Document: 514 U.S. 268115 S.Ct. 1477131 L.Ed.2d 374 Donna E. SHALALA, Secretary of Health and Human Services, Petitioner,v.Margaret WHITECOTTON et al. No. 94-372. Supreme Court the United States Argued Feb. 28, 1995. Decided April 18, Syllabus * Respondents, Margaret Whitecotton her parents, filed a claim for compensation under National Childhood Vaccine Injury Act, alleging that had suffered encephalopathy as result vaccination against diphtheria, pertussis, tetanus (DPT). Under claimant who, like Margaret, does not attempt to prove actual causation must make out prima facie case by showing "the first symptom or manifestation onset . any [listed] condition occurred within time period after vaccine administration set forth in Table." 42 U.S.C. § 300aa-11(c)(1)(C)(i). That table specifies 3-day following DPT vaccination. 300aa-14(a). The special master ruled failed case, finding, inter alia, she received was "clearly microcephalic," this evidenced pre-existing encephalopathy, that, accordingly, manifestation" condition's before period. Federal Claims affirmed, but Appeals Circuit reversed, holding, among other things, satisfies requirements whenever shows listed period, even if there evidence Held: A who experienced symptoms an injury receiving Act where fails indicate no Appeals' assertion "expressly state" relying on show child sustained prior i.e., vaccination—simply square with 300aa-11(c)(1)(C)(i)'s plain language. If has vaccination, thereafter cannot be first, signal injury's onset. There two onsets same injury. Thus, demonstration during while necessary, is insufficient case. also appeared misread language §§ 300aa-14(a), 300aa-14(b)(2), 300aa-13(a)(2)(B) coming contrary conclusion. Pp. __. 17 F.3d (CA Fed.1994), reversed remanded. SOUTER, J., delivered opinion unanimous Court. O'CONNOR, concurring opinion, which BREYER, joined. Irving L. Gornstein, Washington, DC, petitioner. Robert Thomas Moxley, Cheyenne, WY, respondents. Justice SOUTER 1 question whether makes 100 Stat. 3755, 300aa-1 seq. (1988 ed. Supp. V), We hold compensation. 2 For injuries deaths traceable vaccinations, establishes scheme recovery designed work faster greater ease than civil tort system. H.R.Rep. 99-908, pp. 3-7 (1986). Special masters hear vaccine-related complaints, 300aa-12(c) ed., they adjudicate informally, 300aa-12(d)(2), strict limits, 300aa-12(d)(3)(A), subject similarly expeditious review, 300aa-12(e)(2). more $1,000 damages resulted from Act's effective date 1988 exhaust procedures refuse accept resulting judgment filing de novo action state federal court. 300aa-11(a) V). 3 streamlining stop mechanics litigation, goes substantive standards proof. While may establish entitlement introducing proof causation, 300aa-11(c)(1)(C)(ii), can reach meeting what calls Table. lists vaccines covered together particular conditions associated each one. 300aa-14 meets certain relevant here (or someone whom brings claim) "sustained, significantly aggravated, illness, disability, injury, Table association [a] died such vaccine, significant aggravation death rule turns old maxim its head providing post hoc event happens fast, ergo propter hoc. rebut proving fact caused "factors unrelated vaccine. ." 300aa-13(a)(1)(B). rebut, entitled 300aa-13(a)(1) 4 allegedly DPT) August 1975, when nearly four months old. They alleged (whom we will refer claimant) relied defines "any acquired abnormality of, to, impairment function brain," 300aa-14(b)(3)(A), aggravation" three days order right 300aa-11(c)(1)(C)(i); 300aa-14(a) 5 Master found clonic seizures evening again morning, App. Pet. Cert. 24a, 27a, accepted those encephalopathy. He found, however, microcephalic" (meaning size standard deviations below mean girl age) microcephaly existed Id., at 32a-33a. Accordingly, concluded claimant's ensuing three-day provided table. 34a. 6 then considered series 300aa-11(c)(1)(C)(i), decided it not. "significant change worse preexisting results markedly pain, illness accompanied substantial deterioration health." 300aa-33(4). "[t]here nothing distinguish would reasonably have been expected considering [claimant's] microcephaly. [T]here temporal relationship indicates likely permanently aggravated condition. [T]he did continue dramatic turn basis implicating cause aspect present condition." 41a-43a. Because he satisfy requirements, tried denied failure 7 Master's decision neither arbitrary nor otherwise unlawful, see 300aa-12(e)(2) affirmed. holding "first onset" specified table, showed reason alone made recovery. 374, 376-377 (1994). 8 went say because shown vaccine," provision "facto[r] unrelated" include "idiopathic" condition, 300aa-13(a)(2)(A), court read point specific factor, source defeat identified factor itself unknown. Taking it), Secretary's ground F.3d, 377-378.* 9 granted certiorari address Appeals's construction making rebutting erroneously construed provisions defining reverse without reaching adequacy rebuttal. II 10 declared nowhere "that is, 376. This statement simply statute. In laying elements provides (and aggravation) [her illness] 11 conclusion, contains heading, "Time administration." saw "significant" distinction, 376, between above. do key understanding heading word "onset." Since occurring onset, manifested could qualify only theory onsets, one it. But cannot: Indeed, conflict text latter prevail, since obviously meant short form preceding 12 sought shore up conclusion further arguments. As Congress absence element case" residual seizure disorder (another injury), 376; thus, reasoned, implicitly rejected need negate pre-existence argument rests misreading question. statutory notes explaining provide "may [she] suffer convulsion unaccompanied fever less 102 degrees Fahrenheit involved. 300aa-14(b)(2). requires demonstrate symptoms. instead types (those high fever) disorder, and, so, preclude them carries implication about burden generally undermine Congress's global actually 13 Finally, causal rely occurrences 300aa-13(a)(2)(B), bar establishment instance. wholly independent first-symptom provisions, serving distinct purpose allowing It relieve clear III 14 accordingly remanded proceedings consistent opinion. 15 so ordered. 16 BREYER joins, concurring. born 1975 known microcephaly, defined commonly (but universally) smaller norm. At age months, (DPT) Prior never seizure. day required hospitalization. Over next five years, intermittent seizures. She now cerebral palsy hip joint problems communicate verbally. 1990, Margaret's parents applied 1986. compensation, agreed. (1994), finding Whitecottons 18 Although I join Court's rejecting reading pertinent provision, write separately points. First, wish additional supporting my 300aa-11(c)(1)(C)(i) inconsistent congressional intent. Second, underscore limited nature decides. 19 Examining properly rejects determination "onset" "table illness" Ante, To statute preponderance either (1) (2) rightly concludes, necessary sufficient burden; "first" postvaccine symptom, aggravation, very manifestation. 20 relies commonsense consideration words conclusion: "[i]f onset." find equally persuasive observation deprives all meaningful effect. term If, determined, cases children experience become cases. phrase aggravation," limitations impose including "markedly disability" "substantial health," are altogether lost. 21 extent possible, adhere elementary canon should interpreted render part inoperative." Department Revenue Oregon v. ACF Industries, Inc., 510 ----, 114 843, 848, 127 165 (1994) (internal quotation marks omitted); Pennsylvania Dept. Public Welfare Davenport, 495 552, 562, 110 2126, 2132, 109 588 (1990). adopted contravenes principle. Our gives effect according meaning. 22 Today's quite limited. occasion Whitecottons' challenges factual findings respect their daughter's assume, arguendo, soundness his conclusions prevaccine course challenge these clearly erroneous remand. argument, Master, daughter whatever appears open well, legal used define aggravation." 23 pass misstated petitioner's 300aa-13(a)(1)(B) Given our burden, speculative effort evaluate approach concrete application said, taken Appeals, underlying predated use ill health, unknown, well warrant attention future. syllabus constitutes prepared Reporter Decisions convenience reader. See Detroit Lumber Co., 200 321, 337, 26 282, 287, 50 L.Ed. 499. casting doubt express view validity recently issued new regulations affect definition idiopathic future These apply petitions March 19, 1995, 60 Fed.Reg. 7678-7696 (1995).

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