Bruesewitz v. Wyeth Inc ( 2009 )


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  •                                                                                                                            Opinions of the United
    2009 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    3-27-2009
    Bruesewitz v. Wyeth Inc
    Precedential or Non-Precedential: Precedential
    Docket No. 07-3794
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    http://digitalcommons.law.villanova.edu/thirdcircuit_2009/1613
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    PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    _____________
    No. 07-3794
    _____________
    RUSSELL BRUESEWITZ; ROBALEE BRUESEWITZ,
    parents and natural guardians of Hannah Bruesewitz,
    a minor child and in their own right,
    Appellants
    v.
    WYETH INC.
    f/k/a
    WYETH LABORATORIES, WYETH-AYERST
    LABORATORIES,
    WYETH LEDERLE, WYETH LEDERLE VACCINES,
    AND
    LEDERLE LABORATORIES
    ___________________
    On Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    District Court No. 05-cv-05994
    District Judge: The Honorable Michael M. Baylson
    ____________________
    1
    Argued September 11, 2008
    Before: McKEE, SMITH, and WEIS, Circuit Judges
    (Filed: March 27, 2009)
    Collyn A. Peddie (Argued)
    Williams, Kherkher, Hart & Boundas
    8441 Gulf Freeway
    Suite 600
    Houston, TX 77017-5001
    Counsel for Appellant
    Reetu Dandora
    1650 Market Street
    2500 One Liberty Place
    Philadelphia, PA 19103-7301
    Counsel for Appellee
    Lauren Elliott
    Richard W. Mark (Argued)
    Daniel J. Thomasch
    Orrick, Herrington & Sutcliffe
    666 Fifth Avenue
    New York, NY 10103
    Counsel for Appellee
    Henry F. Reichner
    Michael T. Scott
    Reed Smith
    1650 Market Street
    2
    2500 One Liberty Place
    Philadelphia, PA 19103
    Counsel for Appellee
    ______________
    OPINION
    ______________
    SMITH, Circuit Judge.
    This appeal presents three questions related to the
    National Childhood Vaccine Injury Act: (1) whether the Act
    preempts all design defect claims against the manufacturer of a
    vaccine; (2) whether the plaintiffs demonstrated that the
    manufacturer failed to adequately warn the plaintiffs of the risks
    associated with the vaccine; and (3) whether the plaintiffs
    provided sufficient evidence of a manufacturing defect to
    survive the defendant’s motion for summary judgment. The
    District Court held that the Act preempted all design defect
    claims and concluded that the plaintiffs failed to provide
    sufficient evidence to support the other two claims. For the
    reasons that follow, we will affirm.
    I.
    A.
    Historically, the states have possessed “great latitude
    3
    under their police powers to legislate as to the protection of the
    lives, limbs, health, comfort, and quiet” of their citizens. Metro.
    Life Ins. Co. v. Massachusetts, 
    471 U.S. 724
    , 756 (1985). This
    has been true with regard to drugs, as the Supreme Court has
    declared it “well settled that the State has broad police powers
    in regulating the administration of drugs by the health
    professions.” Whalen v. Roe, 
    429 U.S. 589
    , 603 (1977). And
    the police powers extend to immunization, as state and local
    authorities have responded to illnesses like smallpox and sought
    to inoculate members of the populous. Center for Biologics
    Evaluation and Research, Food and Drug Administration,
    Science and the Regulation of Biological Products: From a Rich
    History to a Challenging Future 8 (2002). Despite calls in the
    late nineteenth-century for the federal regulation of vaccines to
    promote uniform safety regulations, Congress did not act until
    1902, when thirteen children died after being vaccinated with
    contaminated diptheria antitoxin. 
    Id. at 12.
    Over the past
    century, however, the federal government has taken a
    predominate role in approving, regulating, and promoting
    vaccines—from the passage of the Biologics Control Act in
    1902, Pub. L. No. 57-244, which authorized a federal agency to
    issue regulations related to vaccines, to the Public Health
    Service Act, Pub. L. No. 78-410, which required federal
    authorities to license vaccines and vaccine manufacturers, to the
    Emergency Supplemental Appropriations Act for Recovery from
    and Response to Terrorist Attacks on the United States, Pub. L.
    No. 107-9, which appropriated money for the acquisition of a
    sufficient quantity of the smallpox vaccine to inoculate the
    4
    country.
    The National Childhood Vaccine Injury Act (“Vaccine
    Act”) is one such effort. P.L. 99-660, Title III, 100 Stat. 3743,
    3756–3784 (codified at 42 U.S.C. § 300aa-1 et seq.). Enacted
    in 1986, the Vaccine Act established a national vaccine program
    to “achieve optimal prevention of human infectious diseases
    through immunization and to achieve optimal prevention against
    adverse reactions to vaccines.” 42 U.S.C. § 300aa-1. It sought
    to accomplish this primarily through the creation of the National
    Vaccine Injury Compensation Program (“NVICP”) for claims
    against drug manufacturers for vaccine-related injuries and
    deaths. 42 U.S.C. § 300aa-10 et seq.
    The NVICP has two parts. Part A creates a mandatory
    forum for the administration of claims—it requires a petitioner
    seeking compensation, including the injured party’s legal
    representative, to file a petition in the “Vaccine Court,” which
    is part of the United States Court of Federal Claims. 
    Id. at §
    300aa-11. The petitioner is entitled to receive compensation if:
    (1) the affected person received a vaccine covered by the
    Vaccine Act; (2) the affected person suffered a “Table injury”;1
    1
    The Vaccine Act created the “Vaccine Injury Table.” 42
    U.S.C. § 300aa-14. It sets forth the “vaccines, the injuries,
    disabilities, illnesses, conditions, and deaths resulting from the
    administration” of vaccines for which individuals may seek
    compensation. 
    Id. 5 and
    (3) it cannot be shown by a preponderance of the evidence
    that the injuries or death were not caused by the vaccine. 
    Id. at §
    § 300aa-11, 300aa-13. Alternatively, a petitioner who suffers
    a non-Table injury may still obtain compensation by proving
    affirmatively that the vaccine caused the injury. See Grant v.
    Sec’y of HHS, 
    956 F.2d 1144
    , 1148 (Fed. Cir. 1992). Part B of
    the NVICP permits a petitioner, after the Vaccine Court has
    issued a final judgment, to either accept or reject that judgment.
    42 U.S.C. § 300aa-21 et seq. If the petitioner rejects the
    judgment, she may pursue certain limited claims in state or
    federal court.2 42 U.S.C. § 300aa-21.
    B.
    Hannah Bruesewitz was born on October 20, 1991. At
    the time, the federal Advisory Committee on Immunization
    Practices recommended that children receive five doses of the
    diphtheria-pertussis-tetanus (“DPT”) vaccine during the course
    of their childhood, one dose at each of the following ages: (1) 2
    months; (2) 4 months; (3) 6 months; (4) 15-18 months; and (5)
    4-6 years. Hannah received her first three shots of the DPT
    vaccine according to this schedule. After the third DPT shot,
    marketed under the trade name TRI-IMMUNOL and
    administered on April 1, 1992, she suffered a series of seizures.
    2
    The party also has the option of appealing the Court of
    Federal Claims’ judgment to the United States Court of Appeals
    for the Federal Circuit. 42 U.S.C. § 300aa-12(f).
    6
    Doctors subsequently diagnosed Hannah as having residual
    seizure disorder and developmental delay. Hannah, who is now
    seventeen, will likely require some medical care related to that
    condition for the remainder of her life.
    Defendant Wyeth, Inc. and its predecessors 3 (“Wyeth”)
    manufactured TRI-IMMUNOL until 1998. Approved in 1948,
    this vaccine contains the “whole-cell” pertussis vaccine—it is
    prepared using whole, inactivated pertussis bacterial cells.
    Although the whole-cell vaccine effectively reduced pertussis
    infections and deaths associated with these infections, it was
    also linked to a variety of adverse events. This led to interest in
    and efforts to develop a safer, acellular pertussis vaccine.
    In December 1991, the Food and Drug Administration
    (“FDA”) approved the defendant’s application for an alternate
    DPT vaccine, which was known as ACEL-IMUNE. ACEL-
    IMUNE contains an acellular pertussis component. While the
    acellular vaccine contains parts of pertussis bacterial cells,
    because it does not contain a complete cell, it has less endotoxin
    3
    The National Health Institute first issued a product
    license for TRI-IMMUNOL in 1948 to American Cyanamid
    Company (“Cyanamid”).         Lederle Laboratories, an
    unincorporated division of Cyanamid, produced TRI-
    IMMUNOL. In 1994, American Home Products Corporation
    (“AHPC”) acquired Cyanamid. In March 2002, AHPC changed
    its name to Wyeth.
    7
    and is less likely to cause adverse events.4 The FDA initially
    approved ACEL-IMUNE, however, for administration as the
    fourth and/or fifth DPT dose in the series of five. The FDA did
    not approve an acellular pertussis vaccine for the first three
    shots in the series until July 1996 when it approved the license
    of Connaught Laboratories, Inc. Defendant’s ACEL-IMUNE
    did not receive approval for these same doses until December
    1996.
    Nonetheless, at the time of vaccination in April 1992,
    Hannah’s doctor administered the TRI-IMMUNOL vaccine
    because there were no acellular pertussis vaccines commercially
    available for the third dose. Hannah’s particular vaccine came
    from a lot that generated sixty-five reports of adverse reactions
    with the FDA and Centers for Disease Control and Prevention,
    including thirty-nine em ergency room visits, six
    hospitalizations, and two deaths. Hannah’s physician later
    4
    The acellular pertussis vaccine contains pertussis toxin
    and other bacterial components. These components, however,
    are less reactive and cause fewer adverse events because they
    have been detoxified using chemical or genetic techniques.
    Centers for Disease Control and Prevention, Pertussis
    Vaccination: Acellular Pertussis Vaccine for the Fourth and
    Fifth Doses of the DPT Series; Update to Supplementary ACIP
    Stat Recommendations of the Advisory Committee on
    Immunization Practices, October 9, 1992,
    http://www.cdc.gov/mmwr/preview/mmwrhtml/00048610.htm.
    8
    indicated, as part of this litigation, that she would not have
    immunized Hannah had she known of the adverse event reports
    associated with this lot of the vaccine.
    In 1998, Wyeth voluntarily discontinued manufacturing
    TRI-IMMUNOL.
    C.
    Hannah’s parents (“plaintiffs”) filed a petition in the
    Vaccine Court in April 1995, alleging that Hannah suffered an
    on-Table residual seizure disorder and encephalopathy.5
    Bruesewitz v. Sec’y of Dep’t of HHS, No. 95-0266V, 
    2002 WL 31965744
    , at *1 n.1 (Fed. Cl. Dec. 20, 2002). The Court held a
    hearing in July 2002 and concluded in December of that year
    that Hannah’s injuries were non-Table injuries and that the
    petitioners had not proven causation in fact. 
    Id. at *13–17.
    Accordingly, it dismissed the claim with prejudice. 
    Id. at *17.
    Hannah’s parents rejected the Court’s judgment on February 14,
    5
    Effective March 10, 1995, approximately one month
    before the plaintiffs filed their petition with the Vaccine Court,
    new regulations deleted residual seizure disorder as a Table
    injury for DPT vaccine. Bruesewitz v. Sec’y of Dep’t of HHS,
    No. 95-0266V, 
    2002 WL 31965744
    , at *1 n.1 (Fed. Cl. Dec. 20,
    2002); see also National Vaccine Injury Compensation Program
    Revision of the Vaccine Injury Table, 60 Fed. Reg. 7678,
    7689–91 (Feb. 8, 1995 ).
    9
    2003.
    Having exhausted their administrative remedies, the
    plaintiffs filed a Complaint in the Philadelphia Court of
    Common Pleas in October 2005. The complaint sought
    recovery on four claims: (I) negligent failure to produce a safer
    vaccine; (II) negligent failure to warn; (III) strict liability for
    design defect; and (IV) strict liability for manufacturing defect.
    Wyeth removed the action on the basis of diversity to the
    Eastern District of Pennsylvania and filed a motion for summary
    judgment. The District Court denied the motion without
    prejudice because the parties had not engaged in discovery.
    Following completion of discovery, Wyeth again moved for
    summary judgment on all four counts.
    Although the District Court did not accept all of Wyeth’s
    theories, it granted summary judgment in Wyeth’s favor on all
    counts on August 24, 2007. The District Court concluded that
    Section 22(b)(1) of the Vaccine Act, 42 U.S.C. § 300aa-
    22(b)(1), preempts all design defect claims arising from a
    vaccine-related injury or death and dismissed Counts I and III on
    that basis. Regarding Count II, which alleged negligent failure
    to warn, the District Court concluded that the plaintiffs had not
    rebutted the statutory presumption created by Section 22(b)(2)
    of the Vaccine Act, 42 U.S.C. § 300aa-22(b)(2), that Wyeth’s
    FDA-compliant warnings were proper. As to Count IV, which
    alleged that the particular lot from which Hannah’s dose
    originated was especially prone to adverse reactions due to a
    10
    manufacturing defect, the District Court concluded that the
    plaintiffs had failed to present sufficient evidence that the lot
    was defective or that it caused Hannah’s injuries.
    The District Court’s ruling on the first and third claims
    warrants further examination. Both counts alleged a design
    defect—Count I alleged that Hannah’s vaccine was negligently
    designed because the defendant knew of a safer alternative and
    failed to produce it, while Count III alleged strict liability design
    defect. The District Court ruled that both claims were
    preempted by the Vaccine Act. It rested this decision on four
    points. First, it stated that a case-by-case consideration of
    whether a vaccine was unavoidably safe would not protect
    vaccine manufacturers from suit. Second, it reasoned that
    Congress passed the Vaccine Act to “provide an umbrella under
    which manufacturers would improve the safety of their products
    while remaining immune from design defect claims.” Third, the
    Court found that Congress achieved an appropriate balance by
    offsetting the effect of the preemption of design defect claims
    with creation of a compensation program for individuals injured
    by vaccines. Finally, it concluded that the Vaccine Act
    preempts both strict liability and negligent design defect claims
    against FDA-approved vaccines. Accordingly, it dismissed
    plaintiffs’ first and third claims.
    The plaintiffs appealed. Their appeal presents this Court
    with three questions: (1) does § 300aa-22(b)(1) act as a
    complete bar to design defect claims; (2) have the plaintiffs in
    11
    this case met their burden under § 22(b)(2) of the Vaccine Act
    to show that defendants failed to provide an adequate warning
    of the alleged dangers of the vaccine; and (3) have the plaintiffs
    provided sufficient evidence of a manufacturing defect to
    survive the defendant’s motion for summary judgment.
    II.
    The District Court had jurisdiction under 28 U.S.C.
    §§ 1332 and 1441, and we have appellate jurisdiction under 28
    U.S.C. § 1291. Our review of a District Court’s grant of
    summary judgment is plenary, and we apply the same standard
    as the District Court to determine whether summary judgment
    was appropriate. Norfolk S. Ry. Co. v. Basell USA Inc., 
    512 F.3d 86
    , 91 (3d Cir. 2008). A grant of summary judgment is
    appropriate “if the pleadings, the discovery and disclosure
    materials on file, and any affidavits show that there is no
    genuine issue as to any material fact and that the movant is
    entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(c).
    In making this determination, we must view the facts in the light
    most favorable to the nonmoving party and draw all inferences
    in that party’s favor. 
    Norfolk, 512 F.3d at 91
    .
    III.
    Preemption doctrine is rooted in the Supremacy Clause
    of the United States Constitution. Article VI declares that the
    laws of the United States “shall be the supreme Law of the
    12
    Land; . . . any Thing in the Constitution or Laws of any State to
    the Contrary notwithstanding.” U.S. Const. art. VI, cl. 2.
    “Under the Supremacy Clause, federal law may supersede state
    law in several different ways.” Hillsborough County, Fla., v.
    Automated Med. Labs., Inc., 
    471 U.S. 707
    , 713 (1985). Over
    the years, the Supreme Court has recognized three types of
    preemption: express preemption, implied conflict preemption,
    and field preemption. 
    Id. A federal
    enactment expressly preempts state law if it
    contains language so requiring. Lorillard Tobacco Co. v. Reilly,
    
    533 U.S. 525
    , 541 (2001). Thus, when construing an express
    preemption clause, a reviewing court must necessarily begin by
    examining the “plain wording of the clause,” as this “necessarily
    contains the best evidence of Congress’ pre-emptive intent.”
    Sprietsma v. Mercury Marine, 
    537 U.S. 51
    , 62–63 (2002)
    (quoting CSX Transp. v. Easterwood, 
    507 U.S. 658
    , 664
    (1993)). Though the language of the provision offers a starting
    point, courts are often called upon to “identify the domain
    expressly pre-empted by that language.” Medtronic, Inc. v.
    Lohr, 
    518 U.S. 470
    , 484 (1996) (internal quotation marks and
    citations omitted). This, in turn, is guided by two principles. 
    Id. at 485.
        First, “Congressional purpose is the ‘ultimate
    touchstone’ of our inquiry.” Lorillard Tobacco 
    Co., 533 U.S. at 541
    (quoting Cipollone v. Liggett Group, Inc., 
    505 U.S. 504
    ,
    516 (1992)); see also Altria Group, Inc. v. Good, 
    129 S. Ct. 538
    ,
    543 (2008) (“If a federal law contains an express pre-emption
    clause, it does not immediately end the inquiry because the
    13
    question of the substance and scope of Congress’ displacement
    of state law still remains.”). Second, courts must operate under
    the “assumption that the historic police powers of the States
    [a]re not to be superseded by the Federal Act unless that [is] the
    clear and manifest purpose of Congress.” Cal. Div. of Labor
    Standards Enforcement v. Dillingham Constr., N.A., Inc., 
    519 U.S. 316
    , 325 (1997).
    Implied conflict preemption arises when state law
    conflicts with a federal statute in one of two situations. First, it
    arises when it is “impossible for a private party to comply with
    both state and federal requirements.” English v. General Elec.
    Co., 
    496 U.S. 72
    , 78–79 (1990). It is also present when state
    law “stands as an obstacle to the accomplishment and execution
    of the full purposes and objectives of Congress.” Hines v.
    Davidowitz, 
    312 U.S. 52
    , 67 (1941). Furthermore, implied
    preemption may exist even in the face of an express preemption
    clause. As the Supreme Court observed in Freightliner Corp. v.
    Myrick, 
    514 U.S. 280
    , 288 (1995), “Congress’ enactment of a
    provision defining the preemptive reach of a statute implies that
    matters beyond that reach are not pre-empted,” but that “does
    not mean that the express clause entirely forecloses any
    possibility of implied pre-emption.”
    When confronting arguments that a law stands as an
    obstacle to Congressional objectives, a court must use its
    judgment: “What is a sufficient obstacle is a matter of judgment,
    to be informed by examining the federal statute as a whole and
    14
    identifying its purpose and intended effects.” Crosby v. Nat’l
    Foreign Trade Council, 
    530 U.S. 363
    , 373 (2000). In fact, we
    must look to “‘the entire scheme of the statute’” and determine
    “‘[i]f the purpose of the [federal] act cannot otherwise be
    accomplished—if its operation with its chosen field [would] be
    frustrated and its provisions be refused their natural effect.’” 
    Id. (quoting Savage
    v. Jones, 
    225 U.S. 501
    , 533 (1912)). Once
    again, this requires an examination of the “‘whole law, and to its
    object and policy.’” Gade v. Nat’l Solid Wastes Mgmt. Assn.,
    
    505 U.S. 88
    , 98 (1992) (quoting Pilot Life Ins. Co. v. Dedeaux,
    
    481 U.S. 41
    , 51 (1987)).
    Field preemption arises by implication when state law
    occupies a “field reserved for federal regulation.” United States
    v. Locke, 
    529 U.S. 89
    , 111 (2000). This occurs when “Congress
    [] left no room for state regulation of these matters.” Id.; see
    also Lorillard Tobacco 
    Co., 533 U.S. at 541
    . It may also be
    inferred when “an Act of Congress ‘touch[es] a field in which
    the federal interest is so dominant that the federal system will be
    assumed to preclude enforcement of state laws on the same
    subject.’” English v. Gen. Elec. Co., 
    496 U.S. 72
    , 79 (1990)
    (quoting Rice v. Santa Fe Elevator Corp., 
    331 U.S. 218
    , 230
    (1947)). Nonetheless, because field preemption typically arises
    in areas traditionally regulated by states under their police
    powers, “congressional intent to supersede state laws must be
    ‘clear and manifest.’” 
    Id. (citation omitted).
    Yet despite the development of the foregoing preemption
    15
    jurisprudence, courts must begin their analysis of these
    questions by applying a presumption against preemption.
    Cipollone v. Liggett Group, Inc., 
    505 U.S. 504
    , 516 (1992). “In
    areas of traditional state regulation, we assume that a federal
    statute has not supplanted state law unless Congress has made
    such an intention ‘clear and manifest.’” Bates v. Dow
    AgroSciences, 
    544 U.S. 431
    , 449 (2005). When faced with two
    equally plausible readings of statutory text, we “have a duty to
    accept the reading that disfavors preemption.” Id; see also
    Altria Group, 
    Inc., 129 S. Ct. at 543
    ; 
    Cipollone, 505 U.S. at 518
    .
    This is true even in the event of an express preemption clause.
    Riegel v. Medtronic, Inc., 
    128 S. Ct. 999
    , 1014 (2008) (quoting
    
    Bates, 544 U.S. at 449
    ). That issues of health and safety have
    traditionally fallen within the province of state regulation is
    beyond refute. That safety of vaccines is an issue of health and
    safety is equally clear. See, e.g., Medtronic, 
    Inc., 518 U.S. at 485
    . Nonetheless, in the face of clear evidence, the presumption
    against preemption can be overcome. See 
    Crosby, 530 U.S. at 374
    n.8. (“Assuming, arguendo, that some presumption against
    preemption is appropriate, we conclude, based on our analysis
    below, that the state Act presents a sufficient obstacle to the full
    accomplishment of Congress’s objectives under the federal Act
    to find it preempted.”).
    We must decide here whether the plaintiffs’ design defect
    claims are preempted. As we have noted, the District Court
    reasoned that four points counseled in favor of finding that both
    claims were preempted by the Vaccine Act: (1) if the Vaccine
    16
    Act permitted case-by-case consideration of design defect
    claims, the Act would do little to protect manufacturers from
    suit; (2) Congress intended the Vaccine Act to encourage
    vaccine improvements while providing immunity for design
    defect claims; (3) Congress achieved a balance between
    manufacturers and patients by creating the compensation system
    to offset design defect immunity; and (4) the Vaccine Act is
    broader than comment k of the Restatement (Second) of Torts
    § 402A such that the Act encompasses both strict liability and
    negligence claims. At the same time, the District Court did not
    explicitly lay out a framework for coming to these conclusions,
    nor did it state whether they were predicated on express,
    implied, or field preemption grounds.
    Plaintiffs now seek to turn such ambiguity to their
    advantage by arguing that the District Court’s decision was
    “based on some kind of implied or field preemption” when the
    defendant’s motion for summary judgment raised only express
    preemption.     This, they maintain, violated “well-settled
    summary judgment principles.” 6 Accordingly, we must consider
    6
    The plaintiffs argue that the District Court’s decision
    violates the principle that a “district court may not grant
    summary judgment sua sponte on grounds not requested by the
    moving party.” John Deere Co. v. Am. Nat’l Bank, 
    809 F.2d 1190
    , 1192 (5th Cir. 1987). This Court has previously
    remanded a claim because the District Court granted summary
    judgment on a ground not offered in the moving party’s motion.
    17
    four questions related to the preemption of the design defect
    claim: (1) whether § 300aa-22(b) constitutes an express
    preemption provision; (2) whether we may use traditional tools
    of statutory interpretation, including legislative history, when
    construing such a provision; (3) whether this provision preempts
    plaintiffs’ design defect claims; and (4) whether the District
    Court’s decision is consistent with this analysis.
    A.
    Part B of the Vaccine Act establishes the circumstances
    under which individuals who have rejected the judgment of the
    Vaccine Court may subsequently file suit in state or federal
    court. Section 300aa-22, entitled “Standards of Responsibility,”
    sets forth both a general rule and several exceptions to that rule.
    It states:
    Brobst v. Columbus Servs. Intern., 
    761 F.2d 148
    , 159 (3d Cir.
    1985). For the reasons that follow, we need not decide this
    issue. We note, however, that our ruling in Brobst was
    predicated on a district court’s obligation to provide notice to
    the parties before ruling on a particular issue. In this case, the
    plaintiffs argued in their response to the motion for summary
    judgment about the propriety of ruling on implied preemption
    grounds, thereby indicating that they were on notice that the
    District Court may have been considering implied preemption
    at that time and furthermore that they had an opportunity to
    respond on this issue.
    18
    (a) General rule
    Except as provided in subsections (b), (c), and (e)
    of this section State law shall apply to a civil
    action brought for damages for a vaccine-related
    injury or death.
    (b) Unavoidable adverse side effects; warnings
    (1) No vaccine manufacturer shall be liable in a
    civil action for damages arising from a vaccine-
    related injury or death associated with the
    administration of a vaccine after October 1, 1988,
    if the injury or death resulted from side effects
    that were unavoidable even though the vaccine
    was properly prepared and was accompanied by
    proper directions and warnings.
    (2) For purposes of paragraph (1), a vaccine shall
    be presumed to be accompanied by proper
    directions and warnings if the vaccine
    manufacturer shows that it complied in all
    material respects with all requirements under the
    Federal Food, Drug, and Cosmetic Act [21
    U.S.C.A. § 301 et seq.] and section 262 of this
    title (including regulations issued under such
    provisions) applicable to the vaccine and related
    to vaccine-related injury or death for which the
    civil action was brought unless the plaintiff
    shows—
    (A) that the manufacturer engaged
    in the conduct set forth in
    subparagraph (A) or (B) of section
    300aa-23(d)(2) of this title, or
    19
    (B) by clear and convincing
    evidence that the manufacturer
    failed to exercise due care
    notwithstanding its compliance
    with such Act and section (and
    regulations issued under such
    provisions).
    (c) Direct warnings
    No vaccine manufacturer shall be liable in a civil
    action for damages arising from a vaccine-related
    injury or death associated with the administration
    of a vaccine after October 1, 1988, solely due to
    the manufacturer’s failure to provide direct
    warnings to the injured party (or the injured
    party’s legal representative) of the potential
    dangers resulting from the administration of the
    vaccine manufactured by the manufacturer.
    (d) Construction
    The standards of responsibility prescribed by this
    section are not to be construed as authorizing a
    person who brought a civil action for damages
    against a vaccine manufacturer for a vaccine-
    related injury or death in which damages were
    denied or which was dismissed with prejudice to
    bring a new civil action against such manufacturer
    for such injury or death.
    (e) Preemption
    No State may establish or enforce a law which
    20
    prohibits an individual from bringing a civil
    action against a vaccine manufacturer for
    damages for a vaccine-related injury or death if
    such civil action is not barred by this part.
    42 U.S.C. § 300aa-22.
    We are guided by two cases interpreting language similar
    to that which appears in § 300aa-22. In Lorillard Tobacco Co.,
    the Supreme Court interpreted the Federal Cigarette Labeling
    and Advertising Act, which stated that “‘[n]o statement relating
    to smoking and health other than the statement required by
    section 1333 of this title, shall be required on any cigarette
    
