Dupuch-Carron v. Hhs

Case: 20-1137 Document: 36 Page: 1 Filed: 08/11/2020

United States Court of Appeals
for the Federal Circuit
______________________

ROBERT DAVID DUPUCH-CARRON, ELIZABETH
JOANNA CARRON, AS THE LEGAL
REPRESENTATIVES OF THEIR MINOR SON, A. R.
D-C.,
Petitioners-Appellants

v.

SECRETARY OF HEALTH AND HUMAN
SERVICES,
Respondent-Appellee
______________________

2020-1137
______________________

Appeal from the United States Court of Federal Claims
in No. 1:17-vv-01551-RAH, Judge Richard A. Hertling.
______________________

Decided: August 11, 2020
______________________

CURTIS RANDAL WEBB, Twin Falls, ID, argued for peti-
tioners-appellants.

ROBERT PAUL COLEMAN, III, Vaccine/Torts Branch,
Civil Division, United States Department of Justice, Wash-
ington, DC, argued for respondent-appellee. Also repre-
sented by ETHAN P. DAVIS, C. SALVATORE D'ALESSIO,
GABRIELLE M. FIELDING, CATHARINE E. REEVES.
______________________
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2 DUPUCH-CARRON v. HHS

Before PROST, Chief Judge, CLEVENGER and STOLL, Circuit
Judges.
CLEVENGER, Circuit Judge.
Appellants Robert David Dupuch-Carron and Eliza-
beth Joanna Carron, husband and wife, are the legal rep-
resentatives of the estate of their deceased infant son, A.R.
D-C. Appellants filed an action seeking compensation for
injuries allegedly compensable under the National Vaccine
Injury Compensation Act, 42 U.S.C. §§ 300aa–1 et seq.
(“the Vaccine Act”). Appellants asserted standing to seek
compensation pursuant to 42 U.S.C. § 300aa–
11(c)(1)(B)(i)(III), which grants standing to a person who
“received [a covered] vaccine outside the United States or
a trust territory and the vaccine was manufactured by a
vaccine manufacturer located in the United States and
such person returned to the United States not later than 6
months after the date of the vaccination.” On the parties’
cross-motions for summary judgment, the Special Master
ruled that Appellants are ineligible to seek compensation
under the Vaccine Act, granted the Secretary of the De-
partment of Health & Human Services’ (the “Government”
or “HHS”) motion, and dismissed the petition. See Dupuch-
Carron v. Sec’y of Health & Hum. Servs., No. 17-1551V,
2019 WL 2263369 (Fed. Cl. Apr. 23, 2019). Appellants filed
a motion for review with the United States Court of Federal
Claims (“the Claims Court”) pursuant to 42 U.S.C. §
300aa–12(e). The Claims Court denied Appellants’ motion
for review. See Dupuch-Carron v. Sec’y of Health & Hum.
Servs., 144 Fed. Cl. 659 (2019). For the reasons discussed
herein, we affirm.
BACKGROUND
I. Facts
Appellants were domiciled in Nassau, The Bahamas,
for the entirety of the time period relevant to this case.
Mrs. Carron is a citizen of the United Kingdom and avers
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DUPUCH-CARRON v. HHS 3

that she is a “frequent visitor to the United States,” spend-
ing “10 to 12 long weekends” in the country each year.
Dupuch-Carron, 144 Fed. Cl. at 660. During a trip to Coral
Gables, Florida from March 24 to April 3, 2015, Mrs. Car-
ron visited an internist, who informed her that she was
pregnant. After learning of her pregnancy, she claims to
have traveled to the United States an additional four times
while pregnant.
Mr. Dupuch-Carron was born in the United States. He
appears to have grown up in The Bahamas but recalls
“spen[ding] a great deal of time [in the United States] as a
child during the summer holidays.” Id. (alteration in orig-
inal). Mr. Dupuch-Carron also avers that he is a “frequent
visitor to the United States,” spending “between 30 and 45
days in the United States on business” in a typical year.
Id.
Mr. and Mrs. Dupuch-Carron’s son, A.R. D-C., was
born on November 24, 2015, at Doctors Hospital in Nassau,
The Bahamas. He continued to live in Nassau for the first
six months of his life. During that time, A.R. D-C. had un-
remarkable well-child visits at his pediatric center in Nas-
sau, and was considered to be healthy and developing
normally. He also received his first two sets of vaccinations
in Nassau, with no apparent adverse consequences.
On June 23, 2016, during his six-month well-child visit
to his pediatrician in Nassau, A.R. D-C. received his third
set of vaccinations, which included the DTap, IPV, HIB,
HBV, Prevnar, and rotavirus vaccinations. There is no dis-
pute that the eight vaccines A.R. D-C. received during his
June 23rd visit to the pediatrician are listed in the Vaccine
Injury Table and were manufactured by companies with a
presence in the United States.
On July 7, 2016 and July 9, 2016, A.R. D-C. presented
at the pediatrician with complaints of a fever greater than
102 degrees Fahrenheit, crankiness, stuffy nose, rattling in
his chest, occasional chesty coughs, reduced activity,
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4 DUPUCH-CARRON v. HHS

