Case Model: Cusati

Cusati v. Secretary of Health and Human Services,
Office of Special Masters, No. 99-0492V
Filed: September 22, 2005

  • MMR vaccine
  • Intractable seizure disorder and death
  • Entitled to compensation

Petitioner Alina Cusati, as the legal representative of the estate of her son, Eric Fernandez, alleged that the measles-mumps-rubella (MMR) immunization that he received on November 5, 1996 caused his intractable seizure disorder and eventually his death.

Special Master John F. Edwards found that the petitioner established “that Eric’s November 4, 1996 MMR immunization was the legal cause of Eric’s intractable seizure disorder that provoked Eric’s death,” and that the petitioner was entitled to compensation in the amount of $250,000.00.

The reasoning of the Special Master exhibits the following features:

    • Under Althen Prong 1, there is a general causal model (MMR / fever / seizures) with two possible mechanisms;
    • The Special Master discussed and used the distinction between “medical cause” and “legal cause” or “logical source”;
    • The respondent attempted to rebut an inference to specific causation, by arguing that the incidence of background fever is greater than the incidence of MMR-related fever;
    • The Special Master made careful use of the assertions agreed upon by opposing experts or conceded by respondent’s expert; and
    • There is tension over which party has to produce or account for possible alternative causes.

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