Opinion ID: 468819
Heading Depth: 2
Heading Rank: 3

Heading: Actual Cause

Text: 24 Although the distinction between actual cause and proximate cause is sometimes an elusive one, in the instant case we view actual cause as proof that the vaccination was the but for cause of appellee's injuries. Proximate cause, on the other hand, requires proof that the breach of duty complained of--the failure to warn of the risk of myalgia--not only caused appellee's injuries, but was not such an attenuated cause as to make the imposition of liability based on that breach of duty somehow unfair. 25 The government argues that the court erred in finding that the vaccination was the actual cause of appellee's injuries. The court's findings on actual cause are findings of fact and will not be disturbed unless clearly erroneous. Petty I, supra, 679 F.2d at 729. The government argues that the court erroneously based its finding of actual cause on the opinion of appellee's doctor which in turn was erroneously based on only the temporal proximity of the vaccination and the onset of appellee's injuries. The court directly addressed this argument and rejected it. We agree. While it is true that the court based its finding that the vaccination caused appellee's injuries on the testimony of appellee's doctor, it is not true that the doctor used only the temporal proximity of the vaccination and appellee's symptoms to form his opinion. Appellee's doctor testified that, based on his observations of appellee, his three year study of the medical literature on the effects of the vaccine, and the temporal proximity of the vaccination and appellee's symptoms, he believed to a reasonable degree of medical certainty that the vaccination caused appellee's myalgia. Likewise, appellee's psychiatrist testified that, based on his observations of appellee, the physical stress caused by the myalgia contributed to appellee's anxiety neurosis. The government's doctors, only one of whom had examined appellee, did not effectively rebut the testimony of appellee's doctors. The government's doctors appear to have focused only on whether the myalgia contributed to appellee's anxiety neurosis and not on the cause of the myalgia. We do not believe that the court committed clear error in crediting one set of witnesses over the other. Moreover, although it might have been error to rely only on the temporal proximity of the injury and the vaccination, we believe the court quite properly could have considered this proximity when making its finding on actual cause. 26 We hold that the court's finding that the vaccination was the actual cause of appellee's injuries is not clearly erroneous.