O'Connell v. SHHS ( 1996 )


Menu:
  • USCA1 Opinion








    UNITED STATES COURT OF APPEALS UNITED STATES COURT OF APPEALS
    FOR THE FIRST CIRCUIT FOR THE FIRST CIRCUIT
    _________________________


    No. 95-1355



    FRANCIS O'CONNELL AND LISA O'CONNELL,
    AS THE LEGAL REPRESENTATIVES OF THEIR MINOR DAUGHTER,
    KELLIANN O'CONNELL, AND DISSATISFIED PARENTS TOGETHER,
    A VIRGINIA NON-PROFIT CORPORATION,

    Petitioners,

    v.

    DONNA E. SHALALA, SECRETARY OF THE UNITED STATES
    DEPARTMENT OF HEALTH AND HUMAN SERVICES,

    Respondent.

    ____________________

    PETITION FOR REVIEW OF A FINAL RULE OF
    THE SECRETARY OF HEALTH AND HUMAN SERVICES
    ____________________

    Before

    Torruella, Chief Judge, ___________

    Aldrich, Senior Circuit Judge, ____________________

    and Selya, Circuit Judge. _____________
    ____________________

    Curtis R. Webb, with whom Michael R. Hugo and Conway, _______________ ________________ _______
    Crowley & Hugo, P.C. were on brief, for petitioners. ____________________
    Charles R. Gross, Attorney, Civil Division, United States _________________
    Department of Justice, with whom Frank W. Hunger, Assistant _________________
    Attorney General, Helene M. Goldberg, Director, Civil Division, ___________________
    Barbara C. Biddle, Attorney, Civil Division, David Benor and __________________ ___________
    Deborah Harris, Office of the General Counsel, United States _______________
    Department of Health and Human Services, were on brief, for
    respondent.
    ____________________

    March 11, 1996
    ____________________















    SELYA, Circuit Judge. This is a petition for review SELYA, Circuit Judge. ______________

    and vacatur of a final rule promulgated by the Secretary of

    Health and Human Services (the Secretary) under the National

    Vaccine Injury Compensation Program, 42 U.S.C. 300aa-10

    through 300aa-34 (1994). We have jurisdiction under 42 U.S.C.

    300aa-32. In the pages that follow, we explore the pertinent

    statutory framework, recount the proceedings to date, and then

    examine the petitioners' three-pronged challenge. When all is

    said and done, we deny the petition and leave the rule intact.

    I. THE STATUTORY SCHEME I. THE STATUTORY SCHEME

    The administration of childhood vaccines, though

    critically important to public health, "is not always without

    risk." Committee to Review the Adverse Consequences of Pertussis

    and Rubella Vaccines, Institute of Medicine, Adverse Effects of ___________________

    Pertussis and Rubella Vaccines 1 (1991) (IOM Report). Since ________________________________

    vaccines generally contain either dead bacteria or live but

    weakened viruses, it is not surprising that they are capable of

    causing serious adverse effects. See id. Despite the ___ ___

    infrequency of such episodes, Congress feared that the long

    shadow of tort liability cast by vaccine-related injuries would

    drive up prices and eventually force vaccine suppliers out of the

    market. See H.R. Rep. No. 908, 99th Cong., 2d Sess. 1, 4, 6-7 ___

    (1986), reprinted in 1986 U.S.C.C.A.N. 6344, 6345, 6347-48. _________ __

    Congress also worried that the vagaries of litigation, coupled

    with the cost, might leave many deserving victims of vaccine-

    related injuries undercompensated. See id. ___ ___


    2












    To protect the supply of vaccines while ensuring fair,

    timely compensation for victims, Congress departed from the

    traditional tort system and wrote the National Childhood Vaccine

    Injury Act (the Act), Pub. L. No. 99-660, tit. III, 100 Stat.

    3755 (1986). Among other things, the Act established a special

    tribunal (the Vaccine Court), and moved vaccine-injury cases

    partly outside the customary tort framework. See Schafer v. ___ _______

    American Cyanamid Co., 20 F.3d 1, 2 (1st Cir. 1994) (explaining _____________________

    the mechanics of the Act).1 In respect to cases brought before

    this tribunal, Congress eased the complainants' burdens both by

    dispensing with the requirement of proving negligence and by

    greatly simplifying the requisite proof of causation. See 42 ___

    U.S.C. 300aa-11. Of course, there are tradeoffs; for example,

    Congress limited the damages that a victim could obtain for

    vaccine-related injuries. See id. 300aa-15. ___ ___

    In aid of the neoteric regulatory regime, the Act

    provides, in tabular format, a listing of vaccines and a parallel

    listing of medical conditions commonly associated with the use of

    each vaccine. See id. 300aa-14(a). These listings, known ___ ___

    collectively as the Vaccine Injury Table (the Table), are

    accompanied by, and are to be read in light of, the

    ____________________

    1The Act does not entirely supplant traditional tort
    remedies. An injured person is required to repair first to the
    Vaccine Court, but if she is not satisfied with the result she
    may reject the judgment and proceed to litigate her claim in a
    more conventional forum subject to certain substantive and
    procedural limitations established by the Act. See Schafer, 20 ___ _______
    F.3d at 2-3 (discussing interplay between the Act and the tort
    system).

    3












    Qualifications and Aids to Interpretation (QAI). The QAI is a

    separate subsection that provides definitions and explanations

    for the terms used in the Table. See id. 300aa-14(b). To ___ ___

    receive compensation for a vaccine-related injury, a recipient

    must simply petition the Vaccine Court and show that, within a

    prescribed time span, she suffered one or more of the disorders

    listed in the Table as associated with the particular vaccine

    that she received. Thus, the content of the Table (a sample of

    which is excerpted in the Appendix) is critical: it is only when

    a vaccinated child suffers a listed condition within applicable

    temporal parameters that compensation will be forthcoming without

    the time, expense, proof requirements, and uncertainty of full-

    blown litigation.

    The Table is not intended to be static. Congress gave

    the Secretary express power to promulgate regulations adding to

    or subtracting from the tabular list of conditions, and changing

    the delineated time periods. See 42 U.S.C. 300aa-14(c)(3). ___

    This is a rather odd approach because it authorizes the

    Secretary, in effect, to amend the statutorily enacted Table by

    way of administrative rulemaking.2 This grant of power probably

    reflected a congressional consensus that the first iteration of

    the Table was not perfect. Driven by a sense of urgency to put
    ____________________

    2As such, the Act may raise questions under the Presentment
    Clause, which requires that all federal laws must be passed by
    both houses of Congress and signed by the President. See U.S. ___
    Const. art. 1, 7; see also INS v. Chadha, 462 U.S. 919, 954 ___ ____ ___ ______
    (1983) ("Amendment and repeal of statutes, no less than
    enactment, must conform with Art[icle] I."). Since this issue is
    not raised in the instant petition, we take no view of it.

    4












    something into place, the solons knowingly used incomplete data

    when forging the causal links between vaccines and associated

    medical conditions. Mindful of its haste, Congress directed the

    Secretary to have the Institute of Medicine (IOM) an arm of the

    National Academy of Science conduct an extensive review of all

    available information bearing on the relationship between

    vaccines and medical conditions, and thereafter to publish

    findings and revise the Table based on the IOM's study. See ___

    Vaccine Act 312, 100 Stat. at 3779.

    To assist the Secretary in updating the Table, Congress

    created the Advisory Commission on Childhood Vaccines (ACCV) a

    body composed of a cross-section of health professionals, legal

    experts, interested citizens (including two who are parents of

    children victimized by vaccine-related injuries), and federal

    officials. See 42 U.S.C. 300aa-19. Congress directed the ___

    Secretary to provide the ACCV with a copy of each contemplated

    regulation before formally proposing it, and then to await the

    expiration of a ninety-day comment period before moving forward.

    See id. 300aa-14(d). ___ ___

    II. THE COURSE OF EVENTS II. THE COURSE OF EVENTS

    In 1991, the IOM completed its study and, on August 27,

    issued the IOM Report. Among the many conclusions contained in

    this tome the IOM found a causal relation between DPT

    (diphtheria-pertussis-tetanus) vaccine, on one hand, and acute

    encephalopathy and hypotonic, hyporesponse episodes (HHE), on the




    5












    other hand.3 See IOM Report at 118, 177. However, the IOM found ___

    insufficient evidence to indicate a causal relationship between

    DPT vaccine and residual seizure disorders (such as epilepsy).

    See id. at 118 n.3. The project director gave the ACCV a full ___ ___

    briefing on the IOM Report in September of 1991.

    In anticipation of receiving the IOM Report, the

    Secretary formed a Public Health Service Task Force as a vehicle

    for revising the Table. She also enlisted yet another helpmate,

    the National Vaccine Advisory Committee (NVAC). Unlike the ACCV,

    which by statute counsels the Secretary in respect to the injury

    compensation program, see 42 U.S.C. 300aa-19, the NVAC's ___

    statutory responsibility is to advise the director of the

    separate national program for developing and administering the

    public health aspects of immunization policy, see id. 300aa-5. ___ ___

    The Secretary transmitted the IOM Report to the Task Force, which

    then recommended a number of changes to the Table (including the

    removal of encephalopathy, HHE, and residual seizure disorders as

    associated medical conditions vis-a-vis DPT vaccination).4 The

    NVAC concurred in these recommendations.

    ____________________

    3Encephalopathy is a general term that refers to "any
    disease of the brain." Stedman's Medical Dictionary 508 (25th ____________________________
    ed. 1990). HHE, also known as shock, shock-like state, or shock
    collapse, refers to "an unusual reaction consisting of an acute
    diminution in sensory awareness or loss of consciousness
    accompanied by pallor and muscle hypotonicity [reduced tension]."
    IOM Report at 171-72.

    4Even though the IOM Report verified a causal relation
    between the first two conditions (encephalopathy and HHE) and DPT
    vaccinations, the Task Force did not believe the study disclosed
    credible evidence of prolonged neurological damage.

    6












    Despite the fact that the ACCV had not yet formally

    received the Task Force's or the NVAC's recommendations, it took

    up the substance of the proposed revisions at its December 1991

    meeting. In lieu of the literal text of the suggested changes,

    the ACCV members received what has been referred to as a "matrix"

    essentially, a table comparing a synthesis of Task Force and

    NVAC recommendations and summarizing the rationales advanced by

    those bodies. The ACCV discussed these recommendations at length

    and approved all but the one that suggested dropping

    encephalopathy from the Table. As a counter-proposal, the ACCV

    encouraged the Secretary to modify the QAI definition of

    encephalopathy in a way that would restrict its meaning to acute

    or chronic episodes of a type more likely to result in

    significant harm.

    In due season, the Secretary published a Notice of

    Proposed Rulemaking (the Notice). See 57 Fed. Reg. 36,878 ___

    (proposed Aug. 14, 1992). The Notice included the required

    scientific findings and set forth regulations designed to revise

    the Table accordingly. These covered all the Task Force's

    recommendations save only for the dropping of encephalopathy. On

    that point the Secretary acquiesced in the ACCV's view and

    proposed a new definition of the condition similar in most

    respects to the definition discussed at the ACCV's December 1991

    meeting. See id. at 36,880. A comment period and public hearing ___ ___

    ensued.

    In 1993, the results of a ten-year study of acute


    7












    childhood neurologic illnesses became available. Recognizing the

    potential importance of the study, the Secretary stayed her hand

    and requested the IOM to review the newly compiled material. In

    March 1994, the IOM concluded that the "balance of the evidence

    is consistent with a causal relationship" between DPT vaccination

    and certain forms of chronic nervous system dysfunction suffered

    by children who experience an acute neurologic illness shortly

    after vaccination. Committee to Study New Research on Vaccines,

    Institute of Medicine, DPT Vaccine and Chronic Nervous System _________________________________________

    Dysfunction: A New Analysis 2-3 (1994). On March 24, 1994, the ____________________________

    Secretary reopened the comment period for a limited time,

    restricting discussion to the question whether the previously

    proposed revisions should be modified in light of the

    supplemental report.

    At its June 1994 meeting the ACCV discussed the new

    information as it concerned the proposed definition of

    encephalopathy. This time, the ACCV did not achieve consensus on

    the subject, and simply transmitted the minutes of its meeting to

    the Secretary. On February 8, 1995, the Secretary promulgated a

    final rule (under attack in this proceeding) that removed HHE and

    residual seizure disorders from the Table and changed the

    definition of encephalopathy in a manner very similar (but not

    identical) to the manner originally suggested by the ACCV and

    proposed in the Notice. See 60 Fed. Reg. 7678 (1995). ___

    Francis and Lisa O'Connell (parents and legal

    representatives of Kelliann O'Connell), joined by a parents'


    8












    advocacy group, now seek judicial review and vacatur of the final

    rule.5

    III. THE PETITIONERS' CHALLENGE III. THE PETITIONERS' CHALLENGE

    The petitioners raise three objections to the

    Secretary's action. First, the petitioners assert that the Act

    does not empower the Secretary to change the definitions included

    in the QAI, but, rather, only authorizes the Secretary to add and

    subtract entries (i.e., vaccines and associated medical

    conditions) and change time periods specified in the Table

    proper. Second, the petitioners contend that, even if the

    Secretary otherwise had authority to effectuate the contested

    change, she failed to follow the procedures mandated by the Act.

    Finally, the petitioners insist that a decision to remove a

    medical condition from the Table must be based on definitive

    evidence refuting the existence of a causal relationship between

    the vaccine in question and the condition, and that the Secretary

    eliminated HHE and residual seizure disorders from the Table

    notwithstanding the absence of such an evidentiary predicate. We

    address each remonstrance separately.

    A. Authority to Revise the QAI. A. Authority to Revise the QAI. ___________________________

    The petitioners argue that the Secretary's attempt to

    change the definition of encephalopathy provided in the QAI is
    ____________________

    5When queried at oral argument as to his clients' standing,
    the petitioners' attorney explained that Kelliann had suffered an
    adverse reaction after vaccination that would have been included
    within the original tabular definition of encephalopathy but
    which fell outside the revised definition. The Secretary does
    not challenge this recital, and we therefore accept counsel's
    explanation at face value.

    9












    impuissant because it surpasses the authority granted to the

    Secretary by the Act. The Act states:

    A modification of the Vaccine Injury Table
    under paragraph (1) [authorizing the
    Secretary to "promulgate regulations to
    modify" the Table] may add to, or delete _______________________
    from, the list of injuries, disabilities, ________________
    illnesses, conditions, and deaths, for which
    compensation may be provided or may change ______________
    the time periods for the first symptom or _________________
    manifestation of the onset or the significant
    aggravation of any such injury, disability,
    illness, condition, or death.

    42 U.S.C. 300aa-14(c)(3) (emphasis supplied). In the

    petitioners' view, the underscored phrases limit the Secretary's

    powers of alteration, and hence, because the QAI provision is

    distinct from the Table proper, the Secretary's revisory

    authority does not extend to it. Ergo, changing the definition

    of encephalopathy contained in the QAI oversteps the Secretary's

    bounds. The Secretary debunks this argument. She construes the

    statute more broadly, urging that it gives her authority to

    rewrite the QAI.

    1. Chevron Deference. Before choosing between these 1. Chevron Deference. __________________

    competing views, we must address a preliminary issue. The

    Secretary, correctly observing that courts ordinarily defer to an

    agency's plausible construction of a silent or ambiguous statute

    as long as Congress has committed the statute to the agency for

    purposes of administration, see Chevron U.S.A. Inc. v. Natural ___ ___________________ _______

    Resources Defense Council, Inc., 467 U.S. 837, 842-43 (1984); ________________________________

    Strickland v. Commissioner, Me. Dep't of Human Servs., 48 F.3d __________ _________________________________________

    12, 16 (1st Cir.), cert. denied, 116 S. Ct. 145 (1995), asks that _____ ______


    10












    we defer to her construction of 300aa-14(c). There may be more

    to this request than meets the eye. The petitioners' objection

    is arguably not directed at a regulation that purports to apply a

    particular statutory directive which the Secretary is concededly

    empowered to implement, but instead at a regulation that lies in

    an area as to which, the petitioners say, the statute grants the

    Secretary no rulemaking authority at all. In the current state __ ___

    of the law, it is unclear whether deference is appropriate under

    such circumstances.6

    Discretion is sometimes the better part of valor.

    Because we decide, as a matter of original statutory

    construction, that the Act grants the Secretary authority to

    revise the QAI provision, see infra, we leave the question of ___ _____

    deference unanswered.

    2. Interpreting the Statute. We turn now to the 2. Interpreting the Statute. _________________________

    disputed statute. While one can focus with Cyclopean intensity

    ____________________

    6The Supreme Court has never taken a clear institutional
    stand on the question. In Mississippi Power & Light Co. v. _______________________________
    Mississippi, 487 U.S. 354 (1988), the Court affirmed an agency's ___________
    interpretation of a statute in a comparable situation, but
    without relying on Chevron-type deference. Justice Scalia, _______
    writing separately, argued for deference even though the
    interpretive question involved the scope of the agency's
    authority under the statute. Id. at 381 (Scalia, J., ___
    concurring). Justice Brennan, writing for himself and two other
    Justices, expressed the view that deference was inappropriate
    because the scope of an administrative agency's jurisdiction is
    not a decision that Congress normally entrusts to the agency.
    Id. at 387 (Brennan, J., concurring). The problem is complicated ___
    by a realization that almost any administrative action can be
    described by a challenger as either exceeding an agency's
    authority or overstepping the authorized application of agency
    authority. See generally Thomas W. Merrill, Judicial Deference ___ _________ __________________
    to Executive Precedent, 101 Yale L.J. 969, 997-98 (1992). ______________________

    11












    on the words singled out by the petitioners and perhaps construct

    a coherent argument that those words restrict the Secretary's

    revisory authority to the Table proper, courts are bound to

    afford statutes a practical, commonsense reading. See King v. ___ ____

    St. Vincent's Hosp., 502 U.S. 215, 221 (1991). Instead of ____________________

    culling selected words from a statute's text and inspecting them

    in an antiseptic laboratory setting, a court engaged in the task

    of statutory interpretation must examine the statute as a whole,

    giving due weight to design, structure, and purpose as well as to

    aggregate language. See National R.R. Passenger Corp. v. Boston ___ ______________________________ ______

    & Me. Corp., 503 U.S. 407, 417 (1992); Dole v. United _____________ ____ ______

    Steelworkers of Am., 494 U.S. 26, 36 (1990); K mart Corp. v. ____________________ _____________

    Cartier, Inc., 486 U.S. 281, 291 (1988); Riva v. Massachusetts, _____________ ____ _____________

    61 F.3d 1003, 1007 (1st Cir. 1995).

    The petitioners' reading of the Act cannot survive the

    application of this global standard. Reading the statute as a

    whole, we are satisfied that Congress gave the Secretary

    authority to revise the QAI. In the absence of such authority

    the system for updating the Act is virtually unworkable. For

    instance, when the Secretary exercises her undeniable power to

    include an emergent condition in the Table, she must be able to

    amend the QAI to reflect the addition. Surely Congress did not

    intend either to leave added conditions unexplained or itself to

    edit the QAI every time the Secretary saw fit to alter the Table.

    In short, the power to revise the QAI is a necessary adjunct of




    12












    the power to revise the Table itself.7 Elsewise, the tension

    that would be created within the structure of the Act would be

    intolerable and would contravene the salutary principle that

    statutes should, whenever possible, be construed sensibly. See ___

    American Tobacco Co. v. Patterson, 456 U.S. 63, 71 (1982); Riva, ____________________ _________ ____

    61 F.3d at 1008; United States v. Meyer, 808 F.2d 912, 919 (1st _____________ _____

    Cir. 1987); see also Norman J. Singer, Sutherland Statutory ___ ____ ____________________

    Construction 45.12, at 61 (5th ed. 1992). ____________

    We add, moreover, that the petitioners' proffered

    reading of the statute is excessively formalistic. If the

    Secretary could not change the definition of encephalopathy

    directly, she could certainly accomplish the same result

    indirectly. She need simply delete encephalopathy from the

    Table, thus rendering its definition nugatory, and then

    immediately add encephalopathy, redefined, to the Table.

    This reality is lethal to the petitioners' position.

    We cannot imagine that Congress intended to force the Secretary

    to go round and round the mulberry bush in order to revise the

    Table and its accompanying explanations. The shortest distance

    between two points is a straight line, and we will not lightly

    presume that Congress lost sight of so abecedarian a principle.8
    ____________________

    7In their reply brief, the petitioners seemingly concede
    that this is so, but suggest that the Secretary may only revise
    the QAI when she is in the process of modifying the Table itself.
    The suggestion is meritless. Nothing in either the text or the
    history of the statute supports such an artificial construction.

    8Congress had a golden opportunity to express an intent
    contrary to the Secretary's view that she possesses the power to
    revise the QAI, but it chose not to do so. Originally, the Act

    13












    See Singer, supra, 45.12, at 61 (advocating the baseline ___ _____

    assumption that an enacted statute should be construed to

    "achieve[] an effective and operative result"). To cinch

    matters, we note that the statutory grant of a greater power

    typically includes the grant of a lesser power, see, e.g., United ___ ____ ______

    States v. O'Neil, 11 F.3d 292, 296 (1st Cir. 1993) (describing ______ ______

    this principle as "a bit of common sense that has been recognized

    in virtually every legal code from time immemorial"), and the

    overall structure of the Vaccine Act confirms its applicability

    here: the brute power to subtract listed medical conditions from

    the Table encompasses the more modest power to trim the

    definitions associated with listed medical conditions.

    We have said enough on this score. We hold that the

    Act grants the Secretary the authority to revise the

    Qualifications and Aids to Interpretation that accompany the

    Vaccine Injury Table. Consequently, the petitioners' initial

    remonstrance fails.

    B. Notification. B. Notification. ____________

    The petitioners accuse the Secretary of failing to

    observe the required notification procedures when she promulgated

    ____________________

    did not permit the Secretary to add vaccines to the Table. In
    1993, Congress amended the law to allow the Secretary to add
    vaccines without specific congressional authorization. See Pub. ___
    L. No. 103-66, 13632(a)(2), 107 Stat. 312, 645-46 (1993).
    Congress made this important modification almost a year after the
    Secretary published the Notice (in which she proposed to alter
    the QAI) and after a number of loud voices had been raised during
    the comment period in strong opposition to the proposed action.
    Despite this public clamor, Congress did not prohibit the
    Secretary from altering the QAI.

    14












    the regulation. The accusation is unfounded.

    The relevant statute provides:

    Except with respect to a regulation
    recommended by the [ACCV], the Secretary may
    not propose a regulation under subsection (c)
    of this section or any revision thereof,
    unless the Secretary has first provided to
    the [ACCV] a copy of the proposed regulation
    or revision, requested recommendations and
    comments by the [ACCV], and afforded the
    [ACCV] at least 90 days to make such
    recommendations.

    42 U.S.C. 300aa-14(d). The petitioners contend that the

    Secretary neglected to follow these procedures twice over, by

    failing to provide the ACCV with (1) a copy of the Notice before

    publishing it, and (2) a copy of the final rule before issuing

    it. We examine each contention.

    1. The Proposed Rule. We rehearse the relevant facts. 1. The Proposed Rule. _________________

    Shortly after publication of the IOM Report, the Task Force made

    its initial recommendations for changing the Table. The NVAC

    substantially concurred in those recommendations. The

    Secretary's proposal was then circulated at the ACCV's December

    1991 meeting in the form of a matrix detailing the various

    recommendations. During the ensuing discussion, the principal

    objection was to the Secretary's proposal, reflected in the

    matrix, for removing encephalopathy from the Table. The ACCV

    urged instead that encephalopathy should be retained in the Table

    but that its definition should be modified in the QAI. The

    Secretary accepted the ACCV's unanimous recommendation and, in





    15












    August 1992, published a Notice that implemented this

    recommendation.9 See 57 Fed. Reg. at 36,880 (accepting ACCV ___

    recommendation to retain encephalopathy in the Table with a new

    definition).

    The petitioners argue that the rule ultimately

    promulgated is invalid because the matrix distributed and

    discussed in December of 1991 was not literally a "copy of the

    proposed regulation" as required by 300aa-14(d). Although the

    matrix may not have been produced in the typical format for a

    proposed administrative regulation, we think that for all intents

    and purposes it was a "copy" of the regulation that the Secretary

    planned to propose. The matrix contained the substance of all

    the proposed changes to the Table. The only real difference

    appears to have been in manner of presentation. The statute

    requires the Secretary to deliver all the meat of a planned rule

    to the Secretary without regard to how it is arranged on the

    platter. Thus, as long as the Secretary transmits the entire

    substance of her proposed regulation to the ACCV in the
    ____________________

    9Though there appears to have been substantial consensus
    among ACCV members about the definition they would recommend to
    the Secretary, it is not clear whether the ACCV members
    irrevocably agreed on an exact definition. This uncertainty
    arises because, while no formal vote was taken, the members
    approved in principle a specific definition proposed by Dr.
    Gerald Fenichel. The members also agreed that some refinements
    to Dr. Fenichel's proposed definition might be necessary and
    apparently agreed to a mechanism for expediting action on any
    such refinements. The administrative record (including the
    minutes approved at the next ACCV meeting) reveals no objections
    to Dr. Fenichel's final proposed definition and discloses no
    suggested refinements to it. The Secretary included in the
    proposed rule a definition of encephalopathy that was
    substantially the same as this definition.

    16












    appropriate time frame, the form of the transmission is

    immaterial. This principle possesses particular force where, as

    here, the unorthodox format does not obfuscate or mislead.

    Indeed, the matrix's tabular format increased comprehension by

    allowing the ACCV to discuss the revisions in a manner

    corresponding to the format of the Vaccine Injury Table itself.

    We hold, therefore, that the Secretary fulfilled her statutory

    pre-publication duty in regard to the proposed regulation.

    If there were any room for doubt about the adequacy of

    the transmittal and we do not believe that there is the

    ACCV's actions would dispel it. We are particularly impressed by

    two things. First, the transcript of the ACCV's December 1991

    meeting makes very clear that ACCV members thought they were

    discussing the Secretary's proposed revisions to the Table.

    Second, after the Secretary published the proposed regulation,

    the ACCV did not cry "foul" or otherwise complain that it had

    been bypassed. These facts plainly show that the ACCV understood

    the matrix to be a "copy of the proposed regulation" and acted

    upon it as such.

    2. The Final Rule. The Secretary's issuance of the 2. The Final Rule. ______________

    final rule poses a somewhat closer question. The Secretary

    openly admits that she did not provide the ACCV with the text of

    the final rule prior to its promulgation. She argues, however,

    that the Act does not oblige her to do so, or that, if it does,

    she substantially complied with that obligation.

    Section 300aa-14(d) provides in material part that "the


    17












    Secretary may not propose a regulation . . . or any revision

    thereof" without first furnishing the ACCV with a copy of "the

    regulation or revision," requesting comment, and marking time for

    ninety days. This aspect of the controversy between the parties

    arises from the phrase "any revision thereof." In context, this

    phrase is susceptible to at least two reasonable meanings. Under

    one interpretation, favored by the Secretary, the phrase refers

    to a revision of a regulation, so that, while the Secretary may

    not propose either a new regulation or a revision to an existing

    regulation without advance notice to the ACCV, she may proceed to

    revise a proposed regulation without resubmitting it to the ACCV.

