINCIPLES OF NEUROLOGY, McGraw- Hill Companies (9th ed. 2009) at 1292-93. 6 A “Table” injury is an injury listed on the Vaccine Injury Table, 42 C.F.R. § 100.3 (2011), corresponding to the vaccine received within the time frame specified. 7 Section 13(a)(1)(A). This section provides that petitioner must demonstrate by a preponderance of the evidence the matters required in the petition by section 300aa–11(c)(1)....” Section 11(c)(1) contains the four factors listed above, along with others not relevant in this case. 5 Once petitioner establishes each of the Althen factors by preponderant evidence, case, the burden of persuasion shifts and respondent must show that the alleged injury was caused by a factor unrelated to the vaccination. See de Bazan, 539 F.3d at 1354 (citing Knudsen v. Sec’y, HHS, 35 F.3d 543, 548 (Fed. Cir. 1994)); § 13(a)(1)(B). Respondent must demonstrate that “the factor unrelated to the vaccination is the more likely or principal cause of the injury alleged. Such a showing establishes that the factor unrelated, not the vaccination, was ‘principally responsible’ for the injury.” Deribeaux v. Sec’y, HHS, 717 F.3d 1363, 1369 (Fed. Cir. 2013). Section 13(a)(2) specifies that factors unrelated do “not include any idiopathic, unexplained, unknown, hypothetical, or undocumented cause factor, injury, illness, or condition.” Close calls regarding causation must be resolved in favor of the petitioner. Althen, 418 F.3d at 1280; but see Knudsen, 35 F.3d at 550 (when evidence is in equipoise, the party with the burden of proof fails to meet that burden). By specifying petitioners’ burden of proof in off-Table cases as the preponderance of the evidence, directing special masters to consider the evidence as a whole, and stating that special masters are not bound by any “diagnosis, conclusion, judgment, test result, report, or summary” contained in the record (§13(b)(1)), Congress contemplated that special masters would weigh and evaluate expert opinions in determining whether petitioners have met their burden of proof. In weighing and evaluating expert opinions in Vaccine Act cases, the same factors the Supreme Court has considered important in determining their admissibility provide the weights and counterweights. See Kumho Tire Co. v. Carmichael, 526 U.S. 137, 149-50 (1999); Terran v. Sec’y, HHS, 195 F.3d 1302, 1316 (Fed. Cir. 1999). As the Supreme Court has noted, a trial court is not required to accept the ipse dixit of any expert’s medical or scientific opinion, because the “court may conclude that there is simply too great an analytical gap between the data and the opinion proffered.” Gen. Elec. Co. v. Joiner, 522 U.S. 136, 146 (1997). B. Parties’ Contentions Regarding Entitlement. There is no dispute that petitioner received a covered vaccine administered in the United States. It is also clear from the medical records that approximately four weeks after receiving a flu vaccine, Ms. Petronelli was diagnosed with GBS and has experienced sequelae of GBS for longer than six months. Therefore, the only issue left to resolve is whether the influenza vaccine administered on September 28, 2010, was the cause-in-fact of petitioner’s GBS. 1. Petitioner’s Expert Report. In support of petitioner’s claim that her September 28, 2010 influenza vaccination caused her GBS, petitioner filed an expert report from Dr. Thomas Morgan. Doctor Morgan is a board certified neurologist who has been an assistant professor with the Department of Clinical Neuroscience at Brown University’s School of Medicine since 1978. Pet. Ex. 13 at 1, 3. His report identifies a theory of causation, molecular mimicry, 6 and indicates that the timing of petitioner’s vaccination and onset of symptoms is consistent with the immune mechanism he identified. Pet. Ex. 12 at 5 (explaining that “the influenza immunization generated an immune response that cross reacted with antigen targets shared by the normal elements of nerve fibers to cause” petitioner’s GBS). Acknowledging the discrepancy in the medical records regarding whether petitioner had an infection prior to her vaccination, which could be the cause of her GBS, Dr. Morgan asserts that the notation of a six week history of cold contained in Dr. Banerjee’s October 21, 2010 consult note must be in error because petitioner would not have been administered a nasal flu vaccine at a time when she was sick with congestion and a cough. Pet. Ex. 12 at 5. He also notes that Dr. Banerjee’s consult note contradicts the history provided to several physicians while petitioner was hospitalized at SCMC and the timeline of events contained in petitioner’s affidavit. Additionally, Dr. Morgan addresses petitioner’s sinusitis, diagnosed by Dr. Banerjee at the October 21, 2012 visit. He remarked that if that diagnosis was proper, it came after petitioner’s flu vaccine and was not the cause of her GBS. Pet. Ex. 12 at 5. Doctor Morgan distinguished upper respiratory infections from sinusitis and noted that sinusitis “is not causally associated with [GBS].” Id. at 6 (citing Duntz, M., Sinus headache and nasal disease, HEADACHES IN CLINICAL PRACTICE, 2d. at 235). 2. Respondent’s Rule 4(c) Report. Respondent declined the opportunity I afforded her to file an expert report. In response to petitioner’s expert report, respondent only filed her Rule 4(c) report and three medical journal articles. In her report, respondent criticizes Dr. Morgan’s report because he did “not address a number of references in the record that refer to an antecedent cold with no mucus or fever that was treated with amoxicillin connected to a vaccination and resolved by October 26, 2010.” Res. Report at 7. Respondent also complains that Dr. Morgan did not specifically address the October 26, 2010 note of Dr. Cho and its reference to petitioner having an upper respiratory infection prior to her influenza vaccination. Res. Report at 7.8 Because two-thirds of patients diagnosed with GBS suffer from an antecedent infectious illness and some of petitioner’s records, particularly Dr. Cho’s, suggest that Ms. Petronelli had an infection prior to her influenza vaccination, respondent argues that “it is exceedingly unlikely that her GBS was caused by a flu vaccine.” Res. Report at 8 (citing Haber et al., Vaccines and Guillain-Barre Syndrome, DRUG SAFETY, 34(4): 309- 323 (2009) at 311). Respondent also questions the likelihood of vaccine causation based on the findings contained in the 2011 IOM Report. After reviewing the available epidemiologic and mechanistic evidence surrounding the influenza vaccine and GBS, 8 Respondent indicated that “Dr. Kelly Yeh, an internst [sic], related to Dr. Cho ‘that the patient had a mild URI, then got flu shot on 9/28 . . . .’” I interpret the record (Pet. Ex. 1, p. 123) as attributing the comment about Ms. Petronelli’s potential URI solely to Dr. Cho. Doctor Yeh’s own note concerning her evaluation of petitioner states “flu vaccine on 9/28/10, thereafter developed a cold.” Pet. Ex. 1, p. 120. 7 the report concluded there was insufficient evidence to support a causal association between the influenza vaccine and GBS. Res. Report at 8 (citing K. Stratton, et al., ADVERSE EVENTS ASSOCIATED WITH CHILDHOOD VACCINES: EVIDENCE BEARING ON CAUSALITY (2011) at 321-34). 3. Petitioner’s Response to Respondent’s Rule 4(c) Report. In her response to respondent’s Rule 4(c) report, petitioner highlights the applicable evidence and discusses how she has satisfied the three Althen prongs. She notes that her theory of causation (molecular mimicry) “has consistently been recognized as a biologically plausible mechanism for the onset of neurologically demyelinating disease, including GBS.” Response at 4. Petitioner also stresses that her treating physicians linked her vaccination to her GBS, and that the timing of approximately four weeks between her vaccination and onset of symptoms is consistent with her causation theory. See Response at 4-7. Petitioner argues that she has made a prima facie case, and that respondent has failed to meet her burden of showing a factor unrelated to petitioner’s vaccination caused her GBS. Petitioner counters respondent’s reliance on the 2011 IOM Report by noting its conclusion of no causal relationship between influenza vaccines and GBS was based on a requirement of scientific certainty and not the preponderant evidence standard applied in the Vaccine Program. Response at 8. Additionally, petitioner notes that the Haber article filed by respondent supports her theory of causation. Response at 7-8. Because respondent did not file an expert report and indicated she would not expend additional resources defending this case, petitioner posits that respondent will be unable to meet her burden. Response at 9. C. Analysis. This case presents the issue of whether an expert report satisfying each of the Althen prongs regarding vaccine causation of GBS can be countered successfully by medical literature alone. Under the circumstances present here, I conclude that literature alone, unexplained by an expert report, does not tip the balance back to respondent. Petitioner’s expert, Dr. Morgan is a board certified neurologist and an assistant professor at Brown University’s School of Medicine. His curriculum vita (Pet. Ex. 13) demonstrates that he is qualified to opine in this case. As petitioner noted in her response, Dr. Morgan’s causation theory is supported by medical literature filed by respondent. See e.g., Haber, Res. Ex. A, at 312 (discussing molecular mimicry as a possible biological mechanism for GBS). Although other decisions involving this vaccine and this injury do not constitute binding authority,9 Dr. Morgan’s opinion is also buttressed by other decisions in the Vaccine Program awarding entitlement for GBS associated with an influenza vaccine. See e.g., Figueroa v. Sec’y, HHS, 715 F.3d 1314, 9 See Hanlon v. Sec’y, HHS, 40 Fed. Cl. 625 (1998). 8 2013 WL 1811018 at *1 (Fed. Cir. May 1, 2013) (citing Torday v. Sec’y, HHS, No. 07- 372V, 2009 U.S. Claims LEXIS 745 (Fed. Cl. Spec. Mstr. Dec. 10, 2009; Griglock v. Sec’y, HHS, 99 Fed. Cl. 373 (2011), aff’d, 687 F.3d 1371 (Fed. Cir. 2012); Stewart v. Sec’y, HHS, No. 06-777, 2011 WL 3241585 (Fed. Cl. Spec. Mstr. July 8, 2011)). Respondent argues that it was not the influenza vaccine but petitioner’s infectious illness that caused her GBS.10 The onset of petitioner’s illness is not concretely established. Some records place onset prior to her influenza vaccination and others afterwards. Compare Pet. Ex. 1, p. 123; Pet. Ex. 2, pp. 38-39 with Pet. Ex. 1, pp. 88-89, 112, 126-27; Pet. Ex. 5, pp. 6-7. Additionally, the evidence in the case record does not establish what infectious illness petitioner had. It is unclear whether petitioner was suffering from an upper respiratory infection or sinusitis; the former being a viral infection and the latter a bacterial infection and typically treated with antibiotics.11 Considering the facts contained in the medical records and petitioner’s affidavit, the medical journal articles cited, and the sole medical expert opinion offered, I conclude that the weight of the evidence in this case favors a finding that petitioner is entitled to compensation. IV. CONCLUSION Based on the record before me, I find that there is preponderant evidence that petitioner’s September 28, 2010 influenza vaccination was a substantial cause of her GBS and that sequelae from petitioner’s GBS persisted for more than six months. I further find that respondent did not meet her burden of establishing a factor unrelated was responsible for petitioner’s injury. I therefore hold that petitioner has established the statutory requirements for entitlement. A damages order will follow. IT IS SO ORDERED. s/ Denise K. Vowell Denise K. Vowell Chief Special Master 10 Respondent’s decision not to file an expert report prevents me from engaging in a comparison of expert qualifications and the rationales behind competing causation theories. 11 Sinusitis Fact Sheet, National Institute of Allergy and Infectious Diseases [“NIAID”] (January 2012) at 3, available at http://www.niaid.nih.gov/topics/sinusitis/Documents/sinusitis.pdf. 9 ================================================================================ DOCUMENT 2: USCOURTS-cofc-1_12-vv-00285-1 Date issued/filed: 2016-06-07 Pages: 10 Docket text: PUBLIC DECISION (Originally filed: 05/12/2016) regarding 121 DECISION of Special Master ( Signed by Special Master Thomas L. Gowen.)(mpj) Copy to parties. -------------------------------------------------------------------------------- Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 1 of 10 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 12-285V Filed: May 12, 2016 * * * * * * * * * * * * * * * * * * * * * MONTEZ PETRONELLI, * * Gowen, Special Master: Petitioner, * v. * * Damages; Present Value; SECRETARY OF HEALTH * Discount Rate. AND HUMAN SERVICES, * * Respondent. * * * * * * * * * * * * * * * * * * * * * * Ronald C. Homer, Conway Homer & Chin-Caplan, P.C., Boston, MA, for petitioner. Michael P. Milmoe, United States Department of Justice, Washington, DC, for respondent. DECISION ON DAMAGES1 A damages hearing was held on February 10, 2016. At the conclusion of the hearing, the undersigned issued a bench ruling awarding petitioner damages for past and future lost wages, past pain and suffering, past expenses, and various life care items. On February 22, 2016, a Ruling on Damages, which memorialized my bench ruling, was issued. The parties were then ordered to file a joint status report providing the present value of the amounts awarded to petitioner for future wage loss and items of future medical and life care, at a 1% discount rate. Thereafter, the parties raised issues of a tax offset to the amount for petitioner’s future lost wages, an adjustment for fringe benefits, a wage growth rate, and the appropriate rate to reduce the future awards to present value. Respondent filed a report from economist Dr. Patrick Kennedy on April 20, 2016, and petitioner filed a responsive expert report from George McLaughlin, MBA, CEA, CVA on May 4, 2016. Respondent filed a responsive expert report from Dr. Kennedy on May 10, 2016. This case is now ripe for a decision on damages. 1 Because this decision contains a reasoned explanation for the undersigned’s action in this case, the undersigned intends to post this ruling on the website of the United States Court of Federal Claims, in accordance with the E-Government Act of 2002, 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government Services). As provided by Vaccine Rule 18(b), each party has 14 days within which to request redaction “of any information furnished by that party: (1) that is a trade secret or commercial or financial in substance and is privileged or confidential; or (2) that includes medical files or similar files, the disclosure of which would constitute a clearly unwarranted invasion of privacy.” Vaccine Rule 18(b). Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 2 of 10 I. Past and Future Lost Wages A comprehensive discussion of petitioner’s award for past and future lost wages can be found in the Ruling on Damages issued on February 22, 2016. In summary, the undersigned considered the parties’ filings in support of their respective positions on all issues relating to petitioner’s damages. Specifically on the issue of petitioner’s lost wages, petitioner’s vocational expert reports and supportive literature, her testimony at the hearing, and the striking impression of her current condition persuasively established that she remains completely disabled from professional employment as an attorney or any other employment. This finding was also well supported by the medical records. The undersigned found that the reports from respondent’s vocational expert, Mr. Edward Bennett, were not reliable or credible, as he mischaracterized the record before him. Consequently, based on the methodology and figures provided by petitioner’s vocational expert, Dr. Staci Schonbrun, petitioner was awarded a raw figure for past and future lost wages in the amount of $2,225,000.00 based on the following rationale:  Petitioner experienced a vaccine injury in October 2010 while out of the job market due to family obligations. According to petitioner, in the beginning of that year, prior to the vaccine injury, she was actively seeking opportunities to re-enter the job market. The undersigned found that had petitioner not experienced a vaccine injury, she likely would have returned to the practice of law, given her education and work experience. However, considering the challenging legal job market in 2010, and petitioner’s testimony of the challenges she encountered in her job search, the undersigned determined that petitioner would have likely spent the remaining months of 2010 looking for employment. Thus petitioner was awarded $0.00 for lost wages in 2010.  In 2011, according to Dr. Schonbrun, petitioner would have entered the job market at the 25th percentile of earnings by lawyers in the State of Colorado, which was approximately $75,000 a year on a full-time basis. See Pet. Ex. 37 at 1-2. Thereafter, petitioner’s earnings would have gradually increased over the following five years to reach the median yearly salary of approximately $125,000. Id. at 2. Thus petitioner was awarded the following amounts for lost wages for 2011 through 2016: $75,000 for 2011; $85,000 for 2012; $95,000 for 2013; $105,000 for 2014; $115,000 for 2015; and $125,000 for 2016. The total amount of petitioner’s past and present lost wages was $600,000.00.  Based on petitioner’s expected retirement age of about sixty-four and a half years, see petitioner’s exhibit 17 at 1, petitioner was awarded $1,625,000 for future lost wages at $125,000 per year from 2017 until retirement (13 years). Adjustments of this amount for wage growth, tax offsets, fringe benefits, and reduction to present value are made below. II. Past and Future Pain and Suffering 2 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 3 of 10 Based on a review of the record and the testimony provided by petitioner at the hearing, petitioner was awarded $250,000.00 for past pain and suffering pursuant to 42 U.S.C. § 300aa- 15(a)(4). III. Past Unreimbursable Expenses Petitioner submitted a statement claiming $9,309.14 for past unreimbursable expenses. Based on a review of petitioner’s itemized list of out-of-pocket expenses and mileage, exhibit 35, and respondent’s recommendations, petitioner was awarded $8,344.64 for past expenses pursuant to 42 U.S.C. § 300aa-15(a)(1)(B). IV. Life Care Items Concerning petitioner’s life care items, the undersigned awarded expenses for items which would ordinarily be covered by an employer, such as a health insurance premium; and awarded expenses for items which are reasonable and necessary as a result of petitioner’s disability. In light of the significant amount for wage loss petitioner was awarded, more routine items of personal care and other typical expenses were not awarded because such items would ordinarily be purchased by petitioner from her income had she been employed. Petitioner was not awarded amounts for a wheelchair accessible van, an all-terrain wheelchair and associated expenses, as it appeared that petitioner was capable of walking short distances and driving short distances in a standard automobile. Petitioner was awarded the following life care items as proposed by her life care planner, Ms. Roberta Hurley, and as supported by the medical records and/or petitioner’s testimony. See Pet. Ex. 29.  Anthem Silver Pathway HMO premium in the amount of $5,068.44 per year, now through 2029.2  Co-pays for treatment by a neurologist in the amount of $45 per year, now to life expectancy.3  Therapeutic massage at $1,800.00 per year now to life expectancy.  Acupuncture at $2,400.00 per year now to life expectancy.  A cane at $22.00 now and every two years to life expectancy.  Pride Go Go-Elite Scooter at $1199.00 now and every five years to life expectancy. As petitioner was not awarded amounts for maximum out-of-pocket expenses and 2 Petitioner will become eligible for Medicare in 2029. 3 I have modestly adjusted the life expectancy for a 51 year old female from 30.5 years as provided by the National Center for Health Statistics to 30 years, based on her health. 3 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 4 of 10 a deductible under the Anthem HMO Plan, petitioner was awarded the cost for replacing the scooter every five years, as that will be an expense petitioner will incur out-of-pocket.  Bath chair with back at $50 now and every five years to life expectancy.  Pride Lift Chair at $812.00 now and every ten years to life expectancy.  Seat belt pull at $10.00 now and every two years to life expectancy.  Button hook/zipper pull at $15.48 now and every five years to life expectancy.  Home care from Bright Star Care at $21.00 per hour for 20 hours a week now to life expectancy.  One pair of orthopedic shoes at $135.00 now and every year to life expectancy. V. Discussion of Rate of Reduction to Present Value, Tax Offsets, Wage Growth and Fringe Benefits At the conclusion of the damages hearing in this case, and after review and consultation with counsel, I announced a decision awarding damages to Ms. Petronelli. I was persuaded that she had suffered substantial and permanent disability secondary to the flu vaccine and Guillain- Barré Syndrome.4 As informal resolution of the amount of petitioner’s damage had been stalled for approximately two years, and I was persuaded that petitioner’s living conditions (supporting herself and a child on about $800.00 a month) were desperate, I decided that a decision on damages should be rendered promptly in order to alleviate that condition. The only matter outstanding at the conclusion of the hearing, in my view, was to have an economist calculate the tax offset and a reduction to present value that I determined should be done at 1% rate. The respondent argued, in a post-hearing status report, that the decisions in the Program required that future wage loss be reduced by a figure equaling “net present value” and that a tax offset should be applied. Upon review of the cases submitted by respondent, it appeared that the concept of reduction to “net present value” was used in prior cases. See Brown v. Sec’y of HHS, No. 00-182V, 2005 WL 2659073 (Fed. Cl. Spec. Mstr. Apr. 17, 2012); Watkins v. Sec’y of HHS, No. 95-154V, 1999 WL 199057 (Fed. Cl. Spec. Mstr. Mar. 12, 1999). Both of the cases cited above quoted the United States Supreme Court decision in Jones & Laughlin Steel Corp. v. Pfeifer, 462 U.S. 523, 524 (1983) in which the Court said: [B]y its very nature the calculation of an award for lost earnings must be a rough approximation. Because the lost stream can never be predicted with complete 4 Chief Special Master Vowell had decided the issue of entitlement in late 2013, and the case was assigned to me shortly after my arrival at the court in March 2014. The parties discussed damages and refined expert reports at my direction since that time. 4 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 5 of 10 confidence, any lump sum represents only a ‘rough and ready’ effort to put the plaintiff in the position he would have been if he had not been injured. Id. The Supreme Court noted that in almost any case, calculating the loss of future wages could become the subject of reasonable debate. See Monessen Southwestern Railway Co. v. Morgan, 486 U.S. 330, 351 (1988). The Court counseled against allowing the average personal injury trial to become a graduate seminar on economic forecasting. Id. at 341. After reviewing the advantages and disadvantages of the various calculation methods, the Court in Jones & Laughlin Steel Corp. found the “economic evidence distinctly inconclusive” and concluded that: “we do not believe a trial court adopting such an approach in a suit . . . should be reversed if it adopts a rate between one and three percent and explains its choice.” Jones & Laughlin Steel, 462 U.S. at 548-49. The Supreme Court reviewed various methods for calculating future losses, including a reduction by a nominal rate of return and the net present value method. A nominal reduction to present value requires a straight forward reduction for the time value of money received at the present time to compensate for future losses. This reduction is usually based upon the projected return on the investment of an awarded lump sum of money in a conservative investment, such as U.S. Treasury bonds. On the other hand, the use of “net present value” requires the estimate of future interest rates less the rate of future wage growth for the petitioner, with the difference representing the reduction factor. The net present value methodology, to some extent, assumes that future interest rates will exceed future wage growth, and thus result in a net reduction of the raw sum awarded for future wage loss. It usually does not, but certainly could, contemplate that wage growth could be higher than interest rates at various times. In an attorneys’ fee case in this Program, based upon a study5 submitted by the respondent, it was indicated that since the beginning of the “great recession” in 2008, attorneys’ fees had grown at an annual rate of 3.7% per annum, which was down from approximately 7% prior to the recession. See McCulloch v. Sec’y of HHS, 09-293V, 2015 WL 5634323 (Fed. Cl. Spec. Mstr. Sept. 1, 2015). I had initially determined that this study, the Real Rate Report, appeared to provide a good guidepost for calculating the rate of future wage growth for Ms. Petronelli, who was an experienced corporate attorney prior to her disability. I observed to counsel in a status conference that given the low interest rates available on U.S. Treasury bonds, even as far out as 10 year maturities, the result of a net present value calculation would likely produce a negative net value, and at a minimum require no reduction, if not actually an increase, in the award. At the same time, petitioner argued that I should add the value of fringe benefits and future wage growth to the initial sum awarded. The parties, at my direction, filed status reports in which they calculated tax offsets and reduction to present value at 1%. Petitioner added fringe benefits at 14.5% of wages, and performed the calculations to increase future wages by 3.7% as directed by 5 The study, the Real Rate Report (“RRR”), was an extensive report on attorneys’ fees billed to corporate clients. This study was cited by petitioner in this case as a reasonable guidepost for projecting attorney wage growth. 5 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 6 of 10 my order. See Status Report, docket no. 108, filed Mar. 25, 2016. Respondent also calculated tax offsets, but did not increase future wages or add fringe benefits. See Respondent’s Exhibit (“Res. Ex.”) M, filed Mar. 25, 2016. Respondent’s counsel further argued that he needed to submit an expert report from Dr. Patrick Kennedy Ph.D. to support an argument for a higher reduction to present value greater than the 1% I had allowed, even though this rate appeared generous to the respondent’s side given the current interest rates. The respondent filed a report from Dr. Kennedy to which the petitioner responded with a report from an economist, George McLauglin, MBA, CEA, CVA. I held a status conference with counsel at which time respondent indicated that he would like to file a responsive report from Dr. Kennedy, which he had in hand. I advised respondent’s counsel to file it promptly, which he did. Respondent also requested a hearing to permit live testimony from Dr. Kennedy and Mr. McLaughlin. Petitioner did not believe a hearing was necessary. As I had extensively reviewed the expert reports, the cases, and supporting economic data, I advised the parties that I did not believe an additional hearing would be necessary or helpful to the decision, and would only have the effect of further delaying the resolution of the case. Particularly, given that the difference between my conclusions as to a discount rate and a wage growth rate appeared to be well within the range of a reasonable rough approximation, and that I was planning to accept the respondent’s estimate for fringe benefits, I denied the request for a hearing. See Order, docket no. 120, filed May 11, 2016. Dr. Kennedy argued for a discount rate of 1.75%, while petitioner’s expert, Mr. McLaughlin, found the 1% rate that I used initially to be reasonable. Dr. Kennedy’s research suggested that over a period of 18 years, the Consumer Price Index averaged 2.2%, and interest rates averaged 3.4%. Res. Ex. N at 7. He opined that the Bureau of Labor Statistics (“BLS”) estimate for wages in the legal industry would be more reliable than the RRR report, which was based on attorneys’ fees rather than net income. Id. Based on the BLS numbers, Dr. Kennedy found that the legal industry growth rate was 0.25% above the rate of inflation, resulting in a net discount rate of approximately 1%, based on this 18-year time period. Id. at 7. Nevertheless, Dr. Kennedy argued for a methodology he called the “real rate of return” or “net discount rate,” which assumed that the relationship between earnings growth and interest rates remains relatively stable over time. Res. Ex. N at 8. Dr. Kennedy looked at three projections for future inflation, which ranged from 1.04% to 2.3% by 2020; and in one projection, a range up to 2.6% in later years. Id. at 5. Not surprisingly, the projections differed significantly, with the Congressional Budget Office projecting a range from 1.04% in 2018 to 1.1% in 2026, and the Federal Reserve projecting 2.3% by 2018, with a “longer run” projection of 2.6%, according to Dr. Kennedy. Id. Dr. Kennedy argued that I should consider average interest rates over the last 30 years, rather than the 18 years he discussed before, because the great recession occurred during the last 18 years, thus depressing growth rates during that time. Id. at 7. Dr. Kennedy neglected to mention that by going back 30 years, he included the latter part of the highest interest rate period subsequent to the OPEC oil crisis and the high inflation which Federal Reserve Chairman Paul Volcker attempted to curb by restricting the money supply. See Petitioner’s Exhibit (“Pet. Ex.”) 40 at 2-3. Mr. McLaughlin argued that past averages are particularly poor predictors of future interest rates. Pet. Ex. 40 at 2. He argued that investors do not make judgments about bond purchases based 6 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 7 of 10 on past averages. Id. Mr. McLaughlin noted the important roles played by Federal Reserve Chairmen in addressing the challenges faced by the economy during their terms in office. He explained that Paul Volcker was challenged with curbing very high inflation after the formation of the oil cartel ignited inflation in the United States. To remedy that situation, Mr. Volcker severely tightened the money supply, which resulted in high interest rates. Id. Alan Greenspan, the subsequent Federal Reserve Chairman, believed in as little regulation as possible on the free market and he generally maintained modest interest rates, which led to the dot.com bubble and the housing bubble with severe recessionary consequences for the economy. Id. at 3. Subsequent Federal Reserve Chairmen, Ben Bernanke and Janet Yellen, have had the challenge of trying to stimulate the economy without the benefit of additional fiscal stimulus employed in the prior recession. Id. They have maintained interest rates close to zero. Id. at 2-3. Neither party mentioned the Federal Reserve Open Market Committee goal of maintaining inflation at 2% in order to achieve price stability and maximum employment.6 While Dr. Kennedy is correct that the Federal Reserve raised its federal funds rate by 0.25% in December 2015, and expects additional increases in the future, he neglected to mention that the Federal Reserve declined to raise interest rates at its March or April 2015 meetings by even another 0.25% because of the sluggish economic conditions. See Res. Ex. N at 5. Both economists agreed that if current interest rates were compared to current wage growth in the legal industry, whether using the 3.7% rate, which Mr. McLaughlin found reasonable, or the 2.65% rate found reasonable by Dr. Kennedy, the result would be a negative present value requiring no reduction. However, Dr. Kennedy argued that a 30-year average should be used to identify expected interest rates for U.S. Treasury bonds. He stated that “[o]ver the last 20 or 30 years, the five year Treasury note has averaged 3.5 to 4.8 percent.” Id. Mr. McLaughlin, though recognizing that the net discount rate could be negative, stated that he thought that the time value of money had to be accounted for, and so concluded that a 1% rate was reasonable, which is a straight nominal rate and not a net rate. See Pet. Ex. 40 at 7. I considered that the challenge for Ms. Petronelli is to be able to take a lump sum of money awarded to her at this time and purchase a portfolio of U.S. Treasury bonds that would provide her with a return sufficient to offset the reduction to present value. Consulting the official site of the U.S. Department of the Treasury on May 5, 2016, I found that the rate for 6 month bonds is 0.41%, for 1 year bonds 0.55%, for 2 year bonds 0.80%, for 3 year bonds 0.96%, and for 5 year bonds 1.32%.7 If Dr. Kennedy’s projections that interest rates could be in the 4 to 5% range in five years was accepted, then it would have to be recognized that a prudent investment advisor would have to invest money received now in shorter maturities because the market value of the bond purchased today, at low interest rates, will decline as interest rates on newer issues increase. In that eventuality, petitioner should not be caught with longer term maturities. If the money were invested in a laddered portfolio, equally divided among 6 month, 1 year, and 2 year maturities, 6 See BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM, Current FAQs: Why Does the Federal Reserve Aim for 2 Percent Inflation Over Time, https://www.federalreserve.gov/faqs/economy_14400.htm (last visited May 11, 2016). 7 See U.S. DEPARTMENT OF THE TREASURY, Daily Treasury Yield Curve Rates, https://www.treasury.gov/resource-center/data-chart-center/interest- rates/Pages/TextView.aspx?data=yield (last visited May 5, 2016). 7 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 8 of 10 then the average return would be 0.58%. If three year and five year maturities were added in equal increments, the average return would be 0.80%. Dr. Kennedy’s argument for the use of a 30-year average might carry more weight in the case of a younger person for whom the court would be projecting wage loss for 30 or 40 years into the future. But, in this case, I projected a work life expectancy of 13 years for Ms. Petronelli, given her current age of 51. So, while she may be able to earn higher returns in the outer years of this time period, she will not be able to earn those returns in the more clearly foreseeable near term. In fact, it can be argued that given that the 10-year maturity for U.S. Treasury bonds is currently at 1.88%, the market is projecting a much lower rate of growth of the interest rate than projected by Dr. Kennedy for a very substantial portion of the petitioner’s work life expectancy. Mr. McLauglin argued that the rate of return on conservative investments like U.S. Treasury bonds is affected by many considerations, and most prominently at this time, by the need to maintain growth in a sluggish economy. He cited an article by Lawrence Summers, the former Treasury Secretary and Harvard President, which suggests the likelihood of “secular stagnation” in the economy over the foreseeable future, as well as research by two economists at the San Francisco Federal Reserve Bank which shows that market expectations for inflation have shifted downward, implying that interest rates will be kept low by the Federal Reserve for a long period of time. See Pet. Ex. 40 at 5. As can be seen from the above discussion, the projections of economists vary greatly and rely upon crystal balls that are rarely very clear, particularly when the intention is to look 5 or 10 years, or more, into the future. What is clear is that Ms. Petronelli’s wage loss is projected over a 13-year work life expectancy, and that for at least the first third to half of that time period, it is unlikely that she will be able to obtain average investment returns in short and intermediate term U.S. Treasury bonds that would exceed Dr. Kennedy’s projected wage growth rate of 2.65%, which is lower than the growth rate found reasonable by Mr. McLaughlin (3.7%). While it seems likely that the petitioner would be able to obtain higher returns in the outer years if the economy returns to past growth rates, it should be noted that even the 20-year U.S. Treasury bond is paying only 2.22% as of May 4, 2016.8 It seems unreasonable to base a decision on a discount rate on the most aggressive inflation models, particularly given that the petitioner would not be able to obtain those returns at any time in the foreseeable future, and her wage loss window is only thirteen years. Accordingly I will order, consistent with my original decision, that Ms. Petronelli’s wage loss be discounted at a rate of 1%, beginning with the year 2017, to account for the potential of higher returns in the latter part of the 13-year wage period. Petitioner argued that I should retain my original growth rate projection for attorney income in the corporate world at 3.7%, and I will. I find that this number comes closer to approximating future losses for a corporate attorney because most growth in attorney wages occurs as a result of progression up the ladder based on experience and expertise. The 3.7% and 2.65% figures approximate an overall number for the profession that does not account for individual progression over the course of a career, which I find reasonable to consider. Accordingly, either figure would provide a conservative estimate of the petitioner’s likely future wage loss. 8 See supra note 7. 