vomiting, and diarrhea. A.R. D-C.’s parents brought him
to the emergency room at Doctors Hospital in Nassau on
July 10, 2016 with complaints of fever and vomiting for five
days, irritability, and decreased appetite. The doctors de-
termined he had thrombocytopenia and pancytopenia for
which he received a blood transfusion, and febrile neutro-
penia for which he was given an intravenous antibiotic. On
July 11, 2016, A.R. D-C. was transferred to the intensive
care unit at Princess Margaret Hospital in Nassau, where
a pediatric hematologist-oncologist recommended he be
transferred to an institution “equipped to enable quick turn
around and confirmation of the leukemia if present.”
Dupuch-Carron, 144 Fed. Cl. at 661.
Physicians in The Bahamas determined that A.R. D-C.
would receive better treatment in the United States, and
on July 13, 2016, A.R. D-C. was transferred by air ambu-
lance to Nicklaus Children’s Hospital in Miami, Florida,
where he was diagnosed with hemophagocytic lymphohis-
tiocytosis (“HLH”). HLH is an autoimmune disease of the
blood, fatal unless treated successfully. A.R. D-C. was
treated at Nicklaus Children’s Hospital until he was dis-
charged on August 12, 2016, “on the condition he remain in
Florida as an outpatient.” Id.
A.R. D-C. received weekly treatment as an outpatient
at Nicklaus Children’s Hospital. A.R. D-C. was cleared to
leave the United States over the Christmas season, so the
family returned to The Bahamas. On February 28, 2017,
A.R. D-C. was readmitted to Nicklaus Children’s Hospital.
He was diagnosed with acute myeloid leukemia (“AML”).
A.R. D-C. underwent treatment, which included chemo-
therapy and radiation at Cincinnati Children’s Hospital in
Cincinnati, Ohio, as well as a bone-marrow transplant at
Johns Hopkins Bloomberg Children’s Hospital in Balti-
more, Maryland.
On October 17, 2017, Appellants filed a petition under
the Vaccine Act. On December 24, 2017, A.R. D-C. died
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DUPUCH-CARRON v. HHS 5

from AML, and on March 26, 2018, Appellants filed an
amended petition, alleging that the AML, which caused
A.R. D-C.’s death, was a complication resulting from the
treatment he had received for his vaccine-induced HLH.
II. Procedural History
In Vaccine Act cases, the Claims Court and its special
masters have jurisdiction over proceedings to determine if
a petitioner under § 300aa–11 is entitled to compensation
and the amount of such compensation. 42 U.S.C. § 300aa–
12(a).
Prior to the filing of the amended petition, the Special
Master in this case identified, as a threshold question, the
issue of whether Appellants were eligible for compensation
under the Vaccine Act because the vaccines were adminis-
tered outside of the United States. The Special Master di-
rected the parties to file cross-motions for summary
judgment on that limited issue.
On March 26, 2018, concurrent with their filing of the
amended petition, Appellants filed a Motion for Partial
Summary Judgment on the limited issue of their eligibility
under the Vaccine Act for compensation. Specifically, Ap-
pellants argued that A.R. D-C. “returned,” under that
term’s plain meaning of “go back,” to the United States
within 6 months of receiving his vaccinations as required
by 42 U.S.C. § 300aa–11(c)(1)(B)(i)(III). Appellants, citing
the maternal immunization amendment to the Vaccine Act
as support, argued that A.R. D-C.’s initial entrance into the
United States occurred while in utero, and that A.R. D-C.’s
“return” to the United States occurred when he traveled to
Florida seeking medical treatment for HLH within 6
months of receiving his vaccinations.
On June 7, 2018, the Government filed a Cross-Motion
for Summary Judgment on that threshold issue. The Gov-
ernment argued that “the recent maternal immunization
amendment to the Vaccine Act establishes that a child in
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6 DUPUCH-CARRON v. HHS

utero can ‘receive’ a vaccine but it does not establish that
the child in utero was ‘present’ in the United States for pur-
poses of a later ‘return.’” Dupuch-Carron, 2019 WL
2263369, at *5. Specifically, the Government argued that:
(1) 42 U.S.C. § 300aa–11(c)(1)(B)(i)(III) requires that a
“person” “return” to the United States within six months of
receiving a vaccination; (2) A.R. D-C.’s “ mother’s entries
into the United States while pregnant do not mean that
[he] was ‘present’ [as a person] in the United States prior
to birth”; and (3) “A.R. D-C. was not present in the United
States at any time between his birth and his vaccinations.”
Id. (internal citations omitted). Thus, according to the Gov-
ernment, because A.R. D-C. had never previously been in
the United States as a “person,” as required by the statute,
his “post-vaccination entry into the United States cannot
constitute a ‘return.’” Id.
The Government also argued that even if A.R. D-C. is
recognized as a “person” who was present in the United
States while in utero, A.R. D-C. did not “return[] to the
United States,” under a proper interpretation of the
phrase, within six months after the date of vaccination.
Specifically, the Government argued that a court does not
construe statutes in a vacuum, and the words of a statute,
such as “return,” must be read in their context and with a
view to their place in the overall statutory scheme. As sup-
port, the Government cited to the Claims Court’s decision
in McGowan v. Secretary of the Department of Health &
Hum. Services, which found that because “the word ‘return’
relies on its context in order to impart a sense of perma-
nence, the plain meaning rule is not dispositive.” 31 Fed.
Cl. 734, 738 (1994). Instead, according to the McGowan
court, the phrase “returned to the United States” was lim-
ited to persons who had previously lived in the United
States and returned within six months of vaccination with
the intention to remain permanently in the United States
from that point on. See id. at 734–40.
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DUPUCH-CARRON v. HHS 7

