M.R. v. HHS - Influenza, left-sided sensorineural hearing loss (2022)
Case summary [AI summaries can sometimes make mistakes]
On August 18, 2016, M.R., a 49-year-old registered nurse, filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that an influenza vaccination administered on October 21, 2014, caused him to develop left-sided sensorineural hearing loss (SNHL). Petitioner reported experiencing vertigo and hearing loss in his left ear six days after vaccination.
Medical evaluations confirmed profound SNHL in his left ear. An MRI subsequently revealed a 5mm vestibular schwannoma (acoustic neuroma) in his left internal auditory canal.
Petitioner's expert, Dr. Edwin Monsell, proposed a "stress response theory" linking the flu vaccine to SNHL, suggesting inflammation and NF-kB activation.
He argued that the tumor was too small to cause the severe hearing loss and that the vaccine was the most likely cause. Respondent's expert, Dr.
Douglas Bigelow, disputed the vaccine's role, citing large studies showing no correlation between flu vaccines and SNHL. He asserted that acoustic neuromas are a common cause of SNHL, regardless of tumor size, and that Petitioner's tumor was the most likely cause.
The Chief Special Master denied entitlement, finding that Petitioner's acoustic neuroma was the most likely cause of his SNHL, precluding a finding that the vaccine caused the injury. The Chief Special Master's decision was based on the conclusion that the neuroma, which likely predated the vaccination, was the principal cause of the SNHL.
On review, the Court of Federal Claims vacated this decision, finding the Chief Special Master's analysis lacked clarity regarding causation and the application of the Shyface standard. The court remanded the case for further proceedings to clarify causation, perform a proper "Shyface" analysis, and potentially reopen the record for further development.
The court noted that the Chief Special Master had not adequately developed the record or performed the necessary analysis to determine if the vaccine and the acoustic neuroma acted in concert, or if one was the independent cause of the injury. The court emphasized that close calls regarding causation are resolved in favor of injured claimants.
Theory of causation
Petitioner M.R., age 49, received an influenza vaccine on October 21, 2014. Six days later, he developed vertigo and left-sided sensorineural hearing loss (SNHL). An MRI revealed a 5mm vestibular schwannoma (acoustic neuroma) in his left internal auditory canal. Petitioner's expert, Dr. Edwin Monsell, proposed the "stress response theory," suggesting the flu vaccine caused inflammation via NF-kB activation, leading to SNHL. He argued the tumor was too small to be the sole cause. Respondent's expert, Dr. Douglas Bigelow, contended that acoustic neuromas are a common cause of SNHL, regardless of size, and that Petitioner's tumor was the most likely cause, citing large studies showing no vaccine-SNHL correlation. The Special Master denied entitlement, finding the acoustic neuroma was the most likely cause. The Court of Federal Claims vacated this decision, finding the Special Master's analysis lacked clarity on causation and the Shyface standard, remanding for further proceedings to clarify findings, perform a proper causation analysis, and potentially reopen the record. The court noted the Special Master did not adequately address whether the vaccine and neuroma acted in concert or if one was the independent cause, and that close calls favor the claimant. Petitioner's counsel was Ronald Craig Homer. Respondent's counsel was Sarah Christina Duncan. Chief Special Master was Brian H. Corcoran. The decision date was October 3, 2022. The outcome was denied entitlement, but the case was remanded by the Court of Federal Claims on August 2, 2023.
Source PDFs
USCOURTS-cofc-1_16-vv-01024