8 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 9 of 10 In his supplemental report, Dr. Kennedy argued that Mr. McLaughlin’s use of a figure for future wage growth compared to foreseeably available interest rates “implies” a negative net discount rate of 2.7%, which he argued contradicted Mr. McLaughlin’s initial report in this case, filed in 2014. See Res. Ex. O at 2. However, both experts were directed by my post-hearing order to consider the definition of “net discount rate” as showing the difference between future wage growth and potential investment return, a methodology recognized by the Second Circuit in Hawaiian Independent Refinery, Inc. v. Caleb Brett U.S.A. Inc., 928 F.2d 39, 44 (2d Cir. 1991) (as cited in Watkins, 1999 WL 199057, at *6). See Scheduling Order, docket no. 109, filed Apr. 4, 2016. When following this directive, and looking at 18-year data for wage loss compared to investment return, Dr. Kennedy concluded that a 1% net discount rate was appropriate. He then argued for a different methodology based on the assumption that interest rates and inflation maintained a relatively constant relationship over time, and that a 30-year look back was necessary. The Supreme Court in Jones & Laughlin Steel Corp. reviewed the various methodologies and concluded that the economic evidence in favor of one method or the other was “distinctly inconclusive.” 462 U.S. at 548-49. As explained above, I have concluded that because of the relatively short term of future wage loss in this case, and the interest rates for short and intermediate term bonds that would be available for investment, the methodology proposed by Dr. Kennedy, (based on a 30-year look back period) was less likely to be predictive. The petitioner argued that fringe benefits of 14.5% of salary should be added, while respondent argued for a 10% rate. On this issue, I find respondent’s argument more reasonable and award a 10% rate, as I found 4% of the 14.5% figure petitioner suggested was attributable to medical benefits (which are awarded separately) and benefits like vacation pay (which are already calculated into total wage loss). Other benefits, such as retirement plans, life or disability insurance, unemployment insurance, and the employer’s FICA payment, may reasonably constitute 10% of earnings. In his responsive report, Dr. Kennedy argues that 10% is reasonable but that I should consider a 7% rate because Mr. McLauglin included items like life and disability insurance in his calculation, and these items should be excluded as the person would have to be dead or disabled to benefit. See Res. Ex. O at 1-2. While I used the above list only by way of examples of employee benefits, Dr. Kennedy’s argument misconstrues the nature of an employee benefit. The benefit is the payment of the premium by the employer for life and disability insurance, or any other kind of insurance for that matter, not the ultimate payout on such a policy. The 10% figure is reasonable. The parties’ respective tax offset calculations were in agreement, and I have adopted those figures in arriving at a final award for past, present, and future wage loss. Additionally, the parties used a 1% rate to calculate the cost of future life care items. See Joint Status Report, docket no. 104, filed Mar. 8, 2016. The parties provided that the total discounted present value of the life care items is $759,367.89. Id. I have also adopted that calculation. In accord with the foregoing, I find that petitioner is entitled to the following amounts for damages: Past Pain and Suffering $250,000.00 9 Case 1:12-vv-00285-UNJ Document 122 Filed 06/07/16 Page 10 of 10 Past and Present Wage Loss with 10% Fringe Benefits Reduced by Tax Offset $480,906.009 Future Wage Loss $1,471,306.5210 Future Medical and Life Care Items $759,367.8911 Past Expenses $8,344.64 Total Award $2,969,925.05 VI. Form of Payment Section 15(f)(4)(A) of the Vaccine Act provides that compensation shall be paid “in a lump sum of which all or a portion may be used as ordered by the special master to purchase an annuity or otherwise to be used, with the consent of the petitioner, in a manner determined by the special master to be in the best interests of the petitioner.” Petitioner has asked for a lump sum payment of compensation with no annuity. The undersigned finds this request reasonable as petitioner is an adult woman with professional experience as a corporate attorney, and thus reasonably capable of making an informed decision. Accordingly, petitioner is awarded the following compensation for all damages that would be available under 42 U.S.C. § 300aa-15(a): 1. A lump sum payment of $2,969,925.05 in the form of a check payable to petitioner, Montez Petronelli. The Clerk of the Court is directed to enter judgment in accordance with this decision.12 IT IS SO ORDERED. s/Thomas L. Gowen Thomas L. Gowen Special Master 9 See Res. Ex. N Tab E at 1 from which this number was taken. 10 In petitioner’s status report filed March 25, 2016, petitioner provided figures for the present value of future wages at a 1% discount rate. See Status Report, docket no. 108, filed Mar. 25, 2016. The present value of her wages, from 2017 to retirement in 2030, was added to provide a total net present value for future wage loss of $1,337,551.40. Then, a 10% fringe benefit rate was added to this net present value to arrive at $1,471,306.52 for future wage loss. 11 See Joint Status Report, docket no. 104, filed Mar. 8, 2016, from which this figure is taken. 12 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party filing a notice renouncing the right to seek review. 10