    package.’” 533 U.S. at 541
    (quoting 15 U.S.C. § 1334). This
    language is analogous to subsection 22(b)(1) of the Vaccine Act,
    which states that “[n]o vaccine manufacturer shall be liable in
    a civil action for damages arising from a vaccine-related injury
    or death . . . if the injury or death resulted from side effects that
    were unavoidable.” In both provisions, without using language
    such as “no state shall” or “state law is preempted,” Congress
    has set forth an area in which state law may not operate. In CSX
    Transportation, Inc., the Supreme Court construed the following
    provision: “A state may adopt or continue in force any law . . .
    until such time as the Secretary has adopted a rule . . . covering
    the subject matter of such State requirement. A state may adopt
    or continue in force an additional or more stringent law . . .
    when not incompatible with any Federal law. . . 
    .” 507 U.S. at 662
    & n.2 (quoting 45 U.S.C. § 434 (repealed 1994)). Similarly,
    Section 22(a) of the Vaccine Act establishes a general rule
    permitting states to regulate vaccines subject to several
    exceptions set forth in subsections (b), (c), and (e).
    21
    In both Lorillard Tobacco Co. and CSX Transportation,
    Inc., the Supreme Court characterized the language at issue as
    an express preemption provision. In the former case, the Court
    declared that “Congress unequivocally preclude[d] the
    requirement of any additional statements on cigarette packages
    beyond those provided in § 1333.” Lorillard Tobacco 
    Co., 533 U.S. at 542
    . In the latter case, the Court characterized the
    quoted language as containing “express saving and preemption
    clauses.” CSX Transp., 
    Inc., 505 U.S. at 662
    . Accordingly, we
    conclude that § 22(a) and § 22(b)(1) of the Vaccine Act also
    contain express preemption clauses.
    Our conclusion is consistent with prior jurisprudence
    from this Court, stating that express preemption “arises when
    there is an explicit statutory command that state law be
    displaced.” St. Thomas-St. John Hotel & Tourism Ass’n, Inc. v.
    Gov’t of the U.S., V.I., 
    218 F.3d 232
    , 238 (3d Cir. 2000).
    Section 22(a) clearly states Congress’s intent to displace state
    law in several enumerated instances, including as provided for
    in subsection (b).        Subsection (b) then declares that
    manufacturers are immune from liability for claims arising from
    “unavoidable” injuries and deaths related to vaccine
    administration, thereby prohibiting states from regulating in this
    area. The scope of a preemption provision stating that “no state
    shall pass laws with the following exceptions” may well be
    broader than a provision stating “state law applies with the
    following exceptions.” Yet the breadth of a provision does not
    alter the import of the underlying language, and here that
    language conveys a clear intent to override state law civil action
    claims in particular, defined circumstances.
    22
    Yet we must still determine the scope and reach of the
    express preemption provision. The plaintiffs here concede that
    the statute “expressly precludes only those state tort claims
    involving vaccines with side effects first shown to be
    ‘unavoidable,’” but they argue that avoidability must first be
    determined “on a case-by-basis” as part of a court’s examination
    of a design defect claim. In response, Wyeth argues that this
    language “preempts all claims arising from allegations of design
    defect.” Accordingly, “we must [] ‘identify the domain
    expressly pre-empted’ by [the] language” of the Vaccine Act.
    Medtronic 
    Inc., 518 U.S. at 484
    .
    B.
    Again, we are mindful that courts seeking to identify the
    scope of an express preemption provision are compelled to
    consider “Congressional purpose [] the ‘ultimate touchstone’ of
    our inquiry.” Lorillard Tobacco 
    Co., 533 U.S. at 541
    (quoting
    Cipollone v. Liggett Group, Inc., 
    505 U.S. 504
    , 516 (1992)).
    The Supreme Court has declared on numerous occasions that
    reviewing courts have several tools to aid them in their
    interpretation of congressional purpose. Courts may be guided
    by the “structure and purpose of the statute as a whole, as
    revealed not only in the text, but through the reviewing court’s
    reasoned understanding of the way in which Congress intended
    the statute and its surrounding regulatory scheme to affect
    business, consumers, and the law.” Medtronic, 
    Inc., 518 U.S. at 486
    (internal quotation marks and citations omitted); see also
    
    Gade, 505 U.S. at 98
    (“Our ultimate task in any pre-emption
    case is to determine whether state regulation is consistent with
    the structure and purpose of the statute as a whole.”);
    23
    Ingersoll-Rand Co. v. McClendon, 
    498 U.S. 133
    , 138 (1990)
    (“To discern Congress’ intent we examine the explicit statutory
    language and the structure and purpose of the statute.”). Beyond
    structure and purpose, the Court has also stated “that ‘[i]n
    expounding a statute, we must not be guided by a single
    sentence or member of a sentence, but look to the provisions of
    the whole law, and to its object and policy.’” Pilot Life Ins. Co.
    v. Dedeaux, 
    481 U.S. 41
    , 51 (1987) (quoting Kelly v. Robinson,
    
    479 U.S. 36
    , 43 (1986).
    The above analysis, allowing courts to consider a
    statute’s purpose, structure, and regulatory scheme, applies even
    in light of the presumption against preemption. The Court’s
    preemption discussion in Cipollone is particularly instructive on
    this point. In that case, the Court considered a statute stating
    that “[n]o statement relating to smoking and health shall be
    required in the advertising of [properly labeled] cigarettes.”
    
    Cipollone, 505 U.S. at 518
    (internal quotations and emphasis
    omitted). The Court reaffirmed the presumption against
    preemption. 
    Id. at 516.
    It also noted the existence of an express
    preemption clause, 
    id. at 517,
    which it construed using several
    tools of statutory construction, 
    id. at 519.
    The Court noted the
    Act’s explicit “statement of purpose,” and it read this against a
    “backdrop of regulatory activity.” 
    Id. It also
    considered the
    “regulatory context,” namely the factors that served as “the
    catalyst for the passage” of the statute. 
    Id. The Court
    stated that
    this backdrop and context supported a narrow reading of the
    preemption clause. 
    Id. at 518–19.
    In dissent, Justice Scalia
    criticized the majority and argued for a broader interpretation of
    the provision, predicated on the statute’s use of the phrase “no
    statement.” 
    Id. at 549–50
    (Scalia, J., dissenting). The majority
    24
    rejected Justice Scalia’s interpretation because it “relie[d] solely
    on an interpretation of those two words, artificially severed from
    both textual and legislative context.” 
    Id. at 519
    n.16.
    We have recognized that legislative history is not without
    its shortcomings as a tool of interpretation. “As a point of fact,
    there can be multiple legislative intents because hundreds of
    men and women must vote in favor of a bill in order for it to
    become a law.” Morgan v. Gay, 
    466 F.3d 276
    , 278 (3d Cir.
    2006); see also Exxon Mobil Corp. v. Allapattah Servs., Inc.,
    
    545 U.S. 546
    , 568 (2005) (noting that “legislative history is
    itself often murky, ambiguous, and contradictory,” and that it
    “may give unrepresentative committee members—or, worse yet,
    unelected staffers and lobbyists—both the power and the
    incentive to . . . secure results they were unable to achieve
    through the statutory text”). Yet, resort to legislative history is
    appropriate “when necessary to interpret ambiguous statutory
    text.” BedRoc Ltd., LLC v. United States, 
    541 U.S. 176
    , 187 n.8
    (2004) (plurality opinion). Although this Court has declined to
    employ legislative history if a statute is clear on its face, we
    have allowed recourse to legislative history in the face of
    ambiguity. See, e.g., In re Mehta, 
    310 F.3d 308
    , 311 (3d Cir.
    2002) (“We look to the text of a statute to determine
    congressional intent, and look to legislative history only if the
    text is ambiguous.”); United States v. Gregg, 
    226 F.3d 253
    , 257
    (3d Cir. 2000) (“To determine a law’s plain meaning, we begin
    with the language of the statute. If the language of the statute
    expresses Congress’s intent with sufficient precision, the inquiry
    ends there . . . Where the statutory language does not express
    Congress’s intent unequivocally, a court traditionally refers to
    the legislative history . . . .”).
    25
    It is, therefore, appropriate to consider legislative history
    to resolve ambiguity in the scope of an express preemption
    provision. In Cipollone, as part of the discussion of the
    regulatory context of the statute at issue, the Court cited
    language from a House of Representatives’ report that was
    issued during Congress’s consideration of the legislation.
    
