there this is a case involving a special master who used a fact determination to supplant every plays a proper all things couples on a determination of this case this case involved whether or not hepatitis b special masters generosity affording the teacher every opportunity to make an argument that the record was expanded to include petitioners alternate and less preferred very significant information and then there's a whole bunch of cites to all these brief so i assume that's what they were going to do so that's what was the supplementation as a script point to start on because let me just explain that there was no reason for us to think that this was a case of significant aggravation because there was no evidence from the fast we aggravate ing circumstance issues not be you really not pursuing that part of the game but we are now because according to what i am doing as an alternative because what we're saying is what we originally pursued this case we had no reason to think there was an the facts what is and what the special master relied upon was the opinion of dr warner he's the only one with this opinion so the crohn's disease may have started earlier he admitted that that's based on subtle medicine he admits is based on a couple articles that he presented evidence one of the article said that you had to have showings of and it talked about the dire the weight loss was a work from nine pounds to sixteen or seventeen pounds in this case we're dealing with a child went from eighty three pounds eighty two and a half pounds then at a time when she had a journey tract infection she went eighty pounds then she went back up to eighty two pounds then she went up to eighty eight the quarter pounds before she got the vaccination so did her weight dropped by two or three pounds yes is that unusual to know she had a u t i at the time she was lost weight what clothes were she wearing and she was way most of the days that she went in she wasn't even away and that the  point of the heroin record that's all the record if you look at the weights on a for a forty eight forty two on october fourteenth ninety four she waited three pounds well if you look at the percent this she she was going downhill there were there was nothing wrong with her she was an athlete she was competing she was had she had no problems this was a healthy girl she had no diarrhea she had no blood in the stool she had noted bombing she had no that by the time she got the shot she had gone back up in weight and so did she go down a little bit or wave yes she dropped off three pounds but the relevance of that simply is that the government's doctor  rational master on the top of my view is one of those special master in this case was trying to substitute what's generally accepted the medical community which is something which all of them does not require any more trying to put that into this case is injecting requirements that were removed in all of them back into the case by relying on the opinion of one expert why because he's treated more cases of crohn's disease i mean that's not that is that's an unknown impossible burden for petitioners to meet in this program if every case we can look back say well that child the or that baby had a funny twitch of the arm and it was three years old therefore that was the onset of symptoms and some doctor comes out and so the fact is there but but but the so if we get past this issue first of all i don't think there was an onset prior to it but even if you say that this is losing three pounds and then really gaining going back up to eighty eight pounds so by the time she got the shot she gone from eighty three days eighty pounds again last three went back up to eighty eight even if you say that was somehow crohn's disease which it wasn't and dr warner admitted that there are things that can cause weight loss he admitted to the subtle medicine but on the basis of speculation the special master was willing to say that of the onset nothing in the record or from any doctor to suggest that say this was the onset of the disease are experts contradicting so what are we don't have a battle of the experts is it are we now looking at expert credibility i thought that was something that was also rejected and under but apparently not of that so if it's expert credibility as to what three pound weight loss means that i think we have real problems but put that aside what happened after the first vaccination was totally different if having nazia diarrhea vomiting severe weight loss and now we're talking about fourteen pounds of weight loss we're talking on a big time we loss if you say all those aren't a significant aggravation that's simply ignoring the facts clearly she had the vaccination clearly according to medical records she now became totally symptomatic to the point where she was diagnosed the called positive rechelle if you look at the chemicals on a decision say you're arguing absolutely significant aggravation no diarrhea none of the stuff before now you've got it afterwards if that's not significant aggravation we have to be put on prednisone then i don't know what significant of your nation is i fail to see how a healthy child before the vaccine goes so sick child after the vaccine has to be on prednisone and that's not significant aggravation and dr warner is answer that is well that's just the natural course of the disease dr warner himself said if you put ten pros patients in a room they will all have ten different courses so how can we say it's a national natural course of disease it doesn't answer the patient maybe how long does it last or it can be it can be acute or it can be chronic and that's that goes back to every everything we have with vaccines relates that which of the animals