    Under the second interpretation, favored by the petitioners, the

    phrase "any revision thereof" refers to proposed regulations, so

    that the Secretary may propose neither a new regulation nor any

    later revision to that proposed regulation without first

    informing the ACCV.

    Once again our analysis begins with a nod in the

    direction of Chevron. The rule of deference traditionally _______

    applies when the agency's interpretation is a "product of

    delegated authority for rulemaking," Stinson v. United States, _______ ______________

    113 S. Ct. 1913, 1918 (1993), a sphere that ordinarily

    encompasses legislative rules and agency adjudications. Here,

    the Secretary's interpretation of the law is not embodied in a

    legislative rule or an adjudication. The evidence of her view

    about how 300aa-14(d) is supposed to operate comes exclusively

    from two sources: the refusal of her subordinates to send the


    18












    ACCV a pre-publication copy of the final rule, and the tactical

    position adopted by her counsel.

    As for the first source, agency positions that are

    pieced together from offhand conduct of bureaucratic fussbudgets

    are entitled to little weight on judicial review, principally

    because they do not reflect the kind of delegated authority for

    policymaking that underlies the Chevron presumption.10 See _______ ___

    Stinson, 113 S. Ct. at 1918; Martin v. OSHRC, 499 U.S. 144, 157 _______ ______ _____

    (1991); Public Citizen v. United States Dep't of Justice, 491 ______________ ________________________________

    U.S. 440, 463 n.12 (1989). As for the second source, courts

    customarily withhold Chevron deference from agencies' litigating _______

    positions. See, e.g., Bowen v. Georgetown Univ. Hosp., 488 U.S. ___ ____ _____ ______________________

    204, 212 (1988); United States v. 29 Cartons of * * * an Article _____________ _______________________________

    of Food, 987 F.2d 33, 38 n.6 (1st Cir. 1993); Director, OWCP v. _______ ______________

    General Dynamics Corp., 980 F.2d 74, 79 (1st Cir. 1992). We see ______________________

    no reason to take a different tack in this instance. We

    therefore decline to defer to the Secretary's construction of

    300aa-14(d).

    Approaching the statutory question without the

    Secretary's thumb on the scale, we believe that both suggested

    interpretations are plausible but imperfect renditions of

    problematic language. The petitioners' interpretation means that

    ____________________

    10In point of fact, the record indicates that the
    Secretary's minions were not even attempting to parse the Act's
    requirements, but, rather, were simply enunciating "a matter of
    procedure and policy" within the agency not to distribute final
    rules prematurely. Quite obviously, this affords no basis for
    deference.

    19












    every alteration to the text of a proposed rule even a minor

    technical or grammatical alteration would have to be rerouted

    through the ACCV, subject to a fresh notice-and-comment period.

    This extra step would be necessary even when the Secretary

    changes a proposed regulation in accordance with the ACCV's ________________________________

    announced wishes or to correct a syntactical bevue. Such a _________________

    construction would create a nearly endless circle and attenuate

    the rulemaking process without achieving any corresponding

    benefit. Because it is difficult to believe that Congress

    intended to prolong the revisory process by directing the

    Secretary to engage in a mindless minuet, the prospect of wasted

    motion cuts against the petitioners' interpretation. See Alabama ___ _______

    Power Co. v. Costle, 636 F.2d 323, 360 (D.C. Cir. 1980) (stating _________ ______

    the obvious proposition that courts should be reluctant to

    interpret the terms of a statute "to mandate pointless

    expenditures of effort").

    The Secretary's construction likewise presents a

    problem in that it may render the phrase "any revision thereof"

    superfluous to some extent. Since the Secretary would have to

    issue a new regulation in order to change an existing one, see 42 ___

    U.S.C. 300aa-14(c), Congress probably did not need to add the

    requirement that a revision to an existing regulation must be

    reviewed by the ACCV. Because courts usually presume that every

    word and phrase in a statute is pregnant with meaning, see, e.g., ___ ____

    United States v. Ven-Fuel, Inc., 758 F.2d 741, 751-52 (1st Cir. _____________ ______________

    1985), the prospect of redundancy cuts against the Secretary's


    20












    interpretation.

    Faced with no ideal choice, we conclude that Congress

    more likely intended the statute to be read as the Secretary

    urges. This interpretation is more plausible and better serves

    the ends that the legislature sought to achieve. Though it is

    possible that Congress could have accomplished its purpose ________

    without adding the disputed phrase ("any revision thereof"), it

    is not certain that it could have done so. A wily lawyer could

    perhaps have argued that the unembellished word "regulation"

    referred only to brand-new regulations, not to adjustments of

    preexisting regulations. Cf. Public Serv. Co. v. United States ___ _________________ _____________

    EPA, 682 F.2d 626, 633 (7th Cir. 1982), cert. denied, 459 U.S. ___ _____ ______

    1127 (1983). Even more likely, Congress might have thought that

    the Secretary would be able to style a revision to a preexisting

    regulation as something other than a new regulation (perhaps as a

    clarification), and thereby evade the statutory safeguards. See, ___

    e,g., Detroit Edison Co. v. United States EPA, 496 F.2d 244, 249 ____ __________________ _________________

    (6th Cir. 1974) (rejecting EPA's attempt to characterize agency

    action as mere "clarification" of regulation as opposed to

    revision); cf. United States v. LaBonte, 70 F.3d 1396, 1411 n.13 ___ _____________ _______

    (1st Cir. 1995) (noting Sentencing Commission's practice of

    styling certain pronouncements affecting the interpretation of

    extant sentencing guidelines as "clarifications" rather than

    amendments). Moreover, a belt-and-suspenders approach is not

    uncommon when the Legislative Branch cedes rulemaking power to

    the Executive Branch. Indeed, Congress has frequently employed


    21












    the phrase "revision thereof" to confirm that its procedural

    mandates apply both to original regulations and future revisions

    of such regulations. See, e.g., 15 U.S.C. 2934(f)(1); 16 ___ ____

    U.S.C. 410cc-32(e); 33 U.S.C. 1314(c); 42 U.S.C.

