VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00968
Package ID: USCOURTS-cofc-1_14-vv-00968
Petitioner: Paula Nilsen
Filed: 2015-01-09
Decided: 2016-09-19
Vaccine: Td
Vaccination date: 2013-03-14
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 128516

AI-assisted case summary:
Paula Nilsen filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) caused by a tetanus diphtheria (Td) vaccine she received on March 14, 2013. The respondent, the Secretary of Health and Human Services, conceded entitlement to compensation, agreeing that the injury was caused by the Td vaccine and lasted for more than six months. The case proceeded as a Table claim. A ruling on entitlement was issued on January 9, 2015, finding petitioner entitled to compensation. Subsequently, on October 6, 2015, the parties filed a proffer on award of compensation. The respondent recommended an award of $128,516.11, which included a lump sum of $125,000.00 payable to Paula Nilsen and $3,516.11 payable to both Paula Nilsen and Optum to satisfy a Medicaid lien. Petitioner agreed to this award. A decision awarding damages was issued on November 16, 2015, reflecting this agreed-upon amount. Later, on March 15, 2016, a decision was issued acknowledging a repayment of $353.66 due to an overpayment of the Medicaid lien, and directing an additional judgment in favor of the respondent for this amount. The total compensation awarded to Paula Nilsen was $128,516.11.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_14-vv-00968-0
Date issued/filed: 2015-02-23
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 01/09/2015) regarding 16 Ruling on Entitlement ( Signed by Chief Special Master Denise Kathryn Vowell.)(mpj) Copy to parties.
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Case 1:14-vv-00968-UNJ Document 20 Filed 02/23/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-968V
Filed: January 9, 2015
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
PAULA NILSEN, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Tetanus Diphtheria Vaccine; Special
* Processing Unit; Shoulder Injury
SECRETARY OF HEALTH * Related to Vaccine Administration;
AND HUMAN SERVICES, * SIRVA
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Danielle Strait, Esq., Maglio, Christopher and Toale, PC Washington, DC, for petitioner.
Debra Begley, Esq., U.S. Dept. of Justice, Washington, DC for respondent.
RULING ON ENTITLEMENT1
Vowell, Chief Special Master:
On October 8, 2014, Paula Nilsen 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”]. Petitioner alleges that she suffered a shoulder injury which
was caused by the tetanus diphtheria [“Td”] vaccine she received on March 14, 2013.
Petition at 1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On January 8, 2015, respondent filed her Rule 4(c) report [“Res. Report”] in
which she concedes that petitioner is entitled to compensation in this case. Res. Report
at 4. Specifically, respondent indicates that she “that the injury to petitioner’s right
shoulder was caused by the administration of her March 14, 2013 Td vaccine.” Id.
Respondent agrees that petitioner’s injury lasted for more than six months and “is not
due to factors unrelated to the administration of the March 14, 2013 Td vaccine.” Id.
1 Because this unpublished ruling contains a reasoned explanation for the action in this case, I intend to
post it 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
redact 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 redact such
material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for
ease of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2006).

Case 1:14-vv-00968-UNJ Document 20 Filed 02/23/15 Page 2 of 2
In view of respondent’s concession and the evidence before me, I find that
petitioner is entitled to compensation.
s/Denise K. Vowell
Denise K. Vowell
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_14-vv-00968-1
Date issued/filed: 2015-11-16
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 10/6/2015) regarding 35 DECISION Stipulation/Proffer, ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:14-vv-00968-UNJ Document 39 Filed 11/16/15 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-0968V
Filed: October 6, 2015
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
PAULA NILSEN, *
*
Petitioner, * Damages Decision Based on Proffer;
* Tetanus Diphtheria (“Td”) Shoulder
* Vaccine; Injury Related to Vaccine
SECRETARY OF HEALTH * Administration SIRVA; Special
AND HUMAN SERVICES, * Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Danielle Anne Strait, Maglio Christopher & Toale, PA, Washington, DC, for petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On October 8, 2015, Paula Nilsen (“petitioner”) 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”]. Petitioner alleges that she suffered a shoulder
injury which was caused by a tetanus diphtheria (“Td”) vaccine she received on March
14, 2013. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On January 9, 2015, a ruling on entitlement was issued, finding that petitioner
was entitled to compensation. On October 6, 2015, respondent filed a proffer on award
of compensation [“Proffer”] stating that petitioner should be awarded $128,516.11.
1 Because this unpublished decision contains a reasoned explanation for the action in this case, I intend
to post it 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
redact 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 redact such
material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for
ease of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:14-vv-00968-UNJ Document 39 Filed 11/16/15 Page 2 of 4
Proffer at 1. According to respondent’s Proffer, petitioner agrees to the proposed award
of compensation.
Pursuant to the terms stated in the attached Proffer, the undersigned awards
petitioner:
a) A lump sum of $125,000.00, in the form of a check payable to petitioner,
Paula Nilsen, and
b) A lump sum of $3,516.11, in the form of a check payable to petitioner and
Optum, in satisfaction of a Medicaid lien from the State of Minnesota.
Petitioner agrees to endorse this check to Optum. This amount represents
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
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief 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.
2

Case 1:14-vv-00968-UNJ Document 39 Filed 11/16/15 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
*************************************
PAULA NILSEN, *
*
Petitioner, * No. 14-968V
* CHIEF SPECIAL MASTER
v. * NORA BETH DORSEY
*
SECRETARY OF HEALTH AND *
HUMAN SERVICES, *
*
Respondent. *
*************************************
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Items of Compensation
For purposes of this proffer, the term “vaccine-related” is as described in Respondent’s
Rule 4(c) Report, filed on January 8, 2015, conceding entitlement in this case. Based upon the
evidence of record, respondent proffers that petitioner should be awarded $128,516.11. This
represents all elements of competition to which petitioner would be entitled under 42 U.S.C. §
300aa-15(a) for her vaccine-related injury.1 Petitioner agrees.
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made
through lump sum payments described below, and request that the Chief Special Master’s
decision and the Court’s judgment award the following:
a) A lump sum of $125,000.00 in the form of a check payable to petitioner, Paula
Nilsen, and
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 lost earnings, and future pain and suffering.

