In light of HHS Secretary Robert F. Kennedy, Jr.’s recent appointment of David Geier to conduct a study of autism and vaccines—a role that could negatively impact vaccine uptake throughout the United States—an exploration of the sources of Mr. Geier’s purported expertise to conduct such a study is in order. Given David Geier’s lifelong professional association with his father, the late Dr. Mark Geier (d. March 20, 2025), a review of Dr. Geier’s career in vaccine-injury litigation is a good place to start.
In the discussion below, I will show that David Geier’s scientific mentor and lifelong co-author was a self-taught “expert” who:
- Had no specialized training in neurology, pediatrics, developmental pediatrics, epidemiology, biostatistics, immunology, rheumatology, or toxicology;
- Repeatedly testified on subjects in which he had no academic training or clinical experience;
- Offered his services to VICP petitioners in spite of multiple findings by VICP special masters that his testimony was worthless;
- Validated parents’ belief that their disabled children were permanently injured by vaccines even when contemporaneous medical records showed that they were not;
- Offered speculative testimony that often bore no relation to the facts of a case;
- Could not read an EEG, a CT scan, or a magnetic resonance image, but claimed to do so in more than one case;
- Cited to outdated textbooks in order to buttress his expert opinions;
- Cited to studies that supported his opinions, but disregarded those that did not;
- Cited to animal studies to support his assertions about the effects of vaccines on humans;
- Switched his scientific arguments in midstream, contradicting his prior testimony;
- Made assertions “as a physician” that he knew were not scientifically supportable;
- Routinely offered subjective belief and unsupported speculation in his testimony;
- Employed analyses that were unreliable and ungrounded in scientific methodology and procedure; and
- Played “fast and loose” with scientific facts and literature.
Caveat lector (Reader Beware)
This is a long post in which I quote from forty different rulings between 1989 and 2003 in cases in which Mark Geier served as an expert witness. I have redacted the names of the people whose disabilities are discussed. I have not cluttered the text with case numbers and reporter citations. Although this may seem like old news, these rulings are well worth considering afresh, since they point to the quality (or lack thereof) of David Geier’s “scientific” mentorship.
In the Beginning…
Prior to 1988, the only legal remedies available to those who believed that they or a family member had sustained a vaccine injury involved suing vaccine manufacturers—a costly, lengthy, cumbersome, adversarial process. During the 1970s and 1980s, dozens of lawsuits were filed against vaccine manufacturers, including Connaught, Lederle, Eli Lilly, Wyeth, Parke-Davis, and Merrell-Dow. Most of these suits alleged harm from the diphtheria-pertussis-tetanus (DPT) vaccine, and many resulted in substantial jury awards. As a result, many vaccine manufacturers abandoned the market, and the price of many vaccines and liability insurance skyrocketed.
Dr. Mark Geier for the Plaintiff
Among the attorneys and expert witnesses who initiated and benefited from this wave of litigation was Maryland native Dr. Mark Geier. Dr. Geier had earned his PhD in genetics in 1973 and his M.D. degree in 1978, both from The George Washington University. In the years that followed, he completed a one-year internship in obstetrics, worked for a time at NIMH and at Maryland Medical Laboratory, and taught several courses at Johns Hopkins University. In 1980, he formed both Molecular Medicine, Inc. and Genetic Consultants of Maryland, the former a medical lab and the latter an obstetrics and genetic counseling practice (which offered, among other services, sex selection).
Between 1971 and 2000, Dr. Geier co-authored approximately three dozen articles and letters to journals, six of them on potentially toxic components of vaccines. Although it is unclear how he originally became involved with vaccine injury litigation, by his own count, between 1985 and 1989 he would consult or testify in over sixty civil cases (including one before the Supreme Court of Canada), routinely asserting that the DPT vaccine was “unreasonably dangerous,” and that it had caused a “toxic encephalopathy” resulting in permanent brain damage. He first offered testimony about the measles-mumps-rubella (MMR) vaccine in the 1992 case Coffelt v. HHS, and would testify in seven more MMR cases between 1998 and 2006.
He Did His Own Research
Unlike most scientific experts-for-hire, Dr. Geier’s understanding of vaccines came not from any formal education in a medical specialty, prior experience in developing vaccines or diagnosing vaccine injuries, or clinical or laboratory experience, but from his independent review of the literature on the subject.
For a time, Dr. Geier succeeded in monetizing his autodidactic avocation on a grand scale. Although at the beginning his testimony was often deemed admissible and probative, his tendency to offer opinions outside the areas of his expertise, to speculate, and to disregard clinical and scientific evidence that countered his conclusions led to increasing skepticism on the part of the jurists who came to know him best: the special masters and judges who consider cases brought before the Vaccine Injury Compensation Program (VICP).
The New Testimonial Arena
The National Childhood Vaccine Injury Act of 1986 authorized establishment of the Vaccine Injury Compensation Program, which commenced operations on October 1, 1988. The no-fault program was intended to stem the loss of manufacturers from the vaccine market due to the onslaught of litigation in which Dr. Geier was a frequent participant, and to provide a speedier, less adversarial means of compensating individuals who were demonstrably injured by vaccines. The establishment of the VICP created a new forum for the evaluation of vaccine-injury claims where attention could be focused on medical facts and evidence rather than questions of blame and liability, and where compensation could be awarded relatively quickly to those able to establish that they met the criteria.
From its inception in October 1988 through the end of 1989, 172 vaccine-injury petitions were filed, and 22 cases were adjudicated. Each petition alleged vaccine injuries that occurred prior to the establishment of the Program, some as far back as 1950.
Auspicious Beginnings
In October 1988, Mark Geier would make his first appearance at a VICP hearing, with Vienna, Virginia attorney Clifford Shoemaker serving as petitioners’ counsel. In the years that followed, he would provide services to petitioners in over ninety VICP cases.
Although the Vaccine Act charged the U.S. Department of Health and Human Services (HHS) with responding to vaccine-injury claims, the funding and staffing to carry out this statutory responsibility was not in place until July 1990. The testimony of petitioners and their experts therefore went unopposed during first year and a half of the Program’s existence. Each of the eleven VICP cases in which Dr. Geier testified in 1989 and for which published decisions are available resulted in a determination of eligibility, and an award of compensation. By the end of June 1990 that number had risen to nineteen.
Positive Reviews
Every published decision in cases where Dr. Mark Geier testified during his first, uncontested year and a half of Vaccine Court involvement describes him as an obstetrical geneticist who had comprehensively reviewed the literature on vaccines (see, e.g., Siegfried v. HHS and Seman v. HHS). In all but three of these cases his was the only medical expert testimony provided. During this period, judges and special masters found him to be:
- “credible and convincing” (Special Master David A. Gerard, Bailey v. HHS)
- “well qualified” (Special Master George Hastings, Ionescu v. HHS)
- “prepared to speak authoritatively on the subject of adverse reactions to DPT vaccines” (Judge Bohdan Futey, Ciotoli v. HHS)
- “qualified to testify as a medical expert in this case” (Chief Special Master Gary Golkiewicz, Meredith v. HHS, Tafoya v. HHS, Berning v. HHS)
In Pusateri v. HHS, Special Master E. LaVon French described Dr. Geier as “the author of numerous publications in his field… [who] has performed extensive research on the results of endotoxins in commercial vaccines,” and determined that “his testimony is entitled to considerable weight.”
Special Master Paul T. Baird was more circumspect in his evaluation of Dr. Geier’s qualifications to offer expert testimony in the fields of neurology and toxicology. Two of his 1989 decisions included the caveat:
Although Dr. Geier’s uncontested testimony is not entitled to as much weight as would be the testimony of a neurologist or some other professional experienced in treating persons affected by neurotoxins, it is generally consistent with the guidance provided in § 14(b) of the Act and does satisfy the requirement of § 13(a)(1) of the Act that the court may award compensation only if a petitioner’s claims are substantiated by medical records or medical opinion. (Siegfried v. HHS, Seman v. HHS)
Familiarity Breeds Suspicion
From mid-1990 forward—once HHS began to scrutinize vaccine-injury claims and solicit outside experts to assess their plausibility—increasing numbers of VICP decisions discussed the limitations of Dr. Geier’s expertise, the increasingly speculative nature of his testimony, and the often-significant distance between his testimony and the facts of a given case.
Mr. Baird issued the first published decision dismissing a VICP case in which Dr. Geier testified. In Chronister v. HHS (1990), petitioners alleged that their child’s disability and death resulted from the DPT vaccine. The court found that their recollection of the timing of events differed from contemporaneous medical records—a lapse not deemed perjurous, but rather a “likely and understandable” error “colored by their desire to find an explanation.” That desire to find an explanation received a helping hand from Dr. Geier.
