White v. Hhs

United States Court of Appeals for the Federal Circuit · August 27, 2025 · No. 24-1372

Summary

This Federal Circuit opinion affirms the Court of Federal Claims' denial of compensation under the National Childhood Vaccine Injury Act for a petitioner who developed Guillain-Barré Syndrome following a flu vaccination. The court clarifies that a Table injury presumption of causation does not equate to actual causation and relieves the government of the burden to disprove the vaccine as a causal factor. Applying the Althen test, the court holds that the special master's findings identifying an alternative cause were supported by the record and not arbitrary or capricious.

Court
United States Court of Appeals for the Federal Circuit
Writing for the Court
Lourie; Reyna; Stark
Jurisdiction
United States Court of Appeals for the Federal Circuit
Decision date
August 27, 2025
Docket number
24-1372
Procedural posture
Appeal from United States Court of Federal Claims, No. 1:20-vv-01319-TMD (special master decision)
Standard of review
De novo for legal rulings; arbitrary and capricious standard for factual findings
Precedential value
published
Parties
Ronald E. White v. Secretary of Health and Human Services
Disposition
affirmed

Topics

health lawstatutory interpretationappellate procedurestandard of review

Practice areas

health lawappellate procedure

Questions Presented

  1. Whether the special master applied the correct burden of proof to the government in a Table case under the Vaccine Act
  2. Whether the special master’s findings under the Althen test were arbitrary and capricious

Holdings

  1. The government bears the burden of proving by a preponderance of the evidence that a factor unrelated to the vaccine was the sole substantial cause of the injury, and the special master satisfied that burden; therefore the denial of compensation is affirmed.
  2. The special master’s factual findings were supported by the record, and his legal conclusions were not arbitrary or capricious; the decision is affirmed.

Key quotations

In Vaccine Act cases, we review a ruling by the Court of Federal Claims de novo, applying the same standard that it applies in reviewing the decision of the special master. (*1)
The Vaccine Act distinguishes between so-called ‘Table injuries,’ for which causation is presumed when a designated condition follows the administration of a designated vaccine within a designated period of time, and all other injuries alleged to be caused by a vaccine, known as ‘off‑Table injuries,’ for which causation must be proved in each case. (*5)

Factual background

Ronald E. White received a flu vaccine on November 1, 2017. In December 2017 he developed Guillain‑Barré Syndrome (GBS) after a respiratory infection that was later identified as Haemophilus influenzae. The special master concluded that the infection, not the vaccine, was the sole substantial factor causing the GBS and denied compensation under the Vaccine Act.

Procedural history

The petitioner filed a claim under the National Childhood Vaccine Injury Act in the Court of Federal Claims. A special master denied the claim, finding that the petitioner’s H. influenzae infection was the sole substantial factor causing Guillain‑Barré Syndrome. The Court of Federal Claims affirmed. The petitioner appealed to the Federal Circuit.

Court Document

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