Case 1:14-vv-00968-UNJ Document 39 Filed 11/16/15 Page 4 of 4
b) A lump sum of $3,516.11 in the form of a check made payable to petitioner and
Optum, in satisfaction of a Medicaid lien from the State of Minnesota. Petitioner
agrees to endorse this check to Optum.
These amounts account for all elements of compensation under 42 U.S.C. § 300aa-15(a) to
which petitioner would be entitled. Petitioner is a competent adult. Evidence of guardianship is
not required in this case.
Respectfully submitted,
BENJAMIN C. MIZER
Principal Deputy Assistant Attorney General
RUPA BHATTACHARYYA
Director
Torts Branch, Civil Division
VINCENT J. MATANOSKI
Deputy Director
Torts Branch, Civil Division
LINDA S. RENZI
Senior Trial Counsel
Torts Branch, Civil Division
/s/ DEBRA A. FILTEAU BEGLEY
DEBRA A. FILTEAU BEGLEY
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Phone: (202) 616-4181
Dated: October 6, 2015 Fax: (202) 353-2988

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DOCUMENT 3: USCOURTS-cofc-1_14-vv-00968-3
Date issued/filed: 2016-09-19
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 03/15/2016) regarding 42 DECISION of Special Master, ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:14-vv-00968-UNJ Document 50 Filed 09/19/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-0968V
Filed: March 15, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
PAULA NILSEN, *
*
Petitioner, * Repayment of Excess Award of
* Compensation; Direction of Additional
* Judgment; Special Processing Unit
SECRETARY OF HEALTH * (“SPU”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Danielle A. Strait, Maglio Christopher & Toale, PA, Washington, DC, for petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC for respondent.
DECISION ACKNOWLEDGING REPAYMENT OF EXCESS COMPENSATION
AND DIRECTING ADDITIONAL JUDGMENT1
Dorsey, Chief Special Master:
On October 6, 2015, respondent filed a proffer on award of compensation
[“Proffer”] stating that petitioner should be awarded $128,516.11 consisting of
$125,000.00 compensation paid to petitioner and $3,516.11 paid to petitioner and
Optum, in satisfaction of a Medicaid lien from the State of Minnesota. Proffer at 1 (ECF
No. 34). On October 6, 2015, the undersigned issued a decision awarding
compensation in the amount of $128,516.11. (ECF No. 35). Judgment entered on
October 19, 2015. (ECF No. 37).
On January 18, 2016, petitioner filed a status report indicating that Optum had
returned $353.66 of the $3,516.11 paid to satisfy the Medicaid lien after determining a
duplicate amount was listed in the Medicaid lien payoff amount. (ECF No. 40). After
conferring with respondent’s counsel, petitioner’s counsel was told petitioner should
1 Because this unpublished decision contains a reasoned explanation for the action in
this case, I intend to post it 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 (2012)). In accordance with
Vaccine Rule 18(b), petitioner has 14 days to identify and move to redact 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
redact such material from public access.

Case 1:14-vv-00968-UNJ Document 50 Filed 09/19/16 Page 2 of 2
return the overpayment by check to the Division of Injury Compensation
Programs/HRSA. Id.
Following the directions of the undersigned, the OSM staff attorney managing
this case conferred with clerk’s office employees and the parties regarding the best
method for amending the judgment to properly reflect the amount awarded petitioner in
this case. See Informal Remarks dated Feb. 3 and 26, 2016. On March 11, 2016, the
parties filed a joint motion to amend the judgment in this case pursuant to Rule 60(a) of
the Rules of the United States Court of Federal Claims. (ECF No. 41). The parties
request that the Clerk issue judgment reflecting the overpayment already returned to
respondent.2
The undersigned finds the parties’ request to be reasonable. Petitioner’s Motion
is GRANTED. Accordingly, the undersigned directs the Clerk to enter an additional
judgment in favor of respondent in the amount of $353.66, representing reimbursement
for the overpayment of the Medicaid lien amount which already has been repaid by
petitioner.
The clerk of the court is directed to enter judgment in accordance with this
decision.3
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
2 In the motion, the parties indicate petitioner’s counsel processed the check returned to
them from Optum and issued a check in the same amount ($353.66) which they sent to
respondent at the following address:
Ms. Cheryl Lee
Division of Vaccine Injury Compensation/HRSA
5600 Fishers Lane, Mail Stop 08N194B
Rockville, MD 20857
Joint Motion to Amend the Judgment at ¶¶ 5-6. The check was sent on February 19,
2016, delivery was made on February 23, 2016 at 10:48 am, and delivery confirmation
was received that same day. Id. at ¶ 6. “On March 11, 2016, Respondent confirmed
receipt of this reimbursement check.” Id. at ¶ 7.
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.
2