Appellants filed their Response and Reply on July 12,
2018. On April 23, 2019, however, the Special Master de-
nied Appellants’ Motion and granted the Government’s Mo-
tion. First, the Special Master found that while “Congress
did expressly amend the Vaccine Act to permit a cause of
action alleging that a child was injured by transplacental
exposure to a vaccine administered to his or her mother
(but only after that child was born alive),” “this amendment
did not change the definition of child or person,” which is
limited to live-born members of the species homo sapiens.
Dupuch-Carron, 2019 WL 2263369, at *6. Thus, according
to the Special Master, “A.R. D-C., while living and breath-
ing outside of his mother’s body, was never present in the
United States before his vaccinations or the onset of his se-
vere illness” and “his entrance to the United States, while
within six months after the vaccinations at issue, cannot
be construed as a ‘return.’” Id. Second, the Special Master
found that even if A.R. D-C. was viewed to be a person upon
being carried in utero into the United States, there was not
sufficient evidence that he would have “returned to the
United States” within six months, as that phrase was con-
strued in McGowan. Id. at *10.
On May 23, 2019, Appellants filed a Motion for Review
of the Special Master’s decision, asking the Claims Court
to review and reverse the Special Master’s decision. In the
Motion for Review, Appellants raised the following objec-
tion:
The special master’s conclusion that the petitioners
were not eligible to seek compensation from the
National Vaccine Injury Compensation Program
because their son [A.R. D-C.]: 1) could not be
viewed as a person who was present in the United
States prior to his vaccinations; and 2) had not re-
turned to the United States within six months after
vaccinations was not in accordance with the law.
Dupuch-Carron, 144 Fed. Cl. at 662.
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8 DUPUCH-CARRON v. HHS

The Government filed its Response to Appellants’ Mo-
tion for Review on June 20, 2019, arguing that the Special
Master’s decision on Appellants’ eligibility to seek compen-
sation under the Vaccine Act was correct. With the Claims
Court’s leave, Appellants filed their Reply on July 5, 2019.
The Claims Court heard oral argument on Appellants’ Mo-
tion for Review on September 5, 2019.
The Claims Court issued its opinion under seal on Sep-
tember 10, 2019 and reissued it for public availability on
September 25, 2019. With respect to the first issue, the
Claims Court found that “[t]he Vaccine Act considers a
child whose mother receives a vaccine while the child is in
utero to be a ‘person,’” and therefore assumed without de-
ciding, for the purposes of its analysis, that A.R. D-C. was
a “person” under the relevant portions of the Vaccine Act,
with a prior presence in the United States. Dupuch-Car-
ron, 144 Fed. Cl. at 664 n.12. Thus, before the Claims
Court, the case turned on the second issue raised by Appel-
lants—whether A.R. D-C.’s arrival for medical treatment
constituted “return” for the purposes of the Vaccine Act’s
exception to its requirement that claimants be vaccinated
in the United States.
While the Claims Court declined to adopt the more nar-
row reading of the statute advanced in McGowan, it never-
theless found that, “[i]n light of the silence in the legislative
record and the presumptions attendant to the task of stat-
utory interpretation in this case, [there is] nothing to sug-
gest that Congress meant to cover foreign nationals
arriving in the United States for the purpose of seeking
medical treatment when it used the word ‘return’ in the
Vaccine Act.” Id. at 666. Accordingly, “[b]ecause A.R. D-
C.’s entry into the United States to receive medical treat-
ment did not fall within the more specific meaning of ‘re-
turn to the United States’” laid out by the Claims Court,
the court held that A.R. D-C. had “not satisfied the require-
ments under 42 U.S.C. § 300aa–11(c)(1)(B)(i)(III),” id. at
667, and denied Appellants’ Motion for Review.
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DUPUCH-CARRON v. HHS 9

This appeal followed.
DISCUSSION
This court has jurisdiction to review the final judgment
of the Claims Court under 42 U.S.C. § 300aa–12(f). In Vac-
cine Act cases, we review the Claims Court’s decision de
novo, “applying the same standard of review as the Court
of Federal Claims applied to its review of the special mas-
ter’s decision.” Griglock v. Sec’y of Health & Hum. Servs.,
687 F.3d 1371, 1374 (Fed. Cir. 2012) (citation omitted); see
also Paluck v. Sec’y of Health & Hum. Servs., 786 F.3d
1373, 1378 (Fed. Cir. 2015). “We owe no deference to the
trial court or the special master on questions of law, but we
uphold the special master’s findings of fact unless they are
arbitrary or capricious.” Lozano v. Sec’y of Health & Hum.
Servs., 958 F.3d 1363, 1368 (Fed. Cir. 2020) (citing
Griglock, 687 F.3d at 1374). “Thus, although we are re-
viewing as a matter of law the decision of the Court of Fed-
eral Claims under a nondeferential standard, we are in
effect reviewing the decision of the Special Master under
the deferential arbitrary and capricious standard on fac-
tual issues.” Griglock, 687 F.3d at 1374 (internal citations
omitted).
The Vaccine Act gives the Claims Court (and its special
masters) jurisdiction “over proceedings to determine if a
petitioner under section 300aa–11 of this title is entitled to
compensation under the [Vaccine Injury Compensation]
Program and the amount of such compensation.” Martin
ex rel. Martin v. Sec’y of Health & Hum. Servs., 62 F.3d
1403, 1406 (Fed. Cir. 1995) (quoting 42 U.S.C. § 300aa–
12(a) (Supp. V 1993)). “Section 300aa–11, in turn, sets out
the rules governing petitions for compensation.” Id.
The Vaccine Act, 42 U.S.C. § 300aa–11(c)(1)(B)(i), de-
limits the categories of persons who may pursue a claim
under it. Pursuant to the relevant provision, the person
seeking compensation under the Act must show that he or
she:
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10 DUPUCH-CARRON v. HHS

