Opinion ID: 4556821
Heading Depth: 2
Heading Rank: 2

Heading: Objective Evidence of Reasonable Basis

Text: Cottingham also challenges the Special Master’s determination that Cottingham failed to establish a reasonable basis for her claim. In his third decision, which denied Cottingham’s request for attorneys’ fees and costs (J.A. 100– 110), the Special Master found that Cottingham presented “no evidence” that supported the petition’s assertion that the Gardasil® vaccination caused K.C.’s injuries. J.A. 109. 2 2 While the Special Master issued three decisions in this case, we review only the June 20, 2019, decision. See Vaccine Rule 28.1(b) (“Unless otherwise specified in the Case: 19-1596 Document: 36 Page: 11 Filed: 08/19/2020 COTTINGHAM v. HHS 11 The Special Master concluded that, “because Ms. Cottingham has not produced any medical records or medical opinions supporting the claim that the vaccination caused any harm,” she fails to meet the reasonable basis standard for receiving attorneys’ fees. Id. at 109 n.3. We conclude that the Special Master’s determination constitutes an abuse of discretion because it rests on a clearly erroneous fact finding. This Court reviews a special master’s denial of attorneys’ fees and costs under the same standard as the Claims Court and determines if the special master’s decision is “arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law.” See Rodriguez v. Sec’y of Health & Human Servs., 632 F.3d 1381, 1384 (Fed. Cir. 2011); see also 42 U.S.C. § 300aa-12(e)(2)(B). We review de novo the Special Master’s application of the law. Simmons, 875 F.3d at 635. An abuse of discretion occurs if the decision is clearly unreasonable, arbitrary, or fanciful; is based on an erroneous conclusion of law; rests on clearly erroneous fact findings; or involves a record that contains no evidence on which the Board could base its decision. In re Durance, 891 F.3d 991, 1000 (Fed. Cir. 2018). Section 15(e) of the Vaccine Act explains that a nonprevailing petitioner must have “a reasonable basis for the claim for which the petition was brought” to be eligible for attorneys’ fees and costs. 42 U.S.C. § 300aa-15(e)(1). The petition must include “an affidavit, and supporting documentation, demonstrating that the person who suffered such injury”: (1) received a vaccine listed on the Vaccine Injury Table; remand order, the decision on remand constitutes a separate decision for purposes of Vaccine Rules 11, 18, and 23.”). Case: 19-1596 Document: 36 Page: 12 Filed: 08/19/2020 12 COTTINGHAM v. HHS (2) received the vaccination in the United States, or under certain stated circumstances outside of the United States; (3) sustained (or had significantly aggravated) an injury as set forth in the Vaccine Injury Table (42 C.F.R. § 100.3(e)) or that was caused by the vaccine; (4) experienced the residual effects of the injury for more than six months, died, or required an in-pa- tient hospitalization with surgical intervention; and (5) has not previously collected an award or settlement of a civil action for damages for the same injury. § 300aa-11(c)(1). Here, the parties’ dispute centers on element three. Because causation is a necessary element of a petition, Cottingham must point to evidence of a causal relationship between the administration of the vaccine and her injuries in order to establish that a reasonable basis for the claim existed when the petition was filed. See § 300aa11(c)(1)(C)(ii). The burden of proof to establish reasonable basis for attorney fees, however, is lower than the preponderant evidence standard required to prove entitlement to compensation. See § 300aa-15(e)(1); see also Chuisano, 116 Fed. Cl. at 287. Indeed, more than a mere scintilla but less than a preponderance of proof could provide sufficient grounds for a special master to find reasonable basis. In this case, the Special Master found that Cottingham provided “no evidence” of causation. J.A. 109. Cottingham argues on appeal that K.C.’s under-oath affidavit and the objective medical evidence of K.C.’s injury provide objective evidence of a reasonable basis of causation. Appellant Br. at 20–25. We conclude that the Special Master’s finding is clearly erroneous because the record does contain objective evidence of causation supporting a reasonable basis. K.C.’s medical records paired with the Gardasil® package insert constitutes objective evidence supporting Case: 19-1596 Document: 36 Page: 13 Filed: 08/19/2020 COTTINGHAM v. HHS 13 causation. Appellant Br. 22–23. Objective medical evidence, including medical records, can constitute evidence of causation supporting a reasonable basis. See Harding v. Sec’y of Dep’t of Health & Human Servs., 146 Fed. Cl. 381, 403 (Fed. Cl. 2019). Medical records can support causation even where the records provide only circumstantial evidence of causation. Id. Here, the record contains seven medical-examination reports detailing