Petitioner states in the fee petition that she “brought her claim based on her ‘motherly intuition’ as to the events preceding her son’s seizures and cerebral palsy, and upon the opinion of causation she received from a highly recognized medical expert, Mark R. Geier, M.D.” Clearly, ‘motherly intuition’ is insufficient by itself to provide a reasonable basis for a claim… In this case, the parents’ testimony provided the necessary support for Dr. Geier’s opinion.
One more 1990 case in which Dr. Geier testified, Grant v. HHS, resulted in an award to the petitioner. Four others were dismissed by the end of the year.
Dr. Mark Geier stated that as a result of his review of the medical records, and after hearing the testimony of Mrs. Tucker, it was his opinion that there was no evidence of any cause for C‘s seizures other than an adverse reaction to the DPT vaccine. The speculative nature of the evidence concerning compensable damages in this case provides an inadequate basis for an award of compensation. (Tucker v. HHS, Special Master French)
While Dr. Geier was qualified in this and many other cases as an expert on DPT, he is not a neurologist… Dr. Geier’s conclusion that the March 5, 1982, episode was a seizure is simply not in keeping with the weight of the evidence. (Lehmann v. HHS, Special Master Denis Hauptly,)
On cross-examination, Dr. Geier testified that pediatric neurologists are normally the ones who determine that a child has a particular neurological disease. He also testified… that he would refer a child with staring to a neurologist to make a diagnosis…. Dr. Geier did not testify that seizures occurred and did not even claim competence to make such a diagnosis. (Beck v. HHS, Special Master Baird)
Dr. Geier was asked if his opinion would change if there was a diagnosis of autism. Dr. Geier stated that such diagnosis is not ‘against his opinion’ but admitted that the question was “getting to the borderline of [his] area of expertise.” (Waddell v. HHS, Special Master French)
This last statement is particularly notable given that fifteen years later, Mark and David Geier would announce that puberty in autistic children is “a ticking time bomb,” and that even though Dr. Geier had never previously worked with children, let alone autistic children, they had already begun trying out a “totally experimental treatment” on a handful of autistic children in order to remove “testosterone sheets” from the brain. But that is another story.
No Seat at the Table
The Vaccine Injury Table is a list of vaccines, adverse effects, and the time period for first symptom or manifestation of onset or of significant aggravation after vaccine administration that would qualify a petitioner for compensation under the VICP.
In his July 1991 ruling in Daly v. HHS, Mr. Golkiewicz, who would go on to serve as Chief Special Master during the Omnibus Autism Proceeding, cautioned:
This court is inclined to not allow Dr. Geier to testify before it on issues of Table injuries. Dr. Geier clearly lacks the expertise to evaluate the symptomatology of the Table injuries and render an opinion thereon…. The court admonishes Dr. Geier to reconsider his role, from an ethical and moral standpoint, as a witness under this Program. Several petitioners have lost cases solely on the little weight given to Dr. Geier’s opinion in those cases and tremendous duplication in expert fees is resulting from petitioners seeking second opinions after being informed of the serious deficiencies in Dr. Geier’s experience.
Mr. Golkiewicz would reiterate his reservations in his July 1992 decision in Jensen v. HHS:
Dr. Geier admittedly has no expertise in diagnosing Table injuries. The court also has serious reservations regarding his expertise on DPT related matters. While Dr. Geier is more familiar than most with the DPT medical literature, because of his lack of clinical practice, he is unable to relate the literature to the injured person. Therefore, Dr. Geier’s usefulness as an expert is limited to his review of the medical literature. The court sees this expertise of limited value. Furthermore, in this matter, the court is troubled by Dr. Geier’s testimony. Without any current literature or clinical experience to support him, Dr. Geier espouses a theory that the endotoxin contained in DPT causes DPT injuries and, in this case, caused J’s HUS [hemolytic uremic syndrome]. Dr. Geier consistently renders opinions in areas where he lacks expertise, with limited medical record support, and little or no support from the medical literature or the relevant medical community.
Grasping at Diagnoses
Over time, special masters who had grown familiar with Dr. Geier’s courtroom style became increasingly less inclined to give credence to his opinions.
“Dr. Geier has no clinical experience and the value of his testimony, especially in the face of treating pediatricians and pediatric neurologists, is severely limited.” (Thelen v. HHS, 1991, Special Master Golkiewicz)
“Dr. Geier knows a lot about the DPT vaccine, but… knowledge about DPT does not render one better able to diagnose a seizure, shock collapse or an encephalopathy.” (McClendon v. HHS, 1991, Special Master Baird)
“Dr. Geier, in my view, strained to find something that was simply not there.” (Chapman v. HHS, 1991, Special Master Hastings)
“Other than petitioner’s expert, Dr. Mark Geier, an obstetrical geneticist, no expert who has ever testified before me has ever linked shock collapse, a vascular event, with seizures or encephalopathy, a neurological event.” (Mills v. HHS, 1992, Special Master Wright)
“The court finds Dr. Geier’s arguments unpersuasive and speculative at best.… Dr. Geier simply fails to provide a rational basis for ignoring the IOM’s 1991 report rejecting a causal relation between DPT and afebrile convulsions and the IOM’s subsequent 1994 follow-up report.” (Salmond v. HHS, 1999, Special Master Golkiewicz)
Although originally sympathetic in her assessment of Dr. Geier, by mid-1992, Ms. Wright came to similar conclusions as her colleagues. In her June 1992 decision in Summar v. HHS, she wrote:
I ultimately perceived the testimony of petitioners’ experts in this case—Dr. Mark Thoman and Dr. Mark Geier—to be of very limited value… After reviewing the testimony of each in a number of cases over the past three years, I have simply found the testimony of each to be of very little persuasive value in case after case. I thus recommend against use of such witnesses before me in future Program cases.
Credibility Wanes
Dr. Geier’s increasing difficulty in persuading the court to adopt his interpretations of petitioners’ circumstances is documented in a series of decisions from 1992 and 1993. In his March 1992 decision in Yeoman v. HHS, Special Master Richard Abell made note of a significant diagnostic error:
Seizures are neurological events, and Dr. Geier is a geneticist, not a neurologist… Dr. Geier provided an excellent example of his limited neurology training and background during the hearing. Dr. Geier consistently referred to the events following the first vaccination… as petit mal seizures. Both Dr. [Marcel] Kinsbourne and Dr. [Joel] Herskowitz, pediatric neurologists, testified categorically that this terminology was incorrect.
That month, recently-appointed Special Master Laura Millman remarked on similar lapses in one of the earliest VICP cases alleging injury from the MMR vaccine, Saia v. HHS.
Petitioner’s own medical expert cannot distinguish between measles and measles vaccine as the cause of M’s encephalopathy. This inability would be harmless if respondent had provided no evidence of a factor unrelated… But respondent has provided such evidence… It then becomes incumbent upon petitioner to refute respondent’s evidence by a preponderance of her own evidence. This she failed to do, despite Dr. Geier’s insouciant comments about the legal consequences of his inability to state that measles vaccine is more likely than not the cause of M’s encephalopathy… Dr. Geier never discusses the significance of onset time in his conclusory affidavits, a peculiar omission considering that onset of measles and fever is crucial to disposition of this case. Perhaps because Dr. Geier’s expertise is in DPT vaccine, not measles vaccine, and in genetics and obstetrics, not neurology or pediatrics, his omission is understandable. His lack of medical knowledge, however, does not avail petitioner.
Three months later, she would be more cursorily dismissive in her opinion in Ormechea v. HHS:
[Dr. Geier’s] testimony is based on his self-generated expertise in DPT-vaccine injuries. Because Dr. Geier has made a profession of testifying in matters to which his professional background (obstetrics, genetics) is unrelated, his testimony is of limited value to the court…. His specialty has nothing to do with his avocation which is testifying in DPT matters. I cannot give his opinion any credence.
Dismissing the Dedicated Contrarian
The lack of support within the scientific community for Dr. Geier’s opinions on vaccines and his disregard for scientific evidence that contradicted his hypotheses were addressed at some length by Special Master Abell in his June 1992 decision in Aldridge v. HHS (1992):
Petitioner’s medical expert, Dr. Geier, is an obstetrical geneticist, not a neurologist. … His expertise in DPT-related injuries stems from his study of the relevant literature, rather than medical training or participation in studies. I would term this an academic rather than professional pursuit…. Dr. Geier’s testimony is necessarily only a summary of the medical literature on DPT reactions.
Dr. Geier opined that J suffered an encephalopathy and that the literature supported his thesis. He based his findings on some 22 studies, the most recent of which is from the mid-80s, and the strongest of which is the British National Child Encephalopathy Study [NCES]. This study does not conclude that DPT causes encephalopathy, but merely suggests it. No reputable American medical association endorses this thesis. In fact, both the Society of Pediatric Neurology and the American Association of Pediatricians have official positions contrary to Dr. Geier’s theories on DPT encephalopathy. The theories espoused by Dr. Geier are not those of a majority of the medical community. This court finds that the most credible report on this topic is the 1991 Institute of Medicine Report. This report does not lend support to Dr. Geier’s theories… Dr. Geier admitted that his theory on a presumed lowering of the blood brain barrier has not been medically proven. His postulations on the synergistic workings of toxins and endotoxins likewise are speculative… In summary, Dr. Geier provided a number of mechanisms by which DPT could have damaged J’s central nervous system. He did not, however, provide any positive evidence that any of these mechanisms actually occurred in this case.
Mr. Abell then voiced his concern regarding Dr. Geier’s citation to older versions of medical textbooks to support his opinions about the plaintiffs’ condition—opinions that were not supported in subsequent editions.
…Additionally, when referring the court to medical literature in an attempt to rule out infection as a cause of J’s encephalopathy, Dr. Geier cited two outdated editions of medical textbooks that allegedly indicated that a DPT encephalopathy would be accompanied by elevated cell counts in the cerebrospinal fluid. The current editions of these textbooks do not support this claim. Dr. Geier relied on a section discussing a reaction to smallpox vaccine rather than DPT vaccine to prove this same point. I find it disquieting that a witness whose expertise depends entirely on review of medical literature would fail to consider, fail to have available and fail to cite the current authority. Were Dr. Geier an attorney, he would fall below the ethical standards for representation. The undersigned is of the opinion that it is cheek at best for a medical expert to quote from an outdated text, and, if he must do so for whatever reason, it is at best negligent if not a fraud on the court to fail to state ab initio. To intentionally rely on outdated medical texts as authority for a given position approaches the disingenuous… His credibility, and therefore his testimony, suffers as a result of his lack of candor or preparation by directing the court to questionable authority in support of his position. (emphasis added)
Opine Away, Skills Be Damned
Dr. Geier was unable to interpret diagnostic imaging, as Judge James Turner noted in Sumrall v. HHS (1991):
Dr. Geier never examined or treated A, has never treated a seizure disorder, and cannot read an EEG, a CT scan, or a magnetic resonance image.
That did not prevent him from offering whatever “expert” opinion his clients might require. In Aldridge v. HHS (1992), this meant purporting to interpret a CT scan:
Dr. Geier opined that an April 14 1983 CT scan report, which stated that the “findings are most consistent with infarction complicating bacterial meningitis,” was also compatible with endotoxin damage and pertussis toxin damage.
In Marascalco v. HHS (1993), he opined on an MRI and disregarded the interpretation of a neurologist:
Dr. Geier opined that C experienced seizures within three days after her first and second DPT vaccinations…. Dr. Geier stated that, in forming his opinion, he reviewed C’s entire medical record. Indeed, Dr. Geier referred specifically to C’s May 1, 1990 MRI record…. Dr. Geier did not address Dr. Seidel’s conclusion that C’s MRI fell ‘within the spectrum of polymicrogyria.’
To Procure & Defend
Notwithstanding the increasing numbers of rulings critical of Dr. Geier’s testimony, by the end of 1992 petitioners’ attorneys had offered him as an expert in over fifty VICP proceedings. His business was derived primarily from those who made the Vaccine Program their primary professional milieu, above all Clifford Shoemaker, who would become treasurer of the antivaccine organization, National Vaccine Information Center. (In 2008, he would be sanctioned for filing an abusive subpoena against this author, and disbarred in 2020 after raiding a disabled client’s fiduciary account.)
In October 1992, Special Master John Edwards issued one of his first public comments on Dr. Geier’s testimony. His ruling in Einspahr v. HHS specifically addressed the attorneys responsible for putting Dr. Geier on the stand over and over again.
Dr. Geier’s speculative testimony is essentially worthless to a special master. Yet, all petitioners’ counsel and Dr. Geier waste an inordinate amount of time by presenting this testimony in Program cases. All petitioners’ counsel are on notice that the special master will no longer allow Dr. Geier to offer his speculative testimony about pertussis toxin or endotoxin until Dr. Geier is able to apply the various theories to the particular case.