(I) received the vaccine in the United States or in
its trust territories,
(II) received the vaccine outside the United States
or a trust territory and at the time of the vaccina-
tion such person was a citizen of the United States
serving abroad as a member of the Armed Forces
or otherwise as an employee of the United States
or a dependent of such a citizen, or
(III) received the vaccine outside the United States
or a trust territory and the vaccine was manufac-
tured by a vaccine manufacturer located in the
United States and such person returned to the
United States not later than 6 months after the
date of the vaccination . . .
42 U.S.C. § 300aa–11(c)(1)(B)(i).
Appellants do not claim that either 42 U.S.C. § 300aa–
11(c)(1)(B)(i)(I) or § 300aa–11(c)(1)(B)(i)(II) is applicable to
this case. Therefore, the question before the court, as it
was before the Claims Court and Special Master, is
whether 42 U.S.C. § 300aa–11(c)(1)(B)(i)(III) allows Appel-
lants, under the specific facts of this case, to apply for com-
pensation under the Vaccine Act.
Section 300aa–11(c)(1)(B)(i)(III) limits compensation
under the Vaccine Act to (1) persons who (2) returned to
the United States not later than 6 months after the date of
the vaccination. Accordingly, we address whether: (1) A.R.
D-C. was a “person” who had previously been in the United
States in order for any subsequent travel there to consti-
tute a “return”; and (2) A.R. D-C. “returned to the United
States” within 6 months after the date of his vaccinations.
I. A.R. D-C. Was Not a “Person” Who Had Pre-
viously Been to the United States
The Claims Court found that “[t]he Vaccine Act consid-
ers a child whose mother receives a vaccine while the child
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DUPUCH-CARRON v. HHS 11

is in utero to be a ‘person,’” Dupuch-Carron, 144 Fed. Cl. at
664 n.12, and therefore assumed without deciding, for the
purposes of its analysis, that A.R. D-C. was a “person” un-
der the relevant portions of the Vaccine Act, with a prior
presence in the United States. We review the Claims
Court’s decision de novo and find, for the reasons discussed
below, that it misinterpreted the relevant language of the
Vaccine Act and thus impermissibly assumed that a child
in utero is a “person” under 42 U.S.C. § 300aa–
11(c)(1)(B)(i)(III).
It is undisputed that A.R. D-C. was born in The Baha-
mas, resided in The Bahamas uninterrupted for his first
six months of life, received the vaccinations at issue in The
Bahamas, and did not enter the United States as a live
born child until nearly three weeks after vaccination for
the purpose of medical treatment. Nevertheless, a “person”
who receives a vaccination outside of the United States is
eligible to seek compensation through the Vaccine Act un-
der Section 300aa–11(c)(1)(B)(i)(III) if he “returned to the
United States” not later than six months after the date of
vaccination. See 42 U.S.C. § 300aa–11(c)(1)(B)(i)(III). Ap-
pellants concede that “[i]mplicit in the word ‘returned’ is a
requirement that the person had been present in the
United States at some time before the vaccination.” Appel-
lants’ Br. 43 (italics added). Thus, in order to show that
A.R. D-C. “returned to the United States,” Appellants must
first show that their child, A.R. D-C., was a “person [that]
had been present in the United States” at some time before
the vaccination. According to Appellants, A.R. D-C.’s prior
presence in the United States in utero satisfies the relevant
statute.
The definition of “person” and “child” applicable to “any
Act of Congress,” including the Vaccine Act, is “every infant
member of the species homo sapiens who is born alive at
any stage of development.” 1 U.S.C. § 8(a). Though they
acknowledge the definition’s applicability, Appellants
point out that 1 U.S.C. § 8(c) states, “[n]othing in this
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12 DUPUCH-CARRON v. HHS

section shall be construed to affirm, deny, expand, or con-
tract any legal status or legal right applicable to any mem-
ber of the species homo sapiens at any point prior to being
‘born alive.’” See Oral Arg. at 28:33–30:04, http://oralargu-
ments.cafc.uscourts.gov/default.aspx?fl=20-1137.mp3.
And, based on the text of the Vaccine Act in view of cases
involving transplacental exposure to a vaccine, and deci-
sions interpreting the Social Security Act, Appellants ar-
gue that an unborn fetus is a “person” having an
independent and legally significant presence under the
Vaccine Act that cannot be denied or contracted by 1 U.S.C.
§ 8(a). Id. We disagree.
Appellants first allege that “[t]wo decisions from the
Court of Federal Claims and a third from a special master
have held that a child in utero is a ‘person’ for the purposes
of the Vaccine Act.” Appellants’ Br. 46–47. In Rooks v.
Sec’y of Dep’t of Health & Hum. Servs., Melton v. Sec’y of
Dep’t of Health & Hum. Servs., and Burch v. Sec’y of Dep’t
of Health & Hum. Servs.—the opinions cited by Appel-
lants—the Claims Court and Special Masters were pre-
sented with the question of whether a child, whose mother
received a vaccine while it was in utero, can be deemed to
have also “received” the vaccine, such that they can peti-
tion for compensation under the Vaccine Act once born. See
Rooks v. Sec’y of Dep’t of Health & Hum. Servs., 35 Fed. Cl.
1, 4 (1996) (stating “this case deals with the special mas-
ter’s legal determination of the meaning of ‘received’ under
the Vaccine Act” and finding “that the potential to ‘receive’
a vaccine while in utero exists”); Burch v. Sec’y of Dep’t of
Health & Hum. Servs., No. 99-946V, 2010 WL 1676767
(Fed. Cl. Spec. Mstr. Apr. 9, 2010); Melton v. Sec’y of Dep’t
of Health & Hum. Servs., No. 01-105V, 2002 WL 229781
(Fed. Cl. Spec. Mstr. Jan. 25, 2002). These cases do not
state or imply, however, that those in utero are themselves
“persons” that have a separate legal presence while travel-
ing abroad for purposes of determining eligibility to seek
compensation through the Vaccine Act.
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DUPUCH-CARRON v. HHS 13

Appellants nevertheless allege that the 21st Century
Cures Act’s (the “Cures Act”) amendment to the Vaccine
Act, 1 which reflects those earlier decisions, “recognized and
ratified the conclusion that a child in utero is a person for
the purposes of the Vaccine Act.” Appellants’ Br. 51. First,
the Cures Act’s amendment to the Vaccine Act—42 U.S.C.
§ 300aa–11(f)—did not amend the subsection concerning
extraterritorial application of the Vaccine Act at issue here.
Second, rather than make explicit the principle that a child
in utero is a “person” for all purposes of the Vaccine Act,
the statute makes clear that those whose mother received
a vaccine while they were in utero do not have a cognizable
claim under the Vaccine Act until they become a “person”—
i.e., “a member of the species homo sapiens who is born
alive at any stage of development.” See 42 U.S.C. § 300aa–
11(f)(1); 1 U.S.C. § 8(a).
The amendment, which addresses “Maternal immun-
ization,” states:
(1) In general
Notwithstanding any other provision of law, for
purposes of this part, both a woman who received a
covered vaccine while pregnant and any child who
was in utero at the time such woman received the
vaccine shall be considered persons to whom the
covered vaccine was administered and persons who
received the covered vaccine.

1 In 2016, the 21st Century Cures Act, Pub. L. No.
114-255, 130 Stat. 1033, 1152 (Dec. 13, 2016), amended the
Vaccine Act to provide that “[a] covered vaccine adminis-
tered to a pregnant woman shall constitute more than one
administration, one to the mother and one to each child . . .
who was in utero at the time such woman was administered
the vaccine.”
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14 DUPUCH-CARRON v. HHS

(2) Definition
As used in this subsection, the term “child” shall
have the meaning given that term by subsections
(a) and (b) of section 8 of Title 1, except that, for
purposes of this subsection, such section 8 shall be
applied as if the term “include” in subsection (a) of
such section were replaced with the term “mean”.
42 U.S.C. § 300aa–11(f) (emphasis added).
Appellants and the Claims Court have both interpreted
42 U.S.C. § 300aa–11(f)(1) as suggesting that a “child in
utero” is a “person.” See Dupuch-Carron, 144 Fed. Cl. at
664 n.12; Appellants’ Reply Br. 16. They are mistaken.
The first paragraph states that both a woman who received
a covered vaccine and a child, who was previously in utero
at the time such woman received the vaccine, are “persons”
deemed to have received the vaccine. 42 U.S.C. § 300aa–
11(f)(1). The second paragraph states that the term “child”
shall retain the meaning given that term by subsections (a)
and (b) of section 8 of Title 1. Id. As mentioned above,
1 U.S.C. § 8(a) states that “the words ‘person’, ‘human be-
ing’, ‘child’, and ‘individual’, shall [mean] 2 every infant
member of the species homo sapiens who is born alive 3 at

2 In accordance with 42 U.S.C. § 300aa–11(f)(2), “the
term ‘include’ in subsection (a) of” 1 U.S.C.A. § 8 has been
“replaced with the term ‘mean.’”
3 “[T]he term ‘born alive’, with respect to a member
of the species homo sapiens, means the complete expulsion
or extraction from his or her mother of that member, at any
stage of development, who after such expulsion or extrac-
tion breathes or has a beating heart, pulsation of the um-
bilical cord, or definite movement of voluntary muscles,
regardless of whether the umbilical cord has been cut, and
regardless of whether the expulsion or extraction occurs as
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DUPUCH-CARRON v. HHS 15

any stage of development.” 1 U.S.C. § 8(a). Thus, unlike
other federal legislation in which Congress has explicitly
bestowed special legal status upon children in utero, 4 42
U.S.C. § 300aa–11(f) makes clear that the words “person”
or “child,” included therein, retain their 1 U.S.C. § 8(a) def-
inition. Accordingly, only once it is born may a child whose
mother received a vaccine while they were in utero be con-
sidered a “person” that has received the vaccine.
Appellants also argue that decisions addressing the
status of a child in utero in the context of surviving child
benefits under the Social Security Act support their claim
that A.R. D-C. was present in the United States before
birth under the Vaccine Act. The cases cited by Appellants
dealt with the issue of whether an applicant met the stat-
utory requirements to be considered a “child” of a deceased
wage earner for purposes of child support under the Social
Security Act. See, e.g., Wagner v. Finch, 413 F.2d 267, 268–
69 (5th Cir. 1969) (“The crucial issue remaining is whether
or not this child, conceived outside of marriage and born
after her father’s death, may nevertheless be deemed to be
her father’s child under 42 U.S.C.A. 416(h)(3) of the Act.”).
Section 8(a) of Title 1 limits the term “child,” as used in all

a result of natural or induced labor, cesarean section, or
induced abortion.” 1 U.S.C. § 8(b).
4 For example, the Unborn Victims of Violence Act,
18 U.S.C. § 1841, applies to injurious acts committed
against a child in utero, but, unlike 42 U.S.C. § 300aa–
11(f), specifically includes its own definition of “unborn
child” that does not incorporate or refer to the “born alive”
language from 1 U.S.C. § 8’s definition of “person” or “child”
applicable to the Vaccine Act. See 18 U.S.C. § 1841(d)
(2018) (“As used in this section, the term ‘unborn child’
means a child in utero, and the term ‘child in utero’ . . .
means a member of the species homo sapiens, at any stage
of development, who is carried in the womb.”).
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16 DUPUCH-CARRON v. HHS