    4916(a)(3)-(4), 7521(a)(2), 7571(b).

    Here, the Secretary's interpretation not only is

    consistent with common congressional statute-drafting practice

    but also ensures the ACCV's input into the rulemaking process

    without inviting the wasteful circularity of proposal, notice,

    comment, changed proposal, re-notice, additional comment, and so

    on and so forth, ad infinitum. The petitioners' suggested

    alternative, on the other hand, creates a perverse incentive. If

    the Secretary is forced to recommit a proposed regulation and

    twiddle her thumbs for an additional three months every time she

    responds agreeably to an ACCV suggestion, she may be less

    inclined to acquiesce in the first place. Hence, the

    interpretation that we adopt actually may increase the chance

    that the Secretary will pay attention to, and act upon, the

    ACCV's advice.

    In reaching the conclusion that the statute refers to

    regulations and revisions thereof (and not to revisions of

    proposed regulations), we necessarily override two other concerns

    anent the ACCV's place in the scheme of things. First, the

    petitioners boast that the ACCV's statutorily prescribed part in

    the process of revising the Table evinces Congress's distrust of

    the Secretary and proves that the reference to "any revision


    22












    thereof" is intended to give the ACCV a more prominent presence

    in the rulemaking process. This distorts the statutory alignment

    by grossly underestimating the Secretary's role and aggrandizing

    the ACCV's importance. In crafting the Act, Congress delegated

    unusually great authority to the Secretary, including the power

    to rewrite the statute by updating one of its hallmark

    provisions. In contrast, Congress assigned the ACCV a purely

    advisory function. See 42 U.S.C. 300aa-19; see also H.R. Rep. ___ ___ ____

    No. 908, supra, 1986 U.S.C.C.A.N. at 6365. Thus, far from _____

    bolstering the petitioners' case, a comparison of the relative

    responsibilities that Congress entrusted to the Secretary and the

    ACCV, respectively, undermines the petitioners' argument.

    Second, the Secretary's construction of the statute

    does not permit her effectively to bypass the ACCV by proposing

    one regulation and then issuing something radically different as

    a final rule. The Administrative Procedure Act applies here, and

    it is axiomatic under that regime that a final rule must be a

    lineal descendant of, and in character with, the earlier proposed

    rule. See, e.g., Kooritzky v. Reich, 17 F.3d 1509, 1513 (D.C. ___ ____ _________ _____

    Cir. 1994); American Medical Ass'n v. United States, 887 F.2d ______________________ ______________

    760, 767 (7th Cir. 1989). Put another way, changes must flow

    logically from the prescribed notice and comment. See Natural ___ _______

    Resources Defense Council, Inc. v. United States EPA, 824 F.2d ________________________________ _________________

    1258, 1283 (1st Cir. 1987). If the final rule deviates

    substantially from the proposed rule, it amounts to a new

    proposal and must run the regulatory gauntlet afresh. Thus, the


    23












    ACCV's right to be consulted is not stunted by the reading of

    300aa-14(d) that we adopt today.

    To recapitulate, we believe that Congress might

    reasonably have inserted the phrase "any revision thereof" to

    close what it suspected were potential loopholes. We therefore

    accept the Secretary's thesis that the phrase "any revision

    thereof," as used in 300aa-14(d), refers exclusively to

    revisions of existing regulations (not to revisions of proposed

    regulations). On this understanding, we hold that the Secretary

    complied with the statutory notice-and-comment requirement by

    providing a pre-publication copy of her proposed regulation to

    the ACCV in December of 1991.

    C. Adding and Subtracting Medical Conditions. C. Adding and Subtracting Medical Conditions. _________________________________________

    The petitioners' final shot injects a new notion into

    the case: the idea that the Act does not authorize the Secretary

    to remove HHE and residual seizure disorders from the Table in

    the absence of "definitive information" attesting to the lack of

    any causal link between DPT vaccination and these medical

    conditions. Since both the IOM and the Secretary herself found

    only that there was "insufficient evidence to indicate a causal

    relation" between vaccination and the kind of permanent

    neurological damage reflected in HHE and residual seizure

    disorders over time, see IOM Report at 118; Notice, 57 Fed. Reg. ___

    at 36,879, they tell us that the deletions cannot survive.

    The Secretary accepts the petitioners' premise the

    available evidence does not flatly disprove the causal relation


    24












    but she vigorously disputes the petitioners' conclusion. In her

    view, the criteria for revising the Table simply do not include

    the requirement that the petitioners seek to impose. We agree

    with the Secretary.

    We need not tarry. Nothing in the text of the Act

    prohibits the Secretary from eliminating a condition from the

    Table if the evidence of a causal relationship between the

    vaccination and that condition is equivocal. The only explicit

    constraints on the Secretary are procedural. See, e.g., 42 ___ ____

    U.S.C. 300aa-14(c) (requiring notice-and-comment period,

    including public hearing); id. 300aa-14(d) (mandating referral ___

    to the ACCV). While some other constraints may be readily

    inferred from the terms, structure, and history of the Act, there

    is no principled basis for the added constraint that the

    petitioners would have us infer.