    Cipollone, 505 U.S. at 519
    . Similarly, in Lorillard Tobacco Co.,
    the Court stated that its task was to “identify the domain
    expressly 
    pre-empted,” 533 U.S. at 541
    , and that this was aided
    “by considering the predecessor pre-emption provision and the
    circumstances in which the current language was adopted.” 
    Id. at 542.
    It went on to cite reports from the United States Surgeon
    General, the House of Representatives, and the Senate in the
    course of its discussion. 
    Id. at 542–44.
    We cannot resolve from statutory text alone the scope of
    the express preemption provision before us. Accordingly, we
    will look at the language, structure, and purpose of the Vaccine
    Act to ascertain whether it preempts all design defect claims,
    and we will resort—as we must—to legislative history to aid our
    interpretation.
    C.
    We are left to construe the scope of preemption created
    by the phrase “if the injury or death resulted from side effects
    that were unavoidable . . . .” § 300aa-22(b). The phrase hinges
    on the word “unavoidable,” yet the term is not defined in the
    Vaccine Act. Nor does the surrounding language answer
    questions such as whether all design defect claims are
    preempted or whether state courts may determine avoidability on
    26
    a case-by-case basis. According to the Oxford English
    Dictionary, “unavoidable” means “[n]ot avoidable; that [which]
    cannot be avoided or escaped; inevitable.” (2d ed. 1989). By
    itself, this succinct definition is unhelpful. Yet, the structure of
    the provision as a whole provides necessary context, and we can
    conceive of two possible interpretations of this language.
    1.
    The first construction would result in the preemption of
    some design defect claims. Subsection (a) expressly preempts
    state law to the degree indicated in subsection (b). Subsection
    (b), in turn, primarily relates to design defect claims, as
    evidenced by the use of a subordinate clause introduced by
    “even though” to reference claims that might arise from a
    manufacturing defect or warning defect. That structure makes
    it clear that we must consider design defects in the first instance.
    Clearly, then, subsection (a) and (b) work in concert to preempt
    state law and exempt manufacturers from liability for some
    design defect claims.
    Section 300aa–22, taken as a whole, further clarifies
    Congress’s intent with regard to design defect claims.
    Subsection (a) displaces state law only as defined in subsections
    (b), (c), and (e). Subsections (b) and (c) employ identical
    introductory language, stating that “[n]o vaccine manufacturer
    shall be liable in a civil action for damages arising from a
    vaccine-related injury or death associated with the
    administration of a vaccine . . . .” Subsection (e) prohibits states
    from foreclosing civil actions that are otherwise “not barred by
    this part,” thereby stating that other parts of § 300aa-22 are
    27
    designed to not only limit liability but bar some claims entirely.
    Thus, by reading these three provisions together, it becomes
    clear that Congress intended that subsections (b) and (c) should
    be an outright bar to some claims.
    In a case presenting design defect claims similar to those
    in the present case, the Georgia Supreme Court reached a
    different conclusion regarding the meaning of § 22(b). Am.
    Home Prods. Corp v. Ferrari, 
    669 S.E.2d 236
    (Ga. 2008). It
    focused on the clause “if the injury or death resulted from side
    effects that were unavoidable.” That Court first noted that this
    language is conditional and implies that some vaccine-related
    injuries and deaths may be avoided. 
    Id. at 240.
    The Ferrari
    Court also reasoned that reading the preemption provision to
    exclude all design defect claims would render the clause
    superfluous. 
    Id. at 240.
    That Court concluded that if Congress
    intended to preempt all design defect claims, it could have
    achieved that result by omitting the “unavoidable” clause such
    that the provision would prevent liability “if the vaccine was
    properly prepared and was accompanied by proper directions
    and warnings.” 
    Id. We do
    not consider the Ferrari Court’s reading to be
    compelling. First, while we recognize that the language is
    conditional, such a reading does not foreclose the preemption
    of some claims. Furthermore, it is always possible to construct
    through hindsight an alternate structure for a statute with
    alternative wording that would render it more clear. For
    instance, subpart (b)(1) notes that manufacturers may not be
    liable for unavoidable side effects caused by a vaccine that was
    “properly prepared and was accompanied by proper directions
    28
    and warnings,” and subpart (b)(2) sets limits on this. In subpart
    22(b)(2), the statute declares that vaccines issued in accordance
    with federal labeling requirements are presumed to have proper
    directions and warnings unless one of the following applies: (1)
    the manufacturer engaged in conduct that would subject it to
    punitive damages under § 300aa-23 of the Vaccine Act, or (2)
    there is clear and convincing evidence that the manufacturer
    failed to exercise due care. § 300aa-22(b)(2). If, as plaintiffs
    claim, Congress intended to carve out from subsection 22(b) a
    mechanism to enable states to determine what side effects could
    have been avoided through an alternate design, Congress could
    have done so in the manner used in subpart (b)(2) to preserve
    some warning defect claims against vaccines that meet federal
    labeling requirements.
    More importantly, we think the Ferrari Court’s
    construction is contrary to the structure of the Act because it
    does not bar any design defect claims. If we interpret the
    Vaccine Act to allow case-by-case analysis of whether particular
    vaccine side effects are avoidable, every design defect claim is
    subject to evaluation by a court. Furthermore, in 1986 when
    Congress enacted the Vaccine Act, several courts had already
    barred strict liability design defect claims against prescription
    drug manufacturers under state law.7 The Ferrari Court’s
    construction of § 300aa-22 could create an awkward dichotomy
    in the case law of these states—their courts would be required
    7
    See, e.g., Davis v. Wyeth Labs., Inc., 
    399 F.2d 121
    , 128
    (9th Cir. 1968); Lewis v. Baker, 
    413 P.2d 400
    , 404 (Or. 1966)
    (overruled in part on other grounds).
    29
    to engage in case-by-case analysis of all strict liability and
    negligent design defect claims brought under the Vaccine Act,
    while barring strict liability design defect claims against
    prescription drug manufacturers. As discussed above, Congress
    could not have intended such a result, as § 300aa-22 makes clear
    that Congress intended to preempt and bar certain claims.
    Though      there are two possible interpretations of
    subsection (b),     we conclude that a “clear and manifest”
    expression of       congressional intent supports the first
    interpretation.8   Our construction, however, does not indicate
    8
    In Wyeth v. Levine, S. Ct. , No. 06-1249, 
    2009 WL 529172
    , at *1 (2009), the Supreme Court examined whether
    federal law preempted state tort claims alleging that a drug
    manufacturer failed to adequately warn of the dangers
    associated with a drug. 
    Id. at *1.
    Though we recognize that the
    Supreme Court concluded that state tort law claims were not
    preempted in that case, 
    id. at 13,
    Levine is readily
    distinguishable on several grounds. First, the Court explicitly
    noted the absence of an express preemption provision and found
    Congress’s silence, “coupled with its certain awareness of the
    prevalence of state tort litigation, [] powerful evidence.” 
    Id. at 10.
    In this case, however, Congress included an express
    preemption provision that was prompted, as evidenced by the
    Committee Report, by the prevalence of state tort litigation.
    Second, it recognized that, under federal law, a drug
    manufacturer could strengthen a drug's label without
    preapproval from the FDA. 
    Id. at 7.
    This stands in contrast to
    the FDA’s far-more extensive control and oversight of the
    30
    whether subsection (b) preempts all design defect claims or only
    strict liability design defect claims.
    2.
    There is no language in the statute indicating whether the
    Vaccine Act preempts only strict liability design defect claims
    or also those based in negligence, and the structure and purpose
    of the Act are of little assistance in resolving that question. As
    a result, there remains some inherent ambiguity in the statute,
    and we must resort to legislative history to resolve that
    ambiguity.      The parties in this case cite to different
    congressional reports to support their claims. Each argument
    will be addressed in turn.
    a.
    Wyeth cites to a report (“Commerce Report”) from the
    House Committee on Energy and Commerce (“Energy and
    Commerce Committee”), which had jurisdiction over the
    Vaccine Act and guided the legislation through passage. H.R.
    Rep. No. 99-108 (1986). The Commerce Report declared that
    childhood vaccinations have been “one of the most spectacularly
    effective public health initiatives this country has ever
    undertaken,” preventing countless deaths and saving billions of
    dollars. 
    Id. at 4.
    The Report stated, however, that “the Nation’s
    ability to maintain this level of success has come into question”
    as a result of tort claims by individuals gravely injured by
    approval of a drug’s design and alteration.
    31
    vaccines. 
    Id. This, in
    turn, caused an increase in the cost of
    vaccines, the withdrawal of some manufacturers from the
    market, and a decreased rate of immunization. 
    Id. The Report
    noted that these conditions prompted the Energy and Commerce
    Committee to reevaluate the federal regulation of vaccines. 
    Id. at 5.
    Though the Committee was concerned with
    compensating individuals injured by vaccines, it also sought to
    reduce the cost of such claims in order to safeguard the
    development and availability of such vaccines. It noted that
    there was “no ‘perfect’ or reaction-free childhood vaccine on the
    market” and that a small number of children suffered serious
    reactions. 
    Id. at 6.
    It then stated that “despite these possibilities
    . . . it is safer to take the required shots than to risk the health
    consequences of contracting the diseases . . . .” 
    Id. The Committee
    expressed concern that the “withdrawal of even a
    single manufacturer would present the very real possibility of
    vaccine shortages, and, in turn, increasing numbers of
    unimmunized children, and, perhaps, a resurgence of
    preventable diseases.” 
    Id. at 7.
    The Report demonstrates that the
    Vaccine Act was motivated in great measure by Congress’s
    belief that an alternate compensation system would reduce
    awards and create a stable, predictable basis for estimating
    liability: “[T]he Committee believes that once this system is in
    place and manufacturers have a better sense of their potential
    litigation obligations, a more stable childhood vaccine market
    will evolve.” 
    Id. Importantly, the
    Commerce Report specifically addressed
    § 300aa-22, the section at issue here. First, it noted that some
    32
    provisions of the Vaccine Act would “change most State laws”
    related to vaccine injuries and deaths. Yet, it deemed this an
    appropriate change “in light of the availability of a
    comprehensive and fair compensation system.” 
    Id. at 25.
    Then,
    the Commerce Report stated that the Vaccine Act reflected the
    principle of Restatement (Second) of Torts § 402A comment k,9
    9
    The Georgia Supreme Court took this reference to mean
    that Congress intended to preserve some design defect claims
    and permit case-by-case consideration of whether a vaccine is
    unavoidably harmful. See 
    Ferrari, 668 S.E.2d at 239
    –40.
    Specifically, the Ferrari Court pointed to the fact that a majority
    of courts have interpreted comment k as permitting a case-by-
    case analysis of whether a vaccine’s side effects are avoidable.
    
