VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-00982
Package ID: USCOURTS-cofc-1_14-vv-00982
Petitioner: Tesha Smith
Filed: 2014-10-14
Decided: 2019-10-23
Vaccine: influenza
Vaccination date: 2012-02-01
Condition: Guillain-Barré Syndrome (“GBS”)
Outcome: compensated
Award amount USD: 646339

AI-assisted case summary:
On October 14, 2014, Tesha Smith filed a petition in the National Vaccine Injury Compensation Program alleging that an influenza vaccine administered in February 2012 caused her to develop Guillain-Barré Syndrome (GBS). The respondent, the Secretary of Health and Human Services, denied that the vaccine caused the GBS. The parties reached a stipulation for compensation, which Special Master Nora Beth Dorsey adopted as the decision of the Court on October 23, 2019. The stipulation stated that petitioner received a covered flu vaccine on an unspecified date in February 2012 in the United States and alleged that this vaccine caused her to develop GBS with residual effects lasting more than six months. The public decision does not describe the onset of symptoms, specific medical tests, or treatments. The parties agreed to a total compensation award of $646,339. This amount included a lump sum payment of $522,882 payable to petitioner, a payment of $25,338.40 jointly to petitioner and Optum to satisfy a State of Florida Medicaid lien, and a payment of $98,119.60 jointly to petitioner and the Agency for Health Care Administration, Florida Medicaid Casualty Recovery Program, to satisfy another State of Florida Medicaid lien. Additionally, an amount sufficient to purchase an annuity contract was allocated for future medical expenses, ancillary services, equipment, medications, attendant care, and transportation. The annuity payments were structured with specific annual amounts, increasing at 3% compounded annually, with varying durations based on specific years and petitioner's lifetime. The annuity contract was to be owned by the Secretary of Health and Human Services and purchased from a life insurance company meeting specific financial and rating criteria. The stipulation also addressed future attorneys' fees and costs, and petitioner released the United States and the Secretary of Health and Human Services from further liability related to the alleged vaccine injury. The decision notes that the stipulation represents a full and complete negotiated settlement of liability and damages, except for attorneys' fees and costs, and is not an admission of causation by the respondent. Petitioner was represented by Renee J. Gentry of The Law Office of Renee J. Gentry, and respondent was represented by Ryan D. Pyles of the U.S. Department of Justice.

Theory of causation field:
Petitioner Tesha Smith alleged that an influenza vaccine administered in February 2012 caused her to develop Guillain-Barré Syndrome (GBS). This case proceeded as a Table claim, as GBS is listed on the Vaccine Injury Table for the influenza vaccine. The respondent denied causation. The parties reached a stipulation for compensation, adopