VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00384
Package ID: USCOURTS-cofc-1_14-vv-00384
Petitioner: Gary Martz
Filed: 2014-12-09
Decided: 2015-01-22
Vaccine: influenza
Vaccination date: 2012-09-01
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 143415

AI-assisted case summary:
Gary Martz, a married man, filed a petition on December 9, 2014, alleging that he suffered a left arm injury, diagnosed as a shoulder injury related to vaccine administration (SIRVA), as a result of an influenza vaccine he received on September 1, 2012. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) Report on September 9, 2014, conceding that Mr. Martz suffered from SIRVA and recommending compensation. The parties subsequently entered into a stipulation and proffer regarding an award of compensation. On December 9, 2014, Special Master Laura D. Millman issued a decision awarding a lump sum payment of $120,000.00, representing all elements of compensation to which petitioner would be entitled under 42 U.S.C. § 300aa-15(a). This award was to be paid via a check made payable to petitioner. Later, on January 22, 2015, the parties filed a stipulation of facts regarding attorneys' fees and costs. Petitioner initially requested $32,236.81, but after respondent raised objections, the amount was amended to $23,415.00, which respondent did not object to. Special Master Millman found this amount to be reasonable and awarded $23,415.00 for attorneys' fees and costs, to be paid via a check made payable jointly to petitioner and the Law Offices of Jay A. Bansal. The total award for compensation, fees, and costs was $143,415.00. Petitioner was represented by Jay A. Bansal, and respondent was represented by Ann D. Martin. The case was decided by Special Master Laura D. Millman.

Theory of causation field:
Petitioner Gary Martz alleged a left arm injury, diagnosed as shoulder injury related to vaccine administration (SIRVA), following an influenza vaccination on September 1, 2012. The respondent conceded the SIRVA diagnosis and recommended compensation. The case proceeded as a Table claim. The parties stipulated to an award of $120,000.00 for all elements of compensation, and subsequently stipulated to an additional $23,415.00 for attorneys' fees and costs. Special Master Laura D. Millman issued a decision on December 9, 2014, awarding the $120,000.00 for compensation, and a further decision on January 22, 2015, awarding the $23,415.00 for attorneys' fees and costs, for a total award of $143,415.00. Petitioner was represented by Jay A. Bansal, and respondent was represented by Ann D. Martin.

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_14-vv-00384-0
Date issued/filed: 2014-12-30
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 12/09/2014) regarding 13 DECISION Stipulation/Proffer Signed by Special Master Laura D Millman. (tlj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:14-vv-00384-UNJ Document 18 Filed 12/30/14 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-384V
Filed: December 9, 2014
Not for Publication
*************************************
GARY MARTZ, a Married Man, *
*
Petitioner, *
* Damages decision based on proffer;
v. * influenza (flu) vaccine; shoulder
* injury related to vaccine
SECRETARY OF HEALTH * administration (SIRVA)
AND HUMAN SERVICES, *
*
Respondent. *
*
*************************************
Jay A. Bansal, Tempe, AZ, for petitioner.
Ann D. Martin, Washington, DC, for respondent.
MILLMAN, Special Master
DECISION AWARDING DAMAGES1
On May 6, 2014, petitioner filed a petition under the National Childhood Vaccine Injury
Act, 42 U.S.C. §§ 300aa-10–34 (2006), alleging that he suffered a left arm injury as a result of
the influenza (“flu”) vaccination he received on September 1, 2012. On September 9, 2014,
respondent filed her Rule 4(c) Report, conceding that petitioner suffered from a shoulder injury
related to vaccine administration (“SIRVA”) and recommending compensation.
1 Because this decision contains a reasoned explanation for the special master's action in this case, the
special master intends to post this decision on the United States Court of Federal Claims's website, in
accordance with the E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899, 2913 (Dec. 17,
2002). Vaccine Rule 18(b) states that all decisions of the special masters will be made available to the
public unless they contain trade secrets or commercial or financial information that is privileged and
confidential, or medical or similar information whose disclosure would constitute a clearly unwarranted
invasion of privacy. When such a decision is filed, petitioner has 14 days to identify and move to redact
such information prior to the document=s disclosure. If the special master, upon review, agrees that the
identified material fits within the banned categories listed above, the special master shall redact such
material from public access.
1

Case 1:14-vv-00384-UNJ Document 18 Filed 12/30/14 Page 2 of 4
On December 9, 2014, respondent filed Respondent’s Proffer on Award of
Compensation. The undersigned finds the terms of the proffer to be reasonable. Based on the
record as a whole, the undersigned finds that petitioner is entitled to the award as stated in the
proffer. Pursuant to the terms stated in the attached proffer, the court awards a lump sum
payment of $120,000.00, representing all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). The award shall be in the form of a check for
$120,000.00 made payable to petitioner.
In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of
the court is directed to enter judgment herewith.2
IT IS SO ORDERED.
Dated: December 9, 2014 /s/ Laura D. Millman
Laura D. Millman
Special Master
2 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party, either separately or
jointly, filing a notice renouncing the right to seek review.
2

Case 1:14-vv-00384-UNJ Document 18 Filed 12/30/14 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
GARY MARTZ, )
)
Petitioner, )
) No. 14-384V
v. ) Special Master Millman
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
$120,000.00, which represents all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made
through a lump sum payment of $120,000.00 in the form of a check payable to petitioner.
Petitioner agrees.
Respectfully submitted,
JOYCE R. BRANDA
Acting Assistant Attorney General
RUPA BHATTACHARYYA
Director
Torts Branch, Civil Division
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 and future pain and suffering.

Case 1:14-vv-00384-UNJ Document 18 Filed 12/30/14 Page 4 of 4
VINCENT J. MATANOSKI
Deputy Director
Torts Branch, Civil Division
LINDA S. RENZI
Senior Trial Counsel
Torts Branch, Civil Division
s/ Ann D. Martin
ANN D. MARTIN
Senior Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Telephone: (202) 307-1815
Dated: December 9, 2014
2

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DOCUMENT 2: USCOURTS-cofc-1_14-vv-00384-1
Date issued/filed: 2015-02-13
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 01/22/2015) regarding 20 DECISION Fees Stipulation/Proffer Signed by Special Master Laura D Millman. (tlj) Copy to parties.
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Case 1:14-vv-00384-UNJ Document 24 Filed 02/13/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-384V
Filed: January 22, 2015
Not for Publication
*************************************
GARY MARTZ, a Married Man, *
*
Petitioner, * Attorneys’ fees and costs decision based on
* stipulation of fact
v. *
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
*
*************************************
Jay A. Bansal, Tempe, AZ, for petitioner.
Ann D. Martin, Washington, DC, for respondent.
MILLMAN, Special Master
DECISION AWARDING ATTORNEYS’ FEES AND COSTS1
On January 22, 2015, the parties filed a stipulation of facts in which they agreed on an
appropriate amount for attorneys’ fees and costs in this case. In accordance with General Order
#9, petitioner asserts that he did not incur any costs in pursuit of his petition.
On December 18, 2014, petitioner provided respondent with his draft application for
attorneys’ fees and costs, in which he requested $32,236.81. During informal discussions,
respondent raised objections to certain items in petitioner’s application. Based on these
1 Because this unpublished decision contains a reasoned explanation for the special master’s action in this
case, the special master intends to post this unpublished decision on the United States Court of Federal
Claims’s website, in accordance with the E-Government Act of 2002, Pub. L. No. 107-347, 116 Stat. 2899,
2913 (Dec. 17, 2002). Vaccine Rule 18(b) states that all decisions of the special masters will be made
available to the public unless they contain trade secrets or commercial or financial information that is
privileged and confidential, or medical or similar information whose disclosure would constitute a clearly
unwarranted invasion of privacy. When such a decision is filed, petitioner has 14 days to identify and
move to redact such information prior to the document=s disclosure. If the special master, upon review,
agrees that the identified material fits within the banned categories listed above, the special master shall
redact such material from public access.

Case 1:14-vv-00384-UNJ Document 24 Filed 02/13/15 Page 2 of 2
objections, petitioner amends his application for attorneys’ fees and costs to $23,415.00.
Respondent does not object to this amount. The undersigned finds this amount to be reasonable.
Accordingly, the court awards $23,415.00, representing reimbursement for attorneys’ fees and
costs. The award shall be in the form of a check payable jointly to petitioner and Law Offices of
Jay A. Bansal for $23,415.00.
In the absence of a motion for review filed pursuant to RCFC Appendix B, the clerk of the
court is directed to enter judgment herewith.2
IT IS SO ORDERED.
Dated: January 22, 2015 s/ Laura D. Millman
Laura D. Millman
Special Master
2 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party, either separately or
jointly, filing a notice renouncing the right to seek review.
2