In spite of Mr. Golkiewicz’s warning in Daly v. HHS, Mr. Shoemaker offered Dr. Geier as an expert in a December 1992 hearing before the same special master. Rejecting the expert testimony presented by the petitioner in Ultimo v. HHS, Mr. Golkiewicz wrote:
Dr. Geier is unqualified to testify on Table injuries, and although Dr. Geier is qualified to discuss the state of medical literature regarding DPT vaccinations, Dr. Geier due to his lack of clinical practice is unqualified to relate the findings of the literature to the facts of a given case. Even if Dr. Geier’s affidavit was considered it would be of no help to petitioner. Dr. Geier found a Table case based upon the onset within 3 days… The facts did not support this timing of onset. Dr. Geier does state in characteristic unsupported fashion that, “It is my opinion, even if D’s first seizures appeared 4 days following his DPT shot, that it is more likely than not that D’s current neurological condition which includes his residual seizure disorder and brain damage were the result of his second DPT shot that the received 12/6/62.” No support is given for this statement. Accordingly, it deserves and receives no weight.
In his July 1993 decision in Marascalco v. HHS, Mr. Edwards offered a damning assessment of Dr. Geier’s analysis and candor, homing in on his disregard for inconvenient portions of the petitioner’s medical records.
The special master rejects specifically Dr. Geier’s testimony. In the special master’s view, Dr. Geier’s September 1990 affidavit in this case was seriously intellectually dishonest. It is absolutely clear that Dr. Geier quoted selectively from C’s medical records. In his September 1990 affidavit, Dr. Geier stated that C’s May 1990 MRI “suggests a remote insult to brain development.” However, the same MRI record indicates also that the “remote insult to brain development” is “within the spectrum of polymicrogyria.” Dr. Geier… admitted that he does not possess the expertise to diagnose a condition such as polymicrogyria. Nevertheless, in September 1990, Dr. Geier stated that in his opinion, extensive medical tests—including C’s May 1990 MRI scan—did not identify any “provable cause for C’s condition other than the DPT shots which she received.
Yet, the diagnosis of polymicrogyria was not definitively excluded as a cause for C’s condition until early 1992—more than one year after Dr. Geier executed his September 1990 affidavit. Thus, the special master finds that Dr. Geier ignored portions of C’s medical records in forming his opinion in this case. The special master concludes that Dr. Geier’s September 1990 affidavit is nothing more than an egregious example of blatant, result-oriented testimony… The special master finds that Dr. Geier’s baseless September 1990 affidavit in this case undermines wholly his credibility as a witness.
Humans Are Animals, but…
In her 1993 decision in Haim v. HHS, Special Master Millman addressed in depth the impact of the Supreme Court decision in Daubert v. Merrell-Dow Pharmaceuticals on the admissibility of expert testimony in the VICP, and trained her sights on the ubiquitous Mark Geier:
Dr. Geier’s testimony is based mainly on the NCES [British National Child Encephelopathy Study] and secondarily on a theory of endotoxin “poisoning” of animals. The court holds that Dr. Geier’s testimony does not reach the level of evidentiary reliability that Daubert requires because it is not based upon scientific validity, valid methodology, peer review or testing, and more than minimal support within the scientific community.
Dr. Geier’s expertise as a doctor in the fields of genetics and obstetrics is of no relevance to the issues in the case…. The only relevancy Dr. Geier’s testimony has to the court is as a scientist who, according to Dr. Geier, is familiar with both epidemiology and animal testing. Dr. Geier testified that… he did not know to a scientific degree of certainty that more likely than not DPT caused N’s seizure. Dr. Geier testified that the most likely cause of N’s illness cannot be determined scientifically. The reason undoubtedly that he so testifies is that he cannot as a scientist give validity to the NCES and the toxin theory. Therefore, Dr. Geier offered his opinion that DPT caused N’s condition as a physician, not as a scientist.
This is legal legerdemain which in essence challenges the court to discern why Dr. Geier switches from physician to scientist for the purpose of discussing the basis of his opinion (the NCES and the toxin theory in animal testing), and then back from scientist to physician for the purpose of discussing his level of certainty regarding causation. Dr. Geier may be clever, but he is not credible. Unless the NCES and the toxin theory are based on principles and methodology that are scientifically valid, his conclusions are irrelevant to this court.
Dr. Geier has sloughed over fundamental scientific principles to offer as the second basis for his causation opinion the results of animal testing. The IOM categorically rejects any interpolation of animal studies in the context of attributing causation of neurologic illness to DPT vaccine…. Dr. Geier’s reliance on animal testing as a basis of his opinion on causation in fact is less than candid and not persuasive to this court.
In both the epidemiologic and animal testing areas, Dr. Geier’s testimony fails the Daubert criteria. Dr. Geier has made a career of testifying in cases involving “long-onset” encephalopathy following DPT vaccine. In light of the clear language of Daubert, no other court should be without the tools with which to dissect Dr. Geier’s testimony and to recognize its frailty. Dr. Geier’s testimony is not reliable, or grounded in scientific methodology and procedure. His testimony is merely subjective belief and unsupported speculation.
New Century, Old Concerns
Throughout the mid- to late 1990s, VICP decisions frequently mentioned Dr. Geier’s habit of relying solely on parent reports as the basis for his diagnoses and prognoses, his disregard for contemporaneous medical records in forming his opinions, and his reliance primarily on the NCES to support his “toxic encephalopathy” hypotheses.
“Furthermore, petitioners’ medical experts who testified in the case, Drs. Geier and Mauk, each based their diagnosis on information provided by the petitioners, particularly Mrs. Epstein.” (Epstein v. HHS, Judge Marian Blank Horn, 1996)
“Dr. Geier’s thesis of a toxic invasion of brain cells is not borne out by the pathology (the coroner did not identify brain edema) and the clinical signs (R’s fontanelle was flat).” (Cox v. HHS, Special Master Millman, 1997)
“Dr. Geier based his opinion on the assumption that D had experienced the seizures described by the petitioners. Although Dr. Geier concluded that D experienced seizures, he based his opinion exclusively on the statements of the petitioners. Because of this, his opinion cannot constitute a “medical opinion” to corroborate petitioners’ claim as required by § 300aa-13(a)(1) of the Vaccine Act.” (Lett v. HHS, Judge James Turner, 1997)
“Dr. Geier relies totally on the affidavits of Mr. and Mrs. Muller and E. Muller to establish a temporal association for on-Table significant aggravation.” (Muller v. HHS, Special Master Millman, 1998)
“Dr. Geier in this case has failed to persuade me that his general causation theory is valid…. Dr. Geier in this case spent relatively little time discussing any specific medical literature beyond the 1991 and 1994 IOM Reports, the original NCES, and the 1993 NCES follow-up study.… In my view, Dr. Geier in this and other cases has simply failed to demonstrate that sufficient evidence exists to support his general causation theory. He has failed to point to particular studies, beyond the NCES, and to explain how they support his theory.” (Lewis v. HHS, 1999, Special Master Hastings)
“Dr. Geier simply fails to provide a rational basis for ignoring the IOM’s 1991 report rejecting a causal relation between DPT and afebrile convulsions and the IOM’s subsequent 1994 follow-up report.” (Salmond v. HHS, 1999, Special Master Golkiewicz)
“Dr. Geier’s affidavit gives no basis other than the NCES and the IOM for his opinion on causation.” (Grady v. HHS, 2000, Special Master Millman)
By the turn of the century, Dr. Geier had failed to rehabilitate his reputation, but continued to offer his services to VICP petitioners. In his 2000 decision in Platt v. HHS, Special Master Hastings expressed his dismay at Dr. Geier’s midstream abandonment of his original theory regarding the petitioners’ injuries, which cast doubt on the veracity of his testimony throughout.
During the proceedings before Special Master Wright, Drs. Geier, Bellanti, and Shoham all explained that a major reason for their conclusion that S’s chronic pancreatitis was vaccine-caused was their view that whatever caused that first episode of a person’s pancreatitis was probably the cause of any ensuing chronic pancreatitis. Dr. Geier even indicated that if S in fact suffered from preexisting pancreatitis, his opinion would be different. Yet on remand, Drs. Bellanti and Geier have abandoned, without explanation, their previously-stated view that the cause of a person’s first episode of pancreatitis is likely the cause for any ensuing chronic pancreatitis. Instead, they now assert that it was the vaccination, not the cause of S’s first pancreatitis episodes, that resulted in the chronic pancreatitis. This abrupt change of direction was not only unconvincing, but, to be frank, makes me doubt very much that either expert was actually offering a candid opinion of the case in the testimony before me.