    Id. at 239.
    It then drew on the Vaccine Act’s legislative history
    to support its conclusion that Congress interpreted comment k
    in the same manner as those other courts. 
    Id. at 240.
            Though we acknowledge that a majority of states permit
    some design defect claims under comment k, we disagree with
    the Georgia Supreme Court on the relevance of this fact. First,
    it discounts that courts in a significant minority of states have
    held that comment k preempts all strict liability design defect
    claims against FDA-approved drugs. Second, the current state
    of affairs with regard to the interpretation of comment k tells us
    little about what Congress knew in 1986 when it passed the
    Vaccine Act. As one court has noted, “in 1986 courts had not
    yet reached a consensus on the meaning of Comment k, or the
    proper treatment of prescription drugs in design defect
    legislation. Thus, while some courts concluded that a case-by-
    case analysis was necessary . . . others concluded that
    33
    which states that sellers of certain products, including vaccines,
    should not be strictly liable for harm caused by their products
    when it is not possible to make these products entirely safe.10 
    Id. prescription drug
    manufacturers were generally not liable for
    design defect claims.” Militrano v. Lederle Labs. 
    769 N.Y.S.2d 839
    , 844–45 (N.Y. Sup. Ct. 2003). Finally, we note that
    regardless of state court consideration of comment k, we believe
    Congress made it clear what it intended when it invoked
    comment k.
    10
    Comment k states the following:
    There are some products which, in the present
    state of human knowledge, are quite incapable of
    being made safe for their intended and ordinary
    use. . . . An outstanding example is the vaccine
    for the Pasteur treatment of rabies, which not
    uncommonly leads to both serious and damaging
    consequences when it is injected. Since the
    disease itself invariably leads to a dreadful death,
    both the marketing and the use of the vaccine are
    fully justified, notwithstanding the unavoidable
    high degree of risk which they involve. Such a
    product, properly prepared, and accompanied by
    proper directions and warning, is not defective,
    nor is it unreasonably dangerous. . . . The seller of
    such products, again with the qualification that
    they are properly prepared and marketed, and
    proper warning is given, where the situation calls
    34
    at 25–26. The Report described the type of vaccine cases in
    which comment k would have import—cases in which innocent
    children would be “badly injured or killed” by a vaccine, but in
    which a jury would likely impose liability on the manufacturer
    “even if the defendant manufacturer may have made as safe a
    vaccine as anyone reasonably could expect.” H.R. Rep. 99–908
    at 26 (emphasis added). Finally, it stated in precise and certain
    terms that its reference to comment k and the language of 22(b)
    results in immunity for liability for all design defects, whether
    liability rests on theories of strict liability or negligence: “[i]f
    [injured individuals] cannot demonstrate under applicable law
    either that a vaccine was improperly prepared or that it was
    accompanied by improper directions or inadequate warnings
    [they] should pursue recompense in the compensation system,
    not the tort system.” 
    Id. In our
    view, the Commerce Report supports the
    conclusion that the Vaccine Act preempts all design defect
    claims, including those based in negligence. First, the
    Committee Report repeatedly stressed the importance of vaccine
    development and availability. Second, it expressed serious
    for it, is not to be held to strict liability for
    unfortunate consequences attending their use,
    merely because he has undertaken to supply the
    public with an apparently useful and desirable
    product, attended with a known but apparently
    reasonable risk.
    Restatement (Second) of Torts § 402A cmt k (1966).
    35
    concern over the withdrawal of even a single vaccine
    manufacturer from the marketplace. Third, though it described
    a regime that sought to compensate individuals, the Commerce
    Report emphasized that the new system would reduce and
    stabilize litigation costs while also enabling manufacturers to
    estimate the costs associated with compensation. Finally, it
    explicitly stated that injured individuals could only seek redress
    in the state tort system for certain manufacturing defect and
    warning claims.
    Each of the objectives extolled by the Commerce Report
    would be undermined if design defect claims were permitted
    under the statute. The plaintiffs’ construction of the statute
    would permit state courts to determine on a case-by-case basis
    whether a vaccine manufacturer could have conceivably created
    a safer vaccine. This would undoubtedly increase the costs and
    risks associated with litigation and would undermine a
    manufacturer’s efforts to estimate and control costs. It would
    also effectively impose an affirmative obligation on vaccine
    manufacturers to pursue, regardless of cost, the countless
    avenues through which they could develop a safer vaccine.
    These were the very problems which led to instability in the
    vaccine market and which caused Congress to intervene through
    the passage of the Vaccine Act.
    b.
    Unfortunately, our review of legislative history does not
    end here. Rather than rely on the Commerce Report, the
    plaintiffs respond that other language in the legislative history
    strongly favors their position that design defect claims are not
    36
    preempted. The Vaccine Act, which Congress passed in 1986,
    did not initially “include a source of payment for such
    compensation and made the compensation program and
    accompanying tort reforms contingent on the enactment of a tax
    to provide funding for the compensation.” H.R. Rep. No. 100-
    391(I), at 690 (1987). In 1987, Congress passed legislation to
    fund the compensation program. On October 26, 1987, as part
    of this funding legislation, the House Committee on the Budget
    (“Budget Committee”) issued its own report (“Budget Report”)
    which stated the following:
    It is not the Committee’s intention to preclude
    court actions under applicable law.           The
    Committee’s intent at the time of considering the
    Act and in these amendments was and is to leave
    otherwise applicable law unaffected, except as
    expressly altered by the Act and the amendments.
    An amendment to establish as part of this
    compensation system that a manufacturer’s failure
    to develop safer vaccine was not grounds for
    liability was rejected by the Committee during its
    original consideration of the Act. Further, the
    codification of Comment (k) of The Restatement
    (Second) of Torts was not intended to decide as a
    matter of law the circumstances in which a
    vaccine should be deemed unavoidably unsafe.
    The Committee stresses that there should be no
    misunderstanding that the Act undertook to
    decide as a matter of law whether vaccines were
    unavoidably unsafe or not. This question is left to
    the courts to determine in accordance with
    37
    applicable law.
    
