VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_12-vv-00511
Package ID: USCOURTS-cofc-1_12-vv-00511
Petitioner: Ann Marie Rivera
Filed: 2012-08-14
Decided: 2014-11-20
Vaccine: influenza
Vaccination date: 2009-09-29
Condition: Guillain-Barré Syndrome (GBS)
Outcome: compensated
Award amount USD: 190000

AI-assisted case summary:
Ann Marie Rivera filed a petition on August 14, 2012, alleging that an influenza vaccination she received on November 6, 2010, a vaccine contained in the Vaccine Injury Table, caused her to develop Guillain-Barré Syndrome (GBS), with residual effects lasting more than six months.

Respondent denied that the influenza vaccine caused petitioner's GBS or any other injury. Nonetheless, both parties agreed in a joint stipulation filed April 8, 2014 to settle the case. Special Master Moran found the stipulation reasonable and adopted it as the decision of the Court. Petitioner received a lump sum of $190,000.00, representing compensation for all damages available under 42 U.S.C. § 300aa-15(a).

Special Master Moran also awarded $12,136.22 in attorneys' fees and costs, payable jointly to petitioner and her counsel, Michael Andrew London of Douglas & London, P.C. Petitioner had not incurred any out-of-pocket litigation expenses.

Theory of causation field:
Flu Nov 6, 2010 → GBS (Table vaccine). (Note: attached stipulation states Sep 29, 2009 — apparent copy-paste error; decision body and fees decision both state Nov 6, 2010.) Joint stipulation Apr 8, 2014; respondent denied causation; SM Moran. $190,000. Fees $12,136.22 (London, Douglas & London, New York NY).

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_12-vv-00511-0
Date issued/filed: 2014-06-09
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 04/10/2014) regarding 45 DECISION Stipulation/Proffer. Signed by Special Master Christian J. Moran. (tpj) Copy to parties.
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Case 1:12-vv-00511-UNJ Document 49 Filed 06/09/14 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
* * * * * * * * * * * * * * * * * * * * *
ANN MARIE RIVERA, *
* No. 12-511V
Petitioner, * Special Master Christian J.
* Moran
*
v. * Filed: April 10, 2014
*
SECRETARY OF HEALTH * Stipulation; Influenza (“flu")
AND HUMAN SERVICES, * Vaccine, Guillain-Barré
* Syndrome (“GBS”).
Respondent. *
* * * * * * * * * * * * * * * * * * * * *
Michael Andrew London, Douglas & London, P.C., New York, NY for Petitioner;
Ann Donohue Martin, U.S. Department of Justice, Washington, D.C., for
Respondent.
UNPUBLISHED DECISION1
On April 8, 2014, the parties filed a joint stipulation concerning the petition
for compensation filed by Ann Marie Rivera on August 14, 2012. In her petition,
petitioner alleged that the influenza vaccine, which is contained in the Vaccine
Injury Table (the “Table”), 42 C.F.R. §100.3(a), and which she received on
November 6, 2010, caused her to suffer Guillain-Barré Syndrome (“GBS”).
Petitioner further alleges that she suffered the residual effects of this injury for
more than six months. Petitioner represents that there has been no prior award or
settlement of a civil action for damages on her behalf as a result of her condition.
1 The E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899, 2913 (Dec. 17,
2002), requires that the Court post this decision on its website. Pursuant to Vaccine Rule 18(b),
the parties have 14 days to file a motion proposing redaction of medical information or other
information described in 42 U.S.C. § 300aa-12(d)(4). Any redactions ordered by the special
master will appear in the document posted on the website.

Case 1:12-vv-00511-UNJ Document 49 Filed 06/09/14 Page 2 of 7
Respondent denies that the influenza vaccine caused petitioner to suffer
GBS or any other injury.
Nevertheless, the parties agree to the joint stipulation, attached hereto as
Appendix A. The undersigned finds said stipulation reasonable and adopts it as the
decision of the Court in awarding damages, on the terms set forth therein.
Damages awarded in that stipulation include:
A lump sum of $190,000.00 in the form of a check payable to
petitioner. This amount represents compensation for all damages
that would be available under 42 U.S.C. § 300aa-15(a).
In the absence of a motion for review filed pursuant to RCFC, Appendix B,
the clerk is directed to enter judgment in case 12-511V according to this decision
and the attached stipulation.2
Any questions may be directed to my law clerk, Marc Langston, at (202)
357-6392.
IT IS SO ORDERED.
s/Christian J. Moran
Christian J. Moran
Special Master
2 Pursuant to Vaccine Rule 11(a), the parties can expedite entry of judgment by each
party filing a notice renouncing the right to seek review by a United States Court of Federal
Claims judge.
2

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IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
ANN MARIE RIVERA, )
)
Petitioner, )
) No. 12-511V
v. ) Special Master Moran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
STIPULATION
The parties hereby stipulate to the following matters:
1. Petitioner, Ann Marie Rivera, filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the “Vaccine
Program”). The petition seeks compensation for injuries allegedly related to petitioner’s receipt
of the influenza vaccine, which is contained in the Vaccine Injury Table (the “Table”), 42 C.F.R.
§ 100.3(a).
2. Petitioner received an influenza immunization on September 29, 2009.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she suffered Guillain-Barre Syndrome (“GBS”) as a result of
the influenza vaccine. Petitioner further alleges that she experienced residual effects of this
condition for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on her behalf as a result of her injuries.
6. Respondent denies that petitioner’s influenza vaccine caused GBS or any other injury.

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7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(1), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $190,000.00 in the form of a check payable to petitioner. This
amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
9. As soon as practicable after the entry of judgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to
42 U.S.C. § 300aa-21(a)(1), and an application, the parties will submit to further proceedings
before the special master to award reasonable attorneys’ fees and costs incurred in proceeding
upon this petition.
10. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.)), or by entities that provide health services on a pre-paid basis.
11. Payment made pursuant to paragraph 8 of this Stipulation and any amounts awarded
pursuant to paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-
15(i), subject to the availability of sufficient statutory funds.
2

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12. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys’ fees and litigation costs, the money provided pursuant to this Stipulation will be
used solely for the benefit of petitioner as contemplated by a strict construction of 42 U.S.C.
§ 300aa-15(a) and (d), and subject to the conditions of 42 U.S.C. § 300aa-15(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements, judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300aa-10 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from, the influenza vaccination administered on September 29,
2009, as alleged by petitioner in a petition for vaccine compensation filed on or about August 14,
2012, in the United States Court of Federal Claims as petition No. 12-511V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
15. If the special master fails to issue a decision in complete conformity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties’
settlement and this Stipulation shall be voidable at the sole discretion of either party.
3

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16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties’ respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the influenza vaccine caused petitioner to develop
GBS or any other injury.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner’s
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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DOCUMENT 2: USCOURTS-cofc-1_12-vv-00511-1
Date issued/filed: 2014-11-20
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 10/27/2014) regarding 52 DECISION Fees Stipulation. Signed by Special Master Christian J. Moran. (tpj) Copy to parties.
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Case 1:12-vv-00511-UNJ Document 55 Filed 11/20/14 Page 1 of 2
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
* * * * * * * * * * * * * * * * * * * * *
ANN MARIE RIVERA, *
* No. 12-511V
Petitioner, * Special Master Christian J. Moran
*
v. * Filed: October 27, 2014
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, * Attorneys’ fees and costs; award
* in the amount to which
Respondent. * respondent does not object.
* * * * * * * * * * * * * * * * * * * * *
Michael Andrew London, Douglas & London, P.C. New York, NY, for Petitioner;
Ann Donohue Martin, U.S. Dep’t of Justice, Washington, DC, for Respondent.
UNPUBLISHED DECISION ON FEES AND COSTS1
On October 24, 2014, petitioner filed a stipulation of fact concerning final
attorneys’ fees and costs in the above-captioned matter. Previously, petitioner
informally submitted a draft application to respondent for review requesting
$12,136.22 for attorneys’ fees and costs. Respondent found petitioner’s
application to be reasonable. The Court awards this amount.
On August 14, 2012, Ann Marie Rivera filed a petition for compensation
alleging that the influenza vaccine, which she received on November 6, 2010,
respectively, caused her to Guillain-Barré Syndrome (“GBS”). Petitioner received
compensation based upon the parties’ stipulation. Decision, issued Apr. 10, 2014.
Because petitioner received compensation, she is entitled to an award of attorneys’
fees and costs. 42 U.S.C. § 300aa-15(e).
1 The E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899, 2913 (Dec. 17,
2002), requires that the Court post this decision on its website. Pursuant to Vaccine Rule 18(b),
the parties have 14 days to file a motion proposing redaction of medical information or other
information described in 42 U.S.C. § 300aa-12(d)(4). Any redactions ordered by the special
master will appear in the document posted on the website.

Case 1:12-vv-00511-UNJ Document 55 Filed 11/20/14 Page 2 of 2
Petitioner seeks a total of $12,136.22 in attorneys’ fees and costs for her
counsel. Additionally, in compliance with General Order No. 9, petitioner states
that she did not incur any in out-of-pocket litigation expenses while pursuing this
claim. Respondent has no objection to the amount requested for attorneys’ fees
and costs.
After reviewing the request, the Court awards the following:
A lump sum of $12,136.22 in the form of a check made payable to
petitioner and petitioner’s attorney, Michael Andrew London, for
attorneys’ fees and other litigation costs available under 42 U.S.C. §
300aa-15(e).
The Court thanks the parties for their cooperative efforts in resolving this
matter. The Clerk shall enter judgment accordingly.
Any questions may be directed to my law clerk, Christina Gervasi, at (202)
357-6521.
IT IS SO ORDERED.
s/Christian J. Moran
Christian J. Moran
Special Master