K.C.’s medical history that address injuries she suffered. J.A. 35, 36, 60, 61, 62, 63–65. The Gardasil® package insert (J.A. 37–59) 3 links K.C.’s injuries to adverse reactions associated with Gardasil’s® administration. The package insert contains a section titled “Adverse Reactions,” which identifies dizziness, headaches, vomiting, and syncope as adverse reactions to the Gardasil® vaccination. J.A. 40–46. K.C.’s medical records report that she suffered each of those injuries after receiving the Gardasil® vaccine. J.A. 32–34; J.A. 35, 36, 60, 61, 62, 63–65. K.C.’s medical records paired with the Gardasil® package insert thus constitute at minimum circumstantial, objective evidence supporting causation. Cottingham argues on appeal that medical literature connecting K.C.’s symptomology to her vaccination constitutes objective evidence supporting causation. Appellant Br. 17–18. Cottingham did not, however, submit these articles in her petition or at any time during the proceeding. Nor did Cottingham argue at any time during that long proceeding that medical literature supported the petition or a reasonable basis. We note that the articles are not in the appellate record despite their availability prior to Cottingham’s October 7, 2016, dismissal of the petition. See 3 Although the Special Master did not address Gar- dasil’s®package insert in its decision, it was included in the appellate record, and no party has contended that it was not part of the record below. See Fed. R. App. P. 10(a)(1). Case: 19-1596 Document: 36 Page: 14 Filed: 08/19/2020 14 COTTINGHAM v. HHS J.A. 2. We therefore decline to consider these articles for the first time on appeal. See Hylete LLC v. Hybrid Athletics, LLC, 931 F.3d 1170, 1174–75 (Fed. Cir. 2019). Cottingham also argues that the Special Master failed to consider Gardasil’s® novelty as evidence of reasonable basis. Appellant Br. 17–20. The Secretary argues that post Simmons, “this aspect of the [Claims Court’s] holding is no longer good law.” Appellee Br. 15 n.3. The Claims Court has identified novelty as a factor in determining reasonable basis. See Amankwaa v. Sec’y of Health & Human Servs., 138 Fed. Cl. 282, 289 (2018) (citing Cloer v. Sec’y of Health & Human Servs., 654 F.3d 1322, 1332 n.4 (Fed. Cir. 2011) (en banc); see also Cottingham v. Sec’y of Health & Human Servs., 134 Fed. Cl. 567, 574 (2017) (mentioning novelty as a factor in determining reasonable basis but providing no such analysis). Cottingham cites Amankwaa as supporting its argument that the Claims Court must analyze novelty. Appellant Br. 15, 17. But Amankwaa imposes no such requirement. The court in Amankwaa acknowledged that novelty could be considered in the reasonable basis analysis. Amankwaa, 138 Fed. Cl. at 289. The court did not, however, explain how novelty impacted its reasonable basis analysis. Id. Amankwaa’s reference to novelty cites to our decision in Cloer. See id. In Cloer, we neither adopted nor rejected novelty as a factor in determining reasonable basis. We recognized the difficulty of proving causation where the injuries are alleged to have been caused by the administration of novel vaccines. We concluded that petitioners can still “muster enough evidence to receive compensation” notwithstanding those difficulties. Cloer, 654 F.3d at 1332. Cottingham misinterprets Amankwaa, and we see no basis to the argument that Amankwaa imposes a requirement that special masters must consider a vaccine’s novelty in a reasonable basis analysis. We decline to impose such a requirement here. Case: 19-1596 Document: 36 Page: 15 Filed: 08/19/2020 COTTINGHAM v. HHS 15 We also reject the Secretary’s argument that Simmons precludes the Claim Court from relying on novelty as a factor in the reasonable basis analysis. As discussed above, Simmons held that evidence of attorney conduct and a looming statute of limitations “has no bearing on” the reasonable basis analysis. Simmons, 875 F.3d at 636. Simmons did not address the Claims Court’s reliance on novelty as a factor in the reasonable basis analysis and, thus, did not abrogate a special master’s discretion to analyze novelty. Based on our review of the record, we conclude that the Special Master’s finding that Cottingham presented “no evidence” of a reasonable basis supporting her claim is clearly erroneous. To be clear, we make no determination on the weight of the objective evidence in the record or whether that evidence establishes reasonable basis, for these are factual findings for the Special Master and not this court. See Milik v. Sec’y of Health & Human Servs., 822 F.3d 1367, 1376 (Fed. Cir. 2016) (“[W]e do not reweigh the factual evidence, assess whether the special master correctly evaluated the evidence, or examine the probative value of the evidence or the credibility of the witnesses—these are all matters within the purview of the fact finder.”) (citation and internal quotation omitted).