    The petitioners' construct rests solely on a suggestion

    in the committee report accompanying the Act to the effect that

    the Secretary may revise the Table when "more definitive

    information" is available. They read this terse reference as

    superimposing on the text of the statute a requirement that the

    Secretary must have definitive evidence rejecting a causal

    relation between vaccination and a medical condition before she

    may delete the condition from the Table.

    The petitioners read the committee report through rose-

    colored glasses. The passage on which they rely is reproduced in




    25












    its entirety in the margin.11 The passage as a whole makes it

    abundantly clear that, though Congress, struggling with a lack of

    information, itself used an initial presumption that the

    conditions listed in the Table were caused by vaccination so long

    as they occurred within the specified time period following

    vaccination, it did not intend to carve this presumption into

    stone. To the precise contrary, the authors of the committee

    report explicitly recognized that the Table, as originally

    devised, might in some cases go too far, and relied on the

    Secretary to reconstitute it in light of the "more definitive

    information" that would be available as a consequence of the ___________________________________________________

    review, in order to reflect more accurately the causal relations ______


    ____________________

    11The passage reads:

    The Committee recognizes that there is public
    debate over the incidence of illnesses that
    coincidentally occur within a short time of
    vaccination. The Committee further
    recognizes that the deeming of vaccine-
    relatedness adopted [in the Table] may
    provide compensation to some children whose
    illness is not, in fact, vaccine-related.
    The Committee anticipates that the research
    on vaccine injury and vaccine safety now
    ongoing and mandated by this legislation will
    soon provide more definitive information
    about the incidence of vaccine injury and
    that, when such information is available, the
    Secretary or the [ACCV] may propose to revise
    the Table . . . . Until such time, however,
    the Committee has chosen to provide
    compensation to all persons whose injuries
    meet the requirements of the petition and the
    Table and whose injuries cannot be
    demonstrated to be caused by other factors.

    H.R. Rep. No. 908, supra, 1986 U.S.C.C.A.N. at 6359. _____

    26












    between vaccines and allegedly associated medical conditions.12

    Had Congress intended the Secretary to revise the Table

    by removing a medical condition only after a causal link was

    definitely disproven, it could quite easily have said so. It

    said nothing of the sort. What is did say is that the Secretary

    should update the Table in light of new and better information

    about causation. The Secretary, in pursuance of this directive,

    decided inter alia to remove HHE and residual seizure disorders _____ ____

    from the Table because the medical evidence failed to establish a

    causal connection between DPT vaccines and these disorders.

    Since there is nothing in the record to suggest that this

    decision is arbitrary or capricious, it must stand. See, e.g., ___ ____

    Strickland, 48 F.3d at 17-18; United States v. Members of the __________ _____________ _______________

    Estate of Luis Boothby, 16 F.3d 19, 21 (1st Cir. 1994); see also _______________________ ___ ____

    5 U.S.C. 706(2)(A).

    IV. CONCLUSION IV. CONCLUSION

    We need go no further. The Secretary had authority to

    issue the regulation about which the petitioners complain, and

    she exercised that authority in a procedurally appropriate and

    substantively permissible manner. No more is exigible.



    The petition to review and vacate the final rule is The petition to review and vacate the final rule is _______________________________________________________

    denied. denied. ______

    ____________________

    12This is of a piece with the statute itself, which
    indicates that the Secretary's revisions should be based on
    findings about whether "each of the illnesses or conditions set
    forth in [the Table] can reasonably be determined in some
    circumstances to be caused or significantly aggravated by
    pertussis-containing vaccines." Vaccine Act 312(b), 100 Stat.
    at 3780.

    27



Document Info

Docket Number: 95-1355

Filed Date: 3/11/1996

Precedential Status: Precedential

Modified Date: 9/21/2015

Authorities (21)

Public Service Company of Indiana, Inc. v. United States ... , 682 F.2d 626 ( 1982 )

Immigration & Naturalization Service v. Chadha , 103 S. Ct. 2764 ( 1983 )

K Mart Corp. v. Cartier, Inc. , 108 S. Ct. 1811 ( 1988 )

mark-schafer-and-melissa-schafer-a-minor-by-and-through-mark-schafer , 20 F.3d 1 ( 1994 )

united-states-v-george-labonte-united-states-of-america-v-david-e , 70 F.3d 1396 ( 1995 )

Chevron U. S. A. Inc. v. Natural Resources Defense Council, ... , 104 S. Ct. 2778 ( 1984 )

Samuel G. Kooritzky v. Robert B. Reich, Secretary of Labor , 17 F.3d 1509 ( 1994 )

Director, Office of Workers' Compensation Programs, United ... , 980 F.2d 74 ( 1992 )

Dole v. United Steelworkers , 110 S. Ct. 929 ( 1990 )

The Detroit Edison Company v. United States Environmental ... , 496 F.2d 244 ( 1974 )

United States v. Members of the Estate of Boothby , 16 F.3d 19 ( 1994 )

United States v. Ven-Fuel, Inc. , 758 F.2d 741 ( 1985 )

King v. St. Vincent's Hospital , 112 S. Ct. 570 ( 1991 )

Mississippi Power & Light Co. v. Mississippi Ex Rel. Moore , 108 S. Ct. 2428 ( 1988 )

United States v. Shaun K. O'Neil , 11 F.3d 292 ( 1993 )

Alabama Power Company v. Douglas M. Costle, as ... , 636 F.2d 323 ( 1980 )

United States v. Robert E. Meyer , 808 F.2d 912 ( 1987 )

National Railroad Passenger Corporation v. Boston & Maine ... , 112 S. Ct. 1394 ( 1992 )

Stinson v. United States , 113 S. Ct. 1913 ( 1993 )

Riva v. Commonwealth of MA , 61 F.3d 1003 ( 1995 )

View All Authorities »