VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00534
Package ID: USCOURTS-cofc-1_13-vv-00534
Petitioner: Raymond Edward Black Jr.
Filed: 2013-08-01
Decided: 2015-02-25
Vaccine: influenza
Vaccination date: 2012-10-01
Condition: significant aggravation of pre-existing cardiomyopathy, chronic left bundle branch block, and gout
Outcome: compensated
Award amount USD: 8000

AI-assisted case summary:
Carissa A. Brink, as personal representative of the Estate of Raymond Edward Black Jr., filed a petition on August 1, 2013, alleging that an influenza (flu) vaccination administered to Mr. Black on October 1, 2012 caused his death, or that the flu vaccine significantly aggravated his pre-existing cardiomyopathy, chronic left bundle branch block, and gout, which caused his death on February 9, 2013. Respondent denied that the flu vaccine caused or significantly aggravated Mr. Black's cardiomyopathy, chronic left bundle branch block, gout, or any other condition.

Nonetheless, both parties agreed to a joint stipulation filed December 3, 2014 to settle the case. Special Master Gowen found the stipulation reasonable and adopted it as the decision of the Court. Petitioner received a lump sum of $8,000.00, representing compensation for all damages available under 42 U.S.C. § 300aa-15(a), payable to Carissa Brink as personal representative of the estate. The parties subsequently agreed to attorneys' fees and costs of $14,500.00, payable jointly to petitioner and her counsel, Juri Jelokov of Chelsey, Kroon, Harvey & Carpenter, PLLP. Petitioner had not personally incurred any out-of-pocket litigation expenses.

Theory of causation field:
Flu Oct 1, 2012 → significant aggravation of cardiomyopathy + CLBBB + gout → death Feb 9, 2013. Petitioner: Carissa A. Brink (estate rep). Joint stipulation Dec 3, 2014; SM Gowen. Comp $8,000. Fees $14,500 (Jelokov, Chelsey Kroon Harvey & Carpenter PLLP, Mankato MN).

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_13-vv-00534-0
Date issued/filed: 2015-01-12
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 12/04/2014) regarding 34 DECISION Stipulation/Proffer ( Signed by Special Master Thomas L. Gowen.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 13-534V
Filed: December 4, 2014
* * * * * * * * * * * * * * * * UNPUBLISHED
CARISSA A BRINK, as personal *
representative of the Estate of Raymond *
Edward Black, Jr. *
* Special Master Gowen
Petitioner, *
* Joint Stipulation on Damages;
v. * Influenza (“Flu”) Vaccine;
* Significant aggravation; Gout;
SECRETARY OF HEALTH * Cardiomyopathy; Chronic left
AND HUMAN SERVICES, * bundle branch block; Death
*
Respondent. *
*
* * * * * * * * * * * * * * * *
Yuri Jelokov, Chelsey, Kroon, et al., Mankato, MN, for petitioner.
Debra A Filteau Begley, United States Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
On August 1, 2013, Carissa Brink (“petitioner”) filed a petition on behalf of the decedent
Raymond Black Jr. (Mr. Black) pursuant to the National Vaccine Injury Compensation
Program.2 42 U.S.C. §§ 300aa-1 to -34 (2006). Petitioner alleged that an influenza (“flu”)
vaccine administered on October 1, 2012 caused Mr. Black’s death, or that the flu vaccine
1 Because this decision contains a reasoned explanation for the undersigned’s action in this case,
the undersigned intends to post this ruling on the website of the United States Court of Federal
Claims, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347, § 205, 116
Stat. 2899, 2913 (codified as amended at 44 U.S.C. § 3501 note (2006)). As provided by
Vaccine Rule 18(b), each party has 14 days within which to request redaction “of any
information furnished by that party: (1) that is a trade secret or commercial or financial in
substance and is privileged or confidential; or (2) that includes medical files or similar files, the
disclosure of which would constitute a clearly unwarranted invasion of privacy.” Vaccine Rule
18(b).
2 The National Vaccine Injury Compensation Program is set forth in Part 2 of the National
Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755, codified as amended,
42 U.S.C. §§ 300aa-1 to -34 (2006) (Vaccine Act or the Act). All citations in this decision to
individual sections of the Vaccine Act are to 42 U.S.C.A. § 300aa.
1

Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 2 of 7
caused significant aggravation of Mr. Black’s pre-existing cardiomyopathy, chronic left bundle
branch block, and gout, which caused his death on February 9, 2013. Stipulation ¶ 2, 4, filed
Dec. 3, 2014.
On December 3, 2014, the parties filed a stipulation in which they state that a decision
should be entered awarding compensation. “Respondent denies that Mr. Black’s
cardiomyopathy, chronic left bundle branch block, gout, or any other condition, was significantly
aggravated by, or that his death was caused by his flu vaccination.” Id. at ¶ 6. Nevertheless, the
parties agree to the joint stipulation, attached hereto as Appendix A. The undersigned finds the
stipulation reasonable and adopts it as the decision of the Court in awarding damages, on the
terms set forth therein.
The parties stipulate that petitioner shall receive the following compensation:
A lump sum of $8,000.00, in the form of a check payable to petitioner, Carissa
Brink, as personal representative of the Estate of Raymond Edward Black Jr. This
amount represents compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
Id. at ¶ 8.
The undersigned approves the requested amount for petitioner’s compensation.
Accordingly, an award should be made consistent with the stipulation.
The clerk of the court SHALL ENTER JUDGMENT in accordance with the terms of
the parties’ stipulation.3
IT IS SO ORDERED.
s/ Thomas L. Gowen
Thomas L. Gowen
Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment is expedited by the parties’ joint filing of
notice renouncing the right to seek review.
2

Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 3 of 7

Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 4 of 7

Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 5 of 7

Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 6 of 7

Case 1:13-vv-00534-UNJ Document 36 Filed 01/12/15 Page 7 of 7

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_13-vv-00534-1
Date issued/filed: 2015-02-25
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 01/29/2015) regarding 40 DECISION Fees Stipulation/Proffer (Signed by Special Master Thomas L. Gowen.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:13-vv-00534-UNJ Document 41 Filed 02/25/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 13-534V
Filed: January 29, 2015
UNPUBLISHED
* * * * * * * * * * * * * * * *
CARISSA A. BRINK, as a personal *
representative of the Estate of Raymond *
Edward Black, Jr. *
*
Petitioner, *
* Stipulation on Attorneys’ Fees &
v. * Costs
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * *
Yuri Jelokov, Chelsey, Kroon, et al., Mankato, MN, for petitioner.
Debra A Filteau Begley, U.S. Dep’t of Justice, Washington, DC, for respondent.
1
DECISION ON ATTORNEY FEES AND COSTS
Gowen, Special Master:
In this case under the National Vaccine Injury Compensation Program,2 I issued
a Decision on December 4, 2014, adopting the parties’ stipulation for award. On
January 27, 2015, the parties filed a Stipulation of Fact concerning attorneys’ fees and
costs. Additionally, pursuant to General Order #9, the stipulation notes that petitioner
incurred no personal litigation costs.
The parties’ stipulation indicates that respondent does not object to the amended
1 Because this unpublished decision contains a reasoned explanation for the action in this case, I intend
to post this decision on the United States Court of Federal Claims' website, in accordance with the E-
Government Act of 2002, Pub. L. No. 107-347, § 205, 116 Stat. 2899, 2913 (codified as amended at 44
U.S.C. § 3501 note (2006)). In accordance with Vaccine Rule 18(b), petitioner has 14 days to identify and
move to delete medical or other information, the disclosure of which would constitute an unwarranted
invasion of privacy. If, upon review, I agree that the identified material fits within this definition, I will
delete such material from public access.
2 The applicable statutory provisions defining the program are found at 42 U.S.C. § 300aa-10 et seq.
(2006).
1

Case 1:13-vv-00534-UNJ Document 41 Filed 02/25/15 Page 2 of 2
amount of $14,500 that petitioner is requesting for attorneys’ fees and costs.
I find that this petition was brought in good faith and that there existed a
reasonable basis for the claim. Therefore, an award for fees and costs is appropriate,
pursuant to 42 U.S.C. §§ 300aa-15(b) and (e)(1). Further, the proposed amount seems
reasonable and appropriate. Accordingly, I hereby award:
• a lump sum of $14,500.00 in the form of a check payable jointly to
petitioner and petitioner’s attorney, Juri Jelokov of Chelsey, Kroon,
Harvey & Carpenter, PLLP, for petitioner’s attorneys’ fees and costs.
The clerk of the court shall enter judgment in accordance herewith.3
IT IS SO ORDERED.
s/ Thomas L. Gowen
Thomas L. Gowen
Special Master
3 Entry of judgment can be expedited by each party’s filing of a notice renouncing the right to seek review.
See Vaccine Rule 11(a).
2