VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00795
Package ID: USCOURTS-cofc-1_13-vv-00795
Petitioner: Janet Buksa
Filed: 2013-10-15
Decided: 2016-01-08
Vaccine: influenza
Vaccination date: 2012-01-27
Condition: shoulder injury related to vaccine administration [“SIRVA”]
Outcome: compensated
Award amount USD: 443284

AI-assisted case summary:
Janet Buksa filed a petition for compensation under the National Vaccine Injury Compensation Program on October 15, 2013, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on January 27, 2012. The respondent filed a proffer on award of compensation on January 8, 2016, agreeing to a settlement. The decision awarded Janet Buksa a lump sum payment of $443,284.82, which included compensation for future medical care expenses ($98,485.68), lost earnings ($209,215.14), pain and suffering ($125,000.00), and past unreimbursable expenses ($10,584.00). The case proceeded as a Table claim, and the parties stipulated to the damages.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_13-vv-00795-1
Date issued/filed: 2016-02-03
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 1/08/2016) regarding 58 DECISION Proffer Signed by Special Master Mindy Michaels Roth. (Attachments: #1 Proffer)(mbl) Copy to parties. Modified on 7/10/2019 to include the attachment(s) in the main document for posting to the courts website (da).
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Case 1:13-vv-00795-UNJ Document 62 Filed 02/03/16 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
(Filed: January 8, 2016)
* * * * * * * * * * * * * * *
JANET BUKSA, *
* No. 13-795V
Petitioner, *
*
v. * Special Master Roth
*
SECRETARY OF HEALTH * Damages Decision Based on Proffer;
AND HUMAN SERVICES, * Influenza Vaccination; Shoulder Injury
* Related to Vaccine Administration
Respondent. * [“SIRVA”]
*
* * * * * * * * * * * * * * *
Danielle A. Strait, Hogan, Maglio Christopher and Toale, PA, Washington, DC, for petitioner.
Claudia B. Gangi, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On October 15, 2013, Janet Buksa filed a petition for compensation under the National
Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10, et seq.2 [the “Vaccine Act” or
“Program”], alleging that that she suffered a shoulder injury as a result of the influenza vaccine
she received on January 27, 2012.
On January 8, 2016, respondent filed a proffer on award of compensation (“Proffer”).
According to respondent’s Proffer, petitioner agrees to the proposed award of compensation.
Pursuant to the terms stated in the attached Proffer, petitioner is AWARDED:
a lump sum payment of $443,284.82, representing compensation for future medical
care expenses ($98,485.68), lost earnings ($209,215.14), pain and suffering
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, 116 Stat. 2899, 2913 (Dec. 17, 2002). In accordance with Vaccine Rule 18(b), petitioners
have 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 Program comprises 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-10 et seq. (hereinafter “Vaccine Act” or “the Act”). Hereafter,
individual section references will be to 42 U.S.C. § 300aa of the Act.

Case 1:13-vv-00795-UNJ Document 62 Filed 02/03/16 Page 2 of 5
($125,000.00), and past unreimbursable expenses ($10,584.00), in the form of a
check payable to petitioner, Janet Buksa.
These amounts represent compensation for all damages that would be available under §
300aa-15(a).
The clerk of the court is directed to enter judgment in accordance with this decision.3
IT IS SO ORDERED.
s/Mindy Michaels Roth
Mindy Michaels Roth
Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party filing a notice renouncing the
right to seek review.

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IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
_________________________________________
)
JANET BUKSA, )
)
Petitioner, )
) No. 13-795V
v. ) Special Master Roth
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
__________________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Items of Compensation
A. Future Medical Care Expenses
Respondent proffers that based on the evidence of record, petitioner is entitled to an
award for projected unreimbursable medical care expenses in the amount of $98,485.68 as
provided under 42 U.S.C. § 300aa-15(a)(1)(A). Petitioner agrees.
B. Lost Earnings
The parties agree that based upon the evidence of record, Janet Buksa has suffered a past
loss of earnings in the amount of $33,044.00, and will suffer a future loss of earnings in the
amount of $176,171.14 as a result of her vaccine-related injury. Therefore, respondent proffers
that the Court should award Janet Buksa a lump sum of $209,215.14 for her lost earnings as
provided under the Vaccine Act, 42 U.S.C. § 300aa-15(a)(3)(A). Petitioner agrees.
1

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C. Pain and Suffering
Respondent proffers that the Court should award Janet Buksa a lump sum of $125,000.00
for her actual and projected pain and suffering. This amount reflects that the award for projected
pain and suffering has been reduced to net present value. See § 300aa-15(a)(4). Petitioner
agrees.
D. Past Unreimbursable Expenses
Evidence supplied by petitioner documents Janet Buksa’s expenditure of past
unreimubursable expenses as a result of her vaccine-related injury. Respondent proffers that the
Court should award Janet Buksa a lump sum of $10,584.00 for past unreimbursable expenses as
provided under the Vaccine Act, 42 U.S.C. § 300aa-15(a)(1)(A). Petitioner agrees.
E. Medicaid Lien
Petitioner represents that there are no outstanding Medicaid liens related to her vaccine-
related injury.
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made
through a lump sum payment as described below and request that the Special Master’s decision
and the Court’s judgment award the following1: a lump sum payment of $443,284.82,
representing compensation for future medical care expenses ($98,485.68), lost earnings
($209,215.14), pain and suffering ($125,000.00), and past unreimbursable expenses
($10,584.00), in the form of a check payable to petitioner, Janet Buksa.
1 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief. In particular, respondent would oppose any award for future medical
expenses, future pain and suffering, and future wage loss.
2

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III. Summary of Recommended Payment Following Judgment
Lump sum payable to petitioner: $443,284.82
BENJAMIN C. MIZER
Principal Acting Assistant Attorney General
RUPA BHATTACHARYYA
Director
Torts Branch, Civil Division
VINCENT J. MATANOSKI
Deputy Director
Torts Branch, Civil Division
LYNN E. RICCIARDELLA
Senior Trial Attorney
Torts Branch, Civil Division
/s/ Claudia B. Gangi
CLAUDIA B. GANGI
Senior Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel.: (202) 616-4138
Dated: January 8, 2016
3