In his 2001 decision in Raj v. HHS Special Master Golkiewicz remarked:
Dr. Geier is wholly unqualified to testify concerning the two major issues in this case.… Concerning the Table encephalopathy issue, the undersigned, in Salmond, found Dr. Geier unqualified to testify… because he is neither board certified nor has formal training in pediatrics and pediatric neurology. Concerning the infantile spasms issue, Dr. Geier admitted at trial that he has no experience treating or diagnosing seizure disorders. The court found both experts to be non-objective advocates whose testimony played fast and loose with the facts and literature.
Special Master Millman’s December 2002 decision in Bruesewitz v. HHS documents considerable lapses in attention by the petitioners’ expert:
Dr. Geier confuses H’s case with someone else’s because he refers to her death and subsequent autopsy. H is still alive.
Regarding Dr. Geier, the specialist in genetics and forensic medicine, his affidavits and report are not credible. First, being a board-certified geneticist and forensic medicine specialist does not qualify him to diagnose neurological diseases and offer an opinion as to how doctors who do specialize in neurology define “encephalopathy.“
In his discussion of DPT causing seizures, Dr. Geier refers in his second affidavit to the IOM’s Adverse Effects of Pertussis and Rubella Vaccines (1991), but significantly omits the IOM’s conclusion that DPT does not cause afebrile seizures. H had afebrile seizures.
The Stealth Witness
By 2003, Dr. Geier’s status with the VICP special masters had sunk so low that in Thompson v. HHS, Clifford Shoemaker filed his response to statement by an expert for HHS lacking any indication of its source. The secrecy surrounding the submission failed to impress Special Master Millman.
On January 29, 2003, respondent filed Dr. Snyder’s response to [plaintiffs’ exhibits]. On February 28, 2003, petitioners filed an unsigned response to Dr. Snyder’s analysis. Not only did this response have no signature, but also there was no letterhead or printed name to indicate who had written it.… The undersigned issued an Order dated March 17, 2003 that petitioners had either to refile this response with the signature of the author or to file the author’s name…. On March 28, 2003, petitioners filed Dr. Mark Robin Geier’s statement that he had written the previously unsigned response to Dr. Snyder’s analysis.
…If the undersigned were to accept the statements of Dr. Geier, petitioner’s “stealth witness,” filed unsigned and unacknowledged as “A Reply to Dr. Russell Snyder’s Comments”, the gist of Dr. Geier’s comments is that statistical significance is unimportant since the court needs a standard of only more likely than not to rule for petitioners. Dr. Geier fails to understand that the undersigned accepts data which are persuasive to individuals in the field at issue (epidemiology, here) in order to accept their conclusions.
…Intellectual rigor is missing from Dr. Tornatore’s testimony and the stealth witness Dr. Geier’s submission after trial. They both posit causation based on the speculation that there are more cases of infantile spasms out there than the NCES and other researchers detected and that, in any event, since the undersigned is looking only for a preponderance of the evidence, statistical significance should not even be relevant here. But it is relevant since professionals in the field of epidemiology rely upon statistical significance in order to reach valid, credible conclusions.
…Frankly, petitioners’ counsel knew it was wrong to submit Dr. Geier’s report after the hearing. That is why he submitted it without any indication of who wrote it. When the undersigned ordered that either the author submit his name or petitioners refile the exhibit with his name, petitioners’ counsel telephoned to inquire if it was sufficient to satisfy the Order if he filed a statement from Dr. Tornatore that he agreed with the report. This was not sufficient and, thus, Dr. Geier emerged from the shadows to proclaim his handiwork.
Neither Dr. Tornatore nor Dr. Geier is qualified to testify about infantile spasms, and their testimony is filled with speculation that is directly contrary to the conclusions reached in well-respected and numerous epidemiologic and medical studies ranging over two decades.
Special Master Millman ruled that the petitioners were ineligible for compensation, and noted that Dr. Geier’s testimony did nothing to further their claim.
To be continued…
In subsequent posts, I will discuss David Geier’s career as a co-author with Mark Geier of numerous journal articles purporting to demonstrate an association between vaccines, autism and other developmental and neurological conditions, and as an aspiring consultant in VICP cases.
This essay is adapted and expanded from my 2008 Neurodiversity Weblog post, The New Testimonial Arena, which was part of the series Vaccine Court Chronicles.