    Id. at 691.
    According to the plaintiffs, this language demonstrates
    that Congress considered and rejected an amendment that would
    have explicitly preempted all design defect claims. This
    argument is premised on the well-settled notion that “[f]ew
    principles of statutory construction are more compelling than the
    proposition that Congress does not intend sub silentio to enact
    statutory language that it has earlier discarded in favor of other
    language.” INS v. Cardoza-Fonseca, 
    480 U.S. 421
    , 442–443
    (1987) (internal quotation marks and citation omitted).
    Additionally, plaintiffs claim that the Budget Report evidences
    Congress’s intent to permit courts to determine on a case-by-
    case basis whether a vaccine’s side effects were “unavoidable.”
    The problems with the Budget Report, however, are
    three-fold. First, the Budget Report repeatedly uses the term
    “the Committee,” but it is unclear whether this refers to the
    Budget Committee or the Energy and Commerce Committee.
    While the Budget Committee did not play a role in the drafting
    or passage of the Vaccine Act, the Energy and Commerce
    Committee had jurisdiction over the bill and held several
    hearings on childhood vaccines and the proposed legislation. A
    subcommittee of the Energy and Commerce Committee also
    held a hearing, known as a “mark-up” hearing, on the Vaccine
    Act in September 1986 during which time it considered
    38
    amendments to the legislation.11 Because the Budget Committee
    did not consider amendments to the Vaccine Act, we will
    presume that references in the Budget Report to “the
    Committee” refer to the Energy and Commerce Committee.
    Second, though the Energy and Commerce Committee
    conducted a mark-up hearing to consider proposed amendments,
    no record is available to confirm that the Energy and Commerce
    Committee considered and rejected an amendment related to
    design defects at that time.12 Third, “the views of a subsequent
    Congress form a hazardous basis for inferring the intent of an
    earlier one.” United States v. Price, 
    361 U.S. 304
    , 313 (1960).
    That danger is amply present here, where the subsequent report
    was not issued by the committee with jurisdiction over the
    legislation, but by a committee which played no role in passage
    of the Vaccine Act. See United States v. United Mine Workers
    of Am., 
    330 U.S. 258
    , 281–82 (1947). Without more, we have
    no basis to conclude that the Budget Report is an accurate
    11
    Information pertaining to Congressional passage of the
    Vaccine Act, including the dates of the markup hearing and
    Committee consideration, can be found on the Library of
    Congress’s website for legislative information. Library of
    Congress, THOMAS, S.1744 (P.L. 99-660): All Congressional
    Actions with Amendments, http://thomas.loc.gov/
    cgi-bin/bdquery/z?d099:SN01744:@@@S|TOM:/bss/d099qu
    ery.html.
    12
    The Energy and Commerce Committee retains a
    transcript of this hearing, but this transcript was not available to
    us.
    39
    reflection of what transpired before the Energy and Commerce
    Committee, or for that matter, the motivations underlying
    Congress’s enactment of the Vaccine Act in 1986.
    For these reasons, and despite plaintiffs urging, we refuse
    to view the relevant legislative history as containing “dueling”
    committee reports.
    3.
    Even if Congress did not intend to prohibit all design
    defect claims against vaccine manufacturers, the legislative
    history indicates that it intended to preempt the specific claim at
    issue here. In the days prior to passage of the Vaccine Act, the
    Energy and Commerce Committee issued a report containing
    “background information on the various issues concerning
    childhood vaccines . . . .” (“Background Report”). Staff of H.
    Comm. on Energy & Commerce, 99th Cong., Childhood
    Immunizations, at III (1986). This report stated that the
    pertussis vaccine “is considered the most reactive of all the
    commonly used vaccines and has been the one of most concern
    in debates over adverse effects of vaccines.” 
    Id. at 24.
    It
    recounted the risks and side effects associated with the pertussis
    vaccine, including neurological problems and even death, and
    the efforts of parent groups to raise awareness of these serious
    consequences. 
    Id. at 24–29.
    The Background Report also stated
    that “research is proceeding on the effort to develop an acellular
    vaccine that would cause fewer side effects.” 
    Id. at 38.
    Namely, it explained that researchers were attempting to isolate
    the reactive components of the pertussis bacterial cell so that
    these components could be excluded from the vaccine. 
    Id. at 24.
    40
    The Background Report also explained that Japan had used such
    a vaccine, but it indicated that the safety and efficacy of this
    vaccine had not been reported. 
    Id. It then
    warned that
    “conducting clinical trials to test any new pertussis vaccine will
    pose major logistic, legal, and ethical problems.” 
    Id. The Commerce
    Report on the Vaccine Act also contained
    numerous references to the DPT vaccine. H.R. Rep. 99-908. It
    noted the “serious—and sometimes deadly—consequences” of
    vaccines and that this was “particularly true with regard to the
    pertussis” component of the DPT vaccine. 
    Id. at 6.
    Before
    warning of the ramifications of the withdrawal of “even a single
    manufacturer,” the Report also highlighted the increasing
    number of lawsuits related to the DPT vaccine and recognized
    that there were only two manufacturers of the DPT vaccine at
    that time. 
    Id. at 6–7.
    Whereas the plaintiffs contend that Wyeth and its
    predecessors knew “for more than 25 years that the acellular
    vaccine was less reactogenic and, therefore, safer for the
    children who receive it” and seek to establish liability by virtue
    of that knowledge, the two reports discussed immediately above,
    taken together, establish that Congress intended to preempt such
    claims. The Background Report indicates that Congress was
    well aware of the state of the art concerning development of an
    acellular DPT vaccine. It also evidences that Congress believed
    there were hurdles before such a vaccine could undergo clinical
    testing in the United States. The Commerce Report stresses the
    particular problems faced by DPT vaccine manufacturers,
    including the high number of lawsuits and existence of only two
    producers. The Commerce Report then concludes that the
    41
    “withdrawal of even a single manufacturer would present the
    very real possibility of vaccine shortages . . . [and] a resurgence
    of preventable diseases” and that the vaccine market will
    stabilize once “manufacturers have a better sense of their
    potential litigation obligations.” 
    Id. at 7.
    This evidence
    indicates that Congress weighed the various concerns related to
    the pertussis vaccine and concluded that DPT manufacturers
    should be shielded from liability for injuries arising from the
    whole-cell pertussis vaccine.
    4.
    As we stated at the beginning of this part, “Congressional
    purpose is the ‘ultimate touchstone’ of our inquiry.” Lorillard
    Tobacco 
    Co., 533 U.S. at 541
    (quoting 
    Cipollone, 505 U.S. at 516
    ). Section 22(a) and 22(b)(1) of the Vaccine Act contain
    express preemption clauses. Further, the structure and purpose
    of § 300aa-22 of the Act make clear that Congress intended to
    preempt some design defect claims. The legislative history
    identifies the scope of this preemption, which encompasses both
    strict liability and negligent design defect claims.
    D.
    The District Court did not clearly explain the basis of its
    summary judgment decision. It neither discussed the three types
    of preemption nor mentioned that the motion for summary
    judgment raised only express preemption. Nevertheless, the
    District Court decision is consistent with an express preemption
    analysis, and we take it to have intended application of that
    doctrine. The four points discussed in the District Court’s
    42
    opinion were grounded in the purpose of the Vaccine Act. As
    discussed in Part III.B above, such an analysis is permitted when
    construing an express preemption clause. Furthermore, in
    response to the motion for summary judgment, the plaintiffs
    cited to the Vaccine Act’s legislative history and purpose to
    support their argument that design defect claims were not
    preempted. As a result, we reject plaintiffs’ argument that the
    District Court’s decision was based on implied or field
    preemption grounds or that it violated well-settled principles of
    summary judgment.
    IV.
    Plaintiffs also allege that Wyeth is liable for failing to
    warn Hannah’s doctor, Jane M. Breck, M.D., that the vaccine
    administered to Hannah came from a lot of TRI-IMMUNOL
    associated with at least two deaths and more than thirty injuries
    prior to April 1992. Dr. Breck testified that had she known that
    the vaccine came from this lot, she would not have administered
    the dose. Although § 22(c) of the Vaccine Act expressly
    preempts failure-to-warn claims based on “the manufacturer’s
    failure to provide direct warnings to the injured party (or the
    injured party’s legal representative),” 42 U.S.C. § 300aa-22(c),
    nothing in the Vaccine Act expressly bars claims based on
    failure to warn “doctors and other medical intermediaries.” 13
    13
    The parties disagree as to whether Section 22(b)(2) is a
    preemption clause. Though Wyeth classified it as such, the
    District Court expressly held that the failure-to-warn claim was
    not preempted. We need not reach this issue, however, for the
    43
    As discussed above, § 22(b)(1) states that manufacturers
    shall not be liable for injuries caused by “side effects that were
    unavoidable even though the vaccine . . . was accompanied by
    proper directions and warnings.” Section 22(b)(2) states that
    proper directions and warnings will be presumed when the
    manufacturer “complied in all material respects with all
    requirements under the Federal Food, Drug, and Cosmetic Act
    . . . and section 262 of this title . . . .” Nevertheless, the Vaccine
    Act provides two circumstances in which this presumption can
    be overridden: (1) when the manufacturer engages in conduct
    that would subject it to punitive damages under the Vaccine Act;
    and (2) when the manufacturer “failed to exercise due care.” 42
    U.S.C. § 300aa-22(b)(2)(A)-(B). As the District Court correctly
    noted, this creates a shifting burden—once the manufacturer
    establishes that it complied with federal law, the burden shifts
    to the plaintiff to establish that either § 22(b)(2)(A) or §
    22(b)(2)(B) has been met.
    The District Court dismissed this claim on the ground
    that Wyeth was entitled to the statutory presumption of proper
    warning and that the plaintiffs had failed to rebut the
    presumption. Noting that Wyeth had presented uncontested
    evidence that TRI-IMMUNOL and its warnings had been
    approved by the FDA, the District Court found that Wyeth was
    entitled to § 22(b)(2)’s presumption of proper warning. Next,
    the District Court noted that the Amended Complaint did not
    allege fraud or wrongful withholding of information within the
    reasons set forth in this section.
    44
    meaning of § 22(b)(2)(A).14 Thus, the only relevant question
    was whether plaintiffs had presented clear and convincing
    evidence that Wyeth had not exercised due care.
    Plaintiffs presented a report of the Vaccine Adverse
    Event Reporting System (“VAERS”)15 confirming that the lot of
    TRI-IMMUNOL that included the dose administered to Hannah