acts of Congress, to those born alive. As Appellants previ-
ously pointed out, however, this definition should not be
construed to affirm, deny, expand, or contract any legal sta-
tus or legal right applicable to any member of the species
homo sapiens at any point prior to being “born alive.” 1
U.S.C. § 8(c). As such, it cannot abridge any legal status
afforded to unborn children under the Social Security Act,
which has its own, separate, definition of “child” that does
not include any requirement that they be “born alive.” See
42 U.S.C. § 416(e). As discussed above, no similar legal
right applicable to fetuses exists under the Vaccine Act.
For at least these reasons, we agree with the Government
that the Social Security Act and its implementing regula-
tions are entirely distinct and separate from the Vaccine
Act, and the interpretation of the Social Security Act’s lan-
guage has no bearing on the language included in the Vac-
cine Act.
For the foregoing reasons, we hold that 1 U.S.C. § 8’s
definition of “person” applies to that term as it is used in
the Vaccine Act. Accordingly, we find that the Claims
Court’s assumption that A.R. D-C. was a “person” with a
prior presence in the United States was legally improper,
and agree with the Special Master that A.R. D-C., while
living and breathing outside of his mother’s body, was
never present in the United States before his vaccinations
and, thus, that his entrance to the United States cannot be
construed as a “return.”
II. A.R. D-C. Had Not “Returned to the United
States” Within the Meaning of the Vaccine
Act
Even if A.R. D-C. could be recognized as a “person” who
was present in the United States before vaccination, and
the Claims Court’s assumption was correct, the parties still
disagree as to whether A.R. D-C. “returned to the United
States” within six months of his vaccinations. § 300aa–
11(c)(1)(B)(i)(III). The Claims Court denied Appellants’
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DUPUCH-CARRON v. HHS 17

Motion for Review after finding “nothing to suggest that
Congress meant to cover” those, like A.R. D-C., who only
travel to “the United States for the purpose of seeking med-
ical treatment when it used the word ‘return’ in the Vaccine
Act.” Dupuch-Carron, 144 Fed. Cl. at 666. For the reasons
discussed herein, we agree.
The scope of the Vaccine Act does not, generally, extend
beyond the borders of the United States. The Act itself re-
fers to a “national” vaccine injury compensation program,
and 42 U.S.C. § 300aa–11(c)(1)(B)(i)(I) broadly provides
that anyone, including temporary visitors, who received a
scheduled vaccine “in the United States or in its trust ter-
ritories,” are eligible to seek compensation under the Act.
The legislative history, moreover, does not address any
concern for the continued supply of vaccines outside the
United States or the compensation of non-residents of the
United States, save for two exceptions. See McGowan,
31 Fed. Cl. at 739. First, families of citizens who were em-
ployees of the United States or members of the armed
forces can petition for compensation under the Vaccine Act,
even if the vaccine was received outside the United States
or its territories. 42 U.S.C. § 300aa–11(c)(1)(B)(i)(II). Sec-
ond, as noted above, anyone who received a vaccine made
in the United States and who subsequently returned to the
United States not later than six months after the vaccina-
tion can petition for compensation under the Vaccine Act.
42 U.S.C. § 300aa–11(c)(1)(B)(i)(III). These exceptions, by
their wording, apply only to those who previously had some
degree of presence in the United States prior to leaving
and, in the case of § 300aa–11(c)(1)(B)(i)(III), “returned.”
On appeal, as below, Appellants argue that both the
Special Master and the Claims Court inappropriately in-
terpreted the word “return” because “[t]he relevant lan-
guage of the Vaccine Act is not ambiguous,” and the Special
Master and Claims Court’s interpretations of “return” do
not comport with the “ordinary meaning” of the word (i.e.
“to come or go back to”). Dupuch-Carron, 144 Fed. Cl. at
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18 DUPUCH-CARRON v. HHS

664; see also, e.g., Appellants’ Br. 18. Appellants contend
that failing to apply the “ordinary meaning” of the word is
inconsistent with the Supreme Court’s unanimous holding
in Sebelius v. Cloer, which stated that “[u]nless otherwise
defined, statutory terms are generally interpreted in ac-
cordance with their ordinary meaning.” 569 U.S. 369, 376–
77 (2013) (quoting BP Am. Prod. Co. v. Burton, 549 U.S. 84,
91 (2006)). 5 Therefore, Appellants argue, under the plain
meaning of the unambiguously used definition of “return,”
they should be allowed to maintain their claim.
Before the Claims Court, the Government did not dis-
pute Appellants’ understanding of the “plain meaning” of
“return,” but instead argued that because such an interpre-
tation, under the Vaccine Act, would lead to “absurd re-
sults,” the plain meaning rule should not apply and that
the court must look to the context surrounding the phrase
“returned to the United States.” According to the Govern-
ment, as construed in McGowan, 31 Fed. Cl. at 740, 6

5 On June 17, 2020, counsel for Appellants also sub-
mitted a Citation of Supplemental Authority pursuant to
Fed. R. App. P. 28(j), which cited, as support, the Supreme
Court’s decision in Bostock v. Clayton County, 590 U.S. ___,
140 S. Ct. 1731 (2020).
6 The decisive issue in McGowan was the meaning of
the word “return” in the relevant provision of the Vaccine
Act. 31 Fed. Cl. at 738. The petitioner, who was born in
the United States, received two vaccinations in Canada,
where she resided and where her father was receiving med-
ical training. Id. at 736. Within six months of her August
20, 1965 vaccination, the petitioner entered the United
States to visit her maternal grandparents. Id. On October
1, 1990, the petitioner filed an application for compensa-
tion under the Vaccine Act, arguing that she suffered en-
cephalopathy as a result of her August 20, 1965 measles
vaccine. Id. As framed by the Claims Court, the question
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DUPUCH-CARRON v. HHS 19