everything you can get one species of animal the same injections another species one animal have an acute reaction like or something the other will have a chronic condition in her case after that second whammo after the third shot when she got really sick then she continues to have now she's got started shooting now she's got all the things going on the perpetually a to cause problems of these you get worse and know after that it can be triggered by using wrong food it can have all kinds of things going to affect the course after it's gotten full blown like it did but certainly this was singing and not only was a significant information it was a positive n symptoms after an additional injection of vaccine if that didn't happen here i don't know what did if dr body isn't the man to talk to that i don't know who is what does a petitioner have to do to win this program or if this program is getting to the point where petitioners cannot win and we cannot appeal because it's based on a factual determination this was more than a factual determination this was a special master inserted fact in stephen's requirements and calling it a factual determination because the facts are the facts in this case the interpretation is what's wrong  the case turned onto fact based question that was what was the timing of the onset of the crohn's disease did that occur before vaccination and if it did that therefore was aggravated by the vaccine that we're making are new in all in terms of aggravation our position from the beginning based on our expert's report was that the evidence showed that she had thrown these before vaccination show that what makes the symptoms she was experiencing after vaccination were not part of the natural course of her disease she never showed that she wouldn't have had the symptoms but for the vaccination but the for the doctors the the special masters point was that neither of the doctors said anything about the activation issue and therefore that interact your argument isn't fair you're through with the condom is for the crohn's disease the vaccinations would have been who at least either directly or indirectly can see that she did had drones before the vaccination so that put the doctors in a rather impossible position they couldn't take the position that she didn't have it and told the vaccination and simultaneously a decision that she did have it and it aggravated so what was the doctor supposed to say well i understand you're under sludge however in this case i do believe that we have an exceptional circumstance which is borne out by judge miller which was that just as we're allowed to get a doctor to specifically address the aggravation issue ye isherwood was allowed to have the record in athens reopened to have that evidence come in so in this situation the doctor who made it first be looking at the case in terms of causation and now louise which gears and have to talk about aggravation that's not exactly the case here there was a doctor dr solomon was a gastroenterologist that petitioner was allowed to submit evidence from after hearing what happened he was asked directly to address is this aggravation our position is that the second claim of migration fails because the dish will never show what we expect an adolescent who had on him from disease at earlier at the time when she has the drop in her growth not just the absolute weight loss but the girl's philosophy that was the onset of her condition we petition never showed us what we expect a child and adolescent to just have later on government experience in saying that this child had since ins that could be interpreted as close disease didn't testify as i recall that true well your honor our position is that the children are failed to establish evidence essentially to the contrary of what respond an expert a falsehood which was that she had to do these already that what she experienced after the vaccination was a natural course of that disease with the type of symptoms that you would see in that in a patient with that disease and petitioners evidence failed and they did not establish that that was not true they did not establish that without the i think this course statement a white cotton concerns it is significant aggravation is as telling in the sense that it's there is a statement that the primary difficulty in a the significant aggravation claims in children with preexisting conditions is the berry it is very difficult to know at the age when the child is vaccinated and what symptoms would have naturally manifested themselves as a child maturing what symptoms might remain la vaccine reactions are rare the reason why some kids react to a vaccine whereas the vast majority do none is based on genetics and it's based on the status of the child's immune system of the time they're vaccinated we know them if everybody hypothetically that the only issue that eventually gets litigated finally is the question of activation and that's assume there is bound to be substantial activation ho going in this case i think they would be easy to assess because there was no evidence prior vaccinations of any of the typical symptoms of crohn's disease no diarrhea no it you know that's an interesting question that may very well be the literature that dr warner's relying upon doesn't tell us that a person these kids had crohn's disease or it may tell us what kids are tested to develop i mean just to lose everything my question i mean consorting as a given given she had problems disease before the vaccination for hypothetical purposes but that i'm also taking as given the vaccine aggravated her problems see this is a hypothetical question but i want to know how would you then go about measuring the damages caused by the vaccine in the cont