    Bruesewitz was associated with two deaths and more than thirty
    injuries. They also presented the affidavit of Dr. Donald H.
    Marks, who claimed that such a lot is sometimes called a “hot
    lot.” Dr. Marks relied on a 1984 memorandum by an
    epidemiologist at the Department of Health and Human Services
    (“HHS”) regarding the “Investigation of Potential Hot Lots,”
    which said that “potential hot fill lots of DTP vaccine” are “fill
    lots that exceeded a threshold of ³2 deaths or ³2 convulsions or
    14
    The District Court acknowledged that the original
    Complaint alleged that Wyeth had committed fraud or wrongful
    withholding of information, but the Amended Complaint failed
    to do so. Nevertheless, even if the Amended Complaint had
    repeated this allegation, the District Court suggested that it
    would not have survived application of Fed. R. Civ. P. 9(b),
    which requires that allegations of fraud be pled with
    particularity.
    15
    As the District Court explained, “VAERS is a database
    created, pursuant to the Vaccine Act, by the FDA and the
    Centers for Disease Control and Prevention to receive reports
    about adverse events which may be associated with vaccines.”
    45
    ³10 total reports.” The District Court, however, found it
    significant that this memorandum identified such lots merely as
    “potential” hot lots.
    The memorandum also stated that “[i]n order to proceed
    with an investigation by which we could differentiate reporting
    bias from a higher rate of reactivity in specific fill lots we
    needed information on the number of doses distributed and
    which percent went to the public sector.” Thus, in order to
    differentiate between a “hot lot” and a “potential hot lot,”
    investigators must know not only the total number of incidents
    but also the rate at which the incidents occurred. Because the
    “[p]laintiffs have produced no evidence from which a trier of
    fact could infer that the dose in question originated” in such a
    lot, the District Court concluded that the plaintiffs had not
    proven that Wyeth failed to exercise due care by distributing
    doses from this lot.
    Before this Court, the plaintiffs argue that the District
    Court’s reasoning is flawed on two grounds: (1) Wyeth is not
    entitled to a presumption of proper warning unless the side
    effects of the vaccine are first shown to be unavoidable; because
    they allege a safer vaccine design was available, they argue that
    § 22(b)(2) should not apply; and (2) Dr. Mark’s opinion raises
    an issue of fact as to whether Hannah’s dose came from a “hot
    lot.” We dismiss both arguments. The first argument must be
    dismissed for the reasons discussed in Part III—the Vaccine Act
    preempts design defect claims premised on the notion that the
    manufacturer could have created a safer vaccine. The second
    requires more discussion.
    46
    As stated above, a court may not grant summary
    judgment so long as there exists a genuine issue of material fact.
    Fed. R. Civ. P. 56(c); Kaucher v. County of Bucks, 
    455 F.3d 418
    , 423 (3d Cir. 2006). To determine whether a factual dispute
    is genuine, “the court’s function is not to weigh the evidence or
    to determine the truth of the matter, but only to determine
    whether the evidence of record is such that a reasonable jury
    could return a verdict for the nonmoving party.” Orsatti v. N.J.
    State Police, 
    71 F.3d 480
    , 482 (3d Cir. 1995); see also
    Anderson v. Liberty Lobby, Inc., 
    477 U.S. 242
    , 248 (1986). The
    “mere existence of a scintilla of evidence” in support of the
    nonmoving party’s claim is insufficent. 
    Anderson, 477 U.S. at 252
    . We will resolve all doubts and draw all reasonable
    inferences in favor of the nonmoving party. Conoshenti v. Pub.
    Serv. Elec. & Gas Co., 
    364 F.3d 135
    , 140 (3d Cir. 2004).
    Dr. Marks identified the HHS memorandum as the basis
    on which he drew his conclusions: “This memorandum provides
    what I understood to be the official definition of a ‘Hot Lot’.” 16
    16
    Dr. Marks also approvingly cited to an older document
    from the Food and Drug Administration. This document states:
    In analyzing patterns of adverse event reporting,
    the FDA considers more than just the number of
    reports for a lot. More reports will be received
    for a large lot than a small one, simply because
    vaccine from the large lot will be given to more
    children. Some lots contain as many as 700,000
    47
    As the District Court correctly noted, the memorandum clearly
    states that the incident statistics, cited above, only establish
    “potential hot lots.” It further states that investigators must
    identify the number of doses administered to determine whether
    a particular vaccine lot qualifies as a “hot lot.” 17 Because
    doses, while others as few as 20,000 doses.
    Similarly, more reports will be received for a lot
    that has been in use for a long time than a lot in
    use for a short time. Even among lots of similar
    size and time in use, some lots will receive more
    reports than others simply due to change. The
    FDA continually looks for lots that have received
    more serious reports tha[n] should be expected on
    the basis of such factors as size, time in use, and
    chance variation.
    Pub. Health Serv., Dep’t of Health & Human Servs., Vaccine
    Adverse Event Reporting System (VAERS) 2.
    17
    Other authorities support this. For instance, according to
    the Centers for Disease Control and Prevention:
    Vaccine lots are not the same. The sizes of
    vaccine lots might vary from several hundred
    thousand doses to several million, and some are in
    distribution much longer than others. Naturally a
    larger lot or one that is in distribution longer will
    be associated with more adverse events, simply by
    chance. Also, more coincidental deaths are
    48
    plaintiffs have not offered any evidence on this point, Dr.
    Marks’ assertions and conclusions are unsupported by the very
    memorandum upon which he relies.
    The plaintiffs also contend that the sheer number of
    adverse events associated with this vaccine lot is sufficient to
    establish “some evidence of a serious health problem no [matter]
    how many doses, circumscribed by the concept of a batch, it
    contains.” While this may be true, the plaintiffs’ burden is not
    to produce “some evidence”—a mere scintilla—but evidence
    sufficient for a reasonable jury to find in their favor. The HHS
    memorandum states that investigators cannot conclude whether
    a vaccine lot is a “hot lot” without evidence on the number of
    doses administered. Thus, even drawing all inferences and
    associated with vaccines given in infancy than
    later in childhood, since the background death
    rates for children are highest during the first year
    of life. So knowing that lot A has been associated
    with x number of adverse events while lot B has
    been associated with y number would not
    necessarily say anything about the relative safety
    of the two lots, even if the vaccine did cause the
    events.
    Centers for Disease Control and Prevention, Some Common
    Misconceptions About Vaccination and How to Respond to
    Them,
    http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#Therear
    ehot.
    49
    doubts in favor of the plaintiffs, there is insufficient evidence on
    which a jury could conclude that Hannah’s vaccine came from
    a “hot lot.” Accordingly, the District Court did not err in
    granting summary judgment on the failure to warn claim.
    V.
    In their Amended Complaint, the plaintiffs alleged that
    Wyeth’s “manufacturing process and inadequate quality control
    resulted in recurrent problems with maintaining the appropriate
    balance between neuron-toxins and endo-toxins in the pertussis
    vaccine.” Plaintiffs also assert, as they do before this Court, that
    they have a “classic manufacturing defect claim here: that the
    vaccine lot used on Hannah Bruesewitz was tainted such that it
    was associated with two deaths and more than 66 injuries, a
    number and percentage far in excess of that for other lots.”
    Under Pennsylvania law, a plaintiff alleging a manufacturing
    defect based on a strict liability theory must show that: (1) “the
    product was defective;” (2) “the defect was a proximate cause
    of the plaintiff’s injuries;” and (3) the defect causing the injury
    existed at the time the product left the seller’s hands.” Berkebile
    v. Brantly Helicopter Corp., 
    337 A.2d 893
    , 898 (Pa. 1975).
    The District Court held that plaintiffs had failed to
    provide enough evidence of a manufacturing defect to meet their
    burden for purposes of summary judgment. With regard to the
    first claim, related to the balance of neuro- and endo-toxins, the
    District Court concluded that “Plaintiffs have offered absolutely
    no evidence to support this allegation . . . .” Moreover, the
    District Court noted this claim was directly refuted by Wyeth,
    which offered undisputed evidence that its pertussis vaccine did
    50
    not contain a neuro-toxin component and was not known to have
    a neuro-toxic effect.
    The District Court also considered the plaintiffs’ second
    argument, which was essentially the same as the “hot lot” theory
    discussed above. The plaintiffs argued to the District Court that
    a “hot lot” can serve as circumstantial evidence of a
    manufacturing defect. The District Court noted that this theory
    is known as the “malfunction theory:”
    The malfunction theory permits a plaintiff to
    prove a defect in a product with evidence of the
    occurrence of a malfunction and with evidence
    eliminating abnormal use or reasonable,
    secondary causes for the malfunction. The
    plaintiff is relieved from demonstrating precisely
    the defect yet it permits the trier-of-fact to infer
    one existed from evidence of the malfunction, of
    the absence of abnormal use and of the absence of
    reasonable secondary causes.
    Bruesewitz v. Wyeth, 
    508 F. Supp. 2d 430
    , 450 (E.D. Pa. 2007)
    (quoting Barnish v. KWI Bldg. Co., 
    916 A.2d 642
    , 646
    (Pa. Super. Ct. 2007)).
    As the District Court recognized, this theory has not been
    applied to allegedly defective vaccines. Nevertheless, we need
    not determine if and how this theory of liability would apply in
    this case. Both before the District Court and this Court, the
    plaintiffs predicated their argument for a manufacturing defect
    on the fact that Hannah’s vaccine came from a “hot lot.” For the
    51
    reasons stated in Part IV, after drawing all reasonable inferences
    in favor of the plaintiffs, we agree with the District Court’s
    conclusion that the plaintiffs have not provided evidence from
    which a jury could conclude that Hannah was administered a
    vaccine from a “hot lot.” Because plaintiffs sole arguments to
    this Court on the manufacturing defect issue require a finding of
    a “hot lot,” we will also affirm the District Court’s judgment on
    this claim.
    VI.
    We hold that the plaintiffs design defect claims are
    expressly preempted by the Vaccine Act. We also conclude that
    the plaintiffs have failed to establish either a manufacturing
    defect or a warning defect claim under the Vaccine Act. For the
    reasons discussed above, we will affirm the District Court’s
    grant of summary judgment in favor of Wyeth.
    52
    

Document Info

Docket Number: 07-3794

Filed Date: 3/27/2009

Precedential Status: Precedential

Modified Date: 10/14/2015

Authorities (43)

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United States v. United Mine Workers of America , 330 U.S. 258 ( 1947 )

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