Michael Civatte v. HHS - Influenza, Guillain-Barre Syndrome (GBS) (2023)

Michael Civatte, a 34-year-old self-employed contractor, filed a petition for compensation under the National Vaccine Injury Compensation Program on November 13, 2018. He alleged that he developed Guillain-Barre Syndrome (GBS) as a result of an influenza vaccine administered on November 11, 2015.

The respondent, the Secretary of Health and Human Services, conceded that Mr. Civatte was entitled to compensation for a Table injury, specifically a flu/GBS Table injury, finding that his condition persisted for at least six months and had no alternative cause.

The case then proceeded to determine damages. Mr.

Civatte's medical history indicated he received the influenza vaccine on November 11, 2015. Five days later, he experienced ascending numbness and weakness in his extremities, leading to hospitalization and a diagnosis of GBS.

His symptoms included facial weakness, difficulty eating, and slurred speech. He was admitted to the intensive care unit and subsequently transferred to a rehabilitation hospital for physical, occupational, and speech therapies.

While his strength improved, he had residual right-sided facial weakness and decreased endurance. He was uninsured during his treatment period from November 2015 to January 2018.

He claimed substantial unreimbursable medical expenses totaling $94,470.57. He also sought compensation for pain and suffering.

The Special Master awarded $185,000.00 for past pain and suffering. In making this award, the Special Master considered the severity and duration of Mr.

Civatte's GBS, including his hospitalization, treatment with IVIg, insertion of a feeding tube, ICU admission, and rehabilitation stay. The Special Master also acknowledged the persistent facial paralysis, decreased endurance, and the significant financial and personal strain from his uninsured medical debt, which included ongoing collection efforts and a severely damaged credit score.

The Special Master declined to make a further award for future pain and suffering. Regarding medical expenses, the Special Master initially awarded only $75.00 for paid medical expenses.

This was because the Special Master determined that most of the claimed debts, totaling $94,395.57, had not been "incurred" under the Vaccine Act, as the North Carolina statute of limitations for collecting these debts had expired, rendering Mr. Civatte no longer legally liable for them.

The Special Master also rejected certain claimed expenses due to insufficient documentation or because they appeared to have been voluntarily written off by the provider, NHRMC. Mr.

Civatte filed a motion for review of the Special Master's decision on medical expenses. The U.S.

Court of Federal Claims, in a memorandum opinion and order, vacated the Special Master's decision regarding medical expenses. The Court held that the Special Master's interpretation of "incurred" was not in accordance with law, as the Vaccine Act does not require ongoing legal liability for an expense to be considered "incurred." The case was remanded to the Special Master to consider whether uncollectable expenses could still be considered "actual unreimbursable expenses" under the Vaccine Act and to make appropriate factual findings.

Following remand, the Special Master re-evaluated the medical expenses. He determined that certain balances were voluntarily borne by NHRMC through charity care adjustments and were not reimbursable.

He also rejected claims to other creditors due to insufficient evidence of ongoing liability. However, for the primary outstanding balances to NHRMC, totaling $85,292.01, after applying a 50% self-pay discount, the Special Master found that these expenses were still being pursued by debt collectors.

Despite the expired statute of limitations, the Special Master ultimately awarded $75.00 for medical expenses, representing sums the petitioner had personally paid. The total award was $185,075.00 ($185,000.00 for pain and suffering and $75.00 for paid medical expenses).