“return” does not mean a temporary visit, but an arrival
“with the intention to remain permanently from that point
on.” Dupuch-Carron, 144 Fed. Cl. at 664.
The Claims Court declined to adopt the reading of the
statute advanced by the Government, in reliance on
McGowan, that “return” must include an intent to estab-
lish permanent residence in the United States. Nonethe-
less, the Claims Court found that “the term ‘return’ must
be limited by its context to avoid absurd results,” and held
that more is needed than the transient presence allowable
under Appellants’ overbroad reading of the word “return.”
Id. at 666. On appeal, the Government, dropping its reli-
ance on McGowan, argues that the Claims Court is correct.
We agree.
Applying the broadest meaning to the phrase “returned
to the United States,” as argued by Appellants, invites ab-
surd results inconsistent with the statute’s context. Take,
for example, a French citizen, resident in France, who flew
from Paris, France to Tokyo, Japan with a one-day stopover
in New York, who then returned to France and received a
vaccination. The fact that within six months of the vac-
cination, the French citizen again stopped for a day in New
York on his way to Tokyo, Japan would permit him to sub-
mit a Vaccine Act claim under Appellants’ broad reading of
the statute. Both the Supreme Court and this court, how-
ever, have repeatedly held over the years that “[i]f a literal
construction of the words of a statute be absurd, the act
must be so construed as to avoid the absurdity.” Holy

“regarding the definition of ‘return’ is whether there is a
sense of permanence inherent in the word.” Id. The Claims
Court found that simple dictionary definitions of “return”
“shed little light on the issue,” id., and, after canvassing
the legislative history of the Vaccine Act, held “[a]n injured
person who does not intend to return to live in the United
States should not be able to petition for a claim,” id. at 739.
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20 DUPUCH-CARRON v. HHS

Trinity Church v. United States, 143 U.S. 457, 460 (1892);
see also Cloer, 569 U.S. at 377 n.4 (avoiding statutory in-
terpretation that would produce an “absurd result”); Mila-
vetz, Gallop & Milavetz, P.A. v. United States, 559 U.S. 229,
252 (2010) (declining to “adopt a view of the statute that . .
. would produce an absurd result”); Pub. Citizen v. U.S.
Dep’t of Justice, 491 U.S. 440, 454 (1989) (“Where the lit-
eral reading of a statutory term would ‘compel an odd re-
sult,’ we must search for other evidence of congressional
intent to lend the term its proper scope.” (quoting Green v.
Bock Laundry Mach. Co., 490 U.S. 504, 509 (1989))); Hag-
gar Co. v. Helvering, 308 U.S. 389, 394 (1940) (explaining
that a reading of a statute that “would lead to absurd re-
sults is to be avoided when [it] can be given a reasonable
application consistent with [its] words and with the legis-
lative purpose”); Pitsker v. Office of Pers. Mgmt., 234 F.3d
1378, 1383 (Fed. Cir. 2000) (finding Office of Personnel
Management’s statutory interpretation violated “the canon
of statutory construction that an interpretation that causes
absurd results is to be avoided if at all possible”); Timex
V.I., Inc. v. United States, 157 F.3d 879, 887 (Fed. Cir.
1998) (finding that where “statutory construction frus-
trates Congress’s intent, encourages undesirable behavior,
and produces absurd results,” it should “be avoided, not
rubber-stamped”).
When construing a statutory term or phrase to avoid
an absurd result, or when the term or phrase is “ambigu-
ous,” it “must be read in [its] context and with a view to
[its] place in the overall statutory scheme.” Colonial Press
Int’l, Inc. v. United States, 788 F.3d 1350, 1357 (Fed. Cir.
2015) (quoting Davis v. Mich. Dep’t of Treasury, 489 U.S.
803, 809 (1989)); see also Wassenaar v. Office of Pers.
Mgmt., 21 F.3d 1090, 1092 (Fed. Cir. 1994) (stating that
“[a] reading of [a statute] which would lead to absurd re-
sults is to be avoided when [it] can be given a reasonable
application consistent with [its] words and legislative pur-
pose”). Indeed, with respect to the language at issue in this
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DUPUCH-CARRON v. HHS 21

case, Appellants’ counsel acknowledged at oral argument
that “the factual context of the person’s prior presence in
the United States and subsequent return is relevant.” See
Oral Arg. at 4:25–43, http://oralargu-
ments.cafc.uscourts.gov/default.aspx?fl=20-1137.mp3.
(“It’s necessary to understand whether or not there was a
return.”); see also id. at 5:53–6:35 (counsel for Appellants
equating “return” with “go back” and acknowledging that
“go back” can be ambiguous). Accordingly, the phrase “re-
turned to the United States” must be read in its context
and with a view to its place in the overall statutory scheme.
The phrase “returned to the United States,” itself, is
not addressed in any of the legislative history concerning
the Vaccine Act. Thus, the purpose of Congress’ enactment
of the Act must be understood to guide the court’s under-
standing of the phrase. See Amendola v. Sec’y of Dep’t of
Health & Hum. Servs., 989 F.2d 1180, 1182 (Fed. Cir.
1993). 7 In Amendola, this court found that “the motivating
factor behind enactment of the [Vaccine Act] was the desire
to protect the vaccine supply by shielding manufacturers
from exposure to liability resulting from the small but nev-
ertheless statistically significant incidence of unavoidable
injury or death from widespread use of the vaccine.” Id. at
1186.
While protection of the United States vaccine supply
was the motivating factor, however, the Vaccine Act’s lim-
ited legislative history makes clear that Congress had two

7 In Amendola, this court found that because the
Vaccine Compensation Act is a “complex piece of legisla-
tion” incorporating its “legislative purpose,” “the meaning
of any particular phrase or provision,” included therein,
“cannot be securely known simply by taking the words out
of context and treating them as self-evident.”
Amendola, 989 F.2d at 1182.
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22 DUPUCH-CARRON v. HHS

goals in its enactment. As the Claims Court correctly noted
in McGowan, and is not disputed by the parties here:
The first goal was to “offer fair compensation to vic-
tims” injured in connection with childhood vaccina-
tion programs. H.R. 1780, 99th Cong., 1st Sess.
(1985); S. 827, 99th Cong., 1st Sess. (1985); H.R.
Rep. No. 908, 99th Cong., 2d Sess., pt. 1, at 7
(1986), U.S. Code Cong. & Admin. News 1986, pp.
6287, 6348. The second was to insure the “contin-
ued supply of vaccines that are vital to the public
health.” H.R. 1780; S. 827; H.R. Rep. No. 908. This
second goal is linked only to the supply of vaccines
in the United States.
Id. at 738–39.
Interpreting the Vaccine Act in view of these goals, the
McGowan court held that 42 U.S.C. § 300aa–
11(c)(1)(B)(i)(III) applies “only to those who previously had
lived in the United States,” id. at 739, and “return[ed] to
the United States within six months of the vaccination
date, with the intention to remain permanently from that
point on,” id. at 740.
Relying on McGowan, the Special Master in this case
dismissed Appellants’ claim after finding that there was no
evidence that A.R. D-C. would have established a perma-
nent presence in this country. As the Claims Court found,
however, upon review of the Special Master’s decision,
while McGowan’s permanent residence requirement was
too restrictive, more is required of a “return” than a tempo-
rary visit for medical treatment. We agree with the Claims
Court that the permanent residence requirement is overly
restrictive. We nonetheless agree with the McGowan court
that some residence is required both before leaving and
upon “return[] to the United States” under 42 U.S.C. §
300aa–11(c)(1)(B)(i)(III).
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DUPUCH-CARRON v. HHS 23

One of the goals of the Vaccine Act was to provide com-
pensation to those injured in connection with childhood
vaccination programs. Congress specifically noted that
vaccination programs are facilitated by state and local dis-
tribution of vaccines, and at the time of the Act’s passage,
state laws mandated that “virtually all” children be vac-
cinated “as a condition for entering school.” H.R. Rep. No.
99-908, 99th Cong., 2d Sess., pt. 1, at 4–7 (1986). It is
doubtful that the United States or any state or local gov-
ernment would have authority to impose vaccination re-
quirements outside of its own borders (with the exception
of persons applying to immigrate to the United States). Al-
lowing those currently living outside the United States,
who have not previously lived in the United States, and
who were not injured in connection with United States vac-
cination programs, to receive compensation under the Vac-
cine Act would not serve the legislative goal of providing
compensation to those injured in connection with those
childhood vaccination programs.
With respect to Congress’s other goal of stabilizing the
vaccine market, Congress undoubtedly intended to reduce
liability for vaccine manufacturers by limiting civil actions
against them from those covered by the Vaccine Act. See
42 U.S.C. § 300aa–11(a)(2)-(3); see also 42 U.S.C. § 300aa–
11(a)(9) (“This subsection applies only to a person who has
sustained a vaccine-related injury or death and who is
qualified to file a petition for compensation under the Pro-
gram.”). Congress, through the Vaccine Act, has explicitly
mandated that “[i]f a civil action which is barred under sub-
paragraph (A) is filed in a State or Federal court, the court
shall dismiss the action.” 42 U.S.C. § 300aa–11(a)(2)(B).
The Vaccine Act, however, does not, nor can it, prevent civil
actions against vaccine manufacturers in other countries.
Thus, allowing residents of other countries, who have not
previously resided in the United States and do not plan on
residing in the United States, and were not injured in con-
nection with United States vaccination programs, to
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24 DUPUCH-CARRON v. HHS

receive compensation under the Vaccine Act would not
serve the goal of immunizing United States vaccine manu-
facturers from suit; those foreign residents could sue in for-
eign courts not similarly prevented from hearing these
cases. 8
If Congress wished to provide such broad immunity as
argued by Appellants, it is hard to see why Congress disal-
lowed claims by persons who never entered the United
States or entered the United States at some point before
vaccination but did not return again within six months.
We surmise that Congress, in enacting this section, in-
tended to provide protection for persons who (1) previously
resided in the United States, where they were subject to
United States vaccination programs, (2) were temporarily
away from the United States when they received the vac-
cination, and (3) “returned to the United States” within six
months with the intention of resuming residence therein.
We hold that because A.R. D-C.’s entry into the United
States to receive medical treatment does not fall within the
more narrowly construed meaning of “returned to the
United States” that the Vaccine Act’s broader context

8 With regard to pending civil actions, the Vaccine
Act manifests a legislative intent to prevent double com-
pensation. See 42 U.S.C.A. § 300aa–11(a)(7) (providing
that a damage award, either by settlement or court action,
precludes a Vaccine Act petition); § 300aa–
11(c)(1)(E) (providing that petitioner must aver in the peti-
tion that he has not previously collected a damage award
either by settlement or court action). We agree with the
McGowan court that logic dictates that Congress would not
allow the opportunity for double compensation when the
petitioner could be compensated outside of the United
States. See McGowan, 31 Fed. Cl. at 740 n.3.
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DUPUCH-CARRON v. HHS 25

demands, Appellants have not satisfied the requirements
of 42 U.S.C. § 300aa–11(c)(1)(B)(i)(III).
CONCLUSION
Appellants are not eligible to seek compensation from
the Vaccine Program under 42 U.S.C. § 300aa–
11(c)(1)(B)(i)(III). First, A.R. D-C., while living and breath-
ing outside of his mother’s body, was never present in the
United States before his vaccinations such that his en-
trance to the United States for medical treatment could be
construed as a “return.” Second, even if A.R. D-C. was a
“person” with a prior presence in the United States as a
result of his in utero travel, he never resided in the United
States nor intended to upon his “return.” Thus, we hold
that A.R. D-C. did not “return[] to the United States”
within the meaning of the Vaccine Act. Accordingly, the
Claims Court’s Order denying Appellants’ Motion for Re-
view is affirmed.
AFFIRMED
COSTS
The parties shall bear their own costs.