LLT Lab: Vaccine/Injury Project

There are many objectives for the Lab’s Vaccine/Injury Project (“V/IP”), but the major ones include:

• First, to investigate the logical structure of the statutory rule system, case law and evidence-assessment patterns under the National Vaccine Injury Compensation Program (“VICP”) in the United States;
• Second, to use our logic investigation and state-of-the-art technology to create useful tools that can increase the efficiency of the VICP decision-making process;
• Third, to create methods for training legal decision-makers and legal practitioners, as well as researchers and students, in the use of logic skills; and
• Fourth, to demonstrate the feasibility of a scalable, team approach in applying the default-logic framework to legal decisions generally.

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Vern Walker submitted a paper and gave a presentation at the Second International Conference on Quantitative Aspects of Justice and Fairness, held on 25-26 February 2011 in Fiesole, near Florence, Italy. The presentation, entitled “Empirically Quantifying Evidence Assessment in Legal Decisions,” reported some baseline results for the Vaccine/Injury Project.

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The decision in Howard v. Secretary of Health and Human Services is an example of a Special Master favoring medical records over familial testimony when determining how events are temporally related.

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In Stewart v. Secretary of the Department of Health and Human Services, Special Master Millman grounds her reasoning and evidence assessment of Althen Prong 1 in part on a substantial amount of policy.

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In Stewart v. Secretary of the Department of Health and Human Services, the Special Master devotes a substantial portion of the discussion not just to assessing the medical evidence that supports a finding on Althen Prong 2, but assessing the credibility of the medical experts themselves.

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Prong 1 of the Althen case requires the plaintiff to prove by preponderance of evidence that the vaccine can cause the type of injury at issue in the case. One question is how much evidence is necessary to meet the preponderance standard for this prong of the Althen test? Would a scientific theory that proposes a connection between the vaccine and alleged injury suffice, or do we need controlled trials using animal or human models, or is there a balancing test involving various elements?

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Stewart is an example of a Special Master giving the medical opinion of a treating physician significant positive weight in the decision-making process, when the treating physician was careful and took the proper steps to make a correct diagnosis.

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The LLT Lab’s template model for the National Vaccine Act currently contains one Rule Factor connected to prong 2 (a “logical sequence of cause and effect”), but could it be that prong 3 (a “proximate temporal relationship”) deserves a Rule Factor of its own?  This blog explores that question in the context of the Bowes case, yet perhaps only time will tell whether a Rule Factor will be appropriate for prong 3.

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Would a medical theory based merely on case reports suffice to prove Prong 1 of the Althen test of causation, or does a petitioner need additional evidence? And if more is needed, what additional evidence is necessary or sufficient? Is there some kind of balancing test at work?

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The Casey decision by Special Master Sweeney illustrates an inference pattern that may incorporate policy considerations unique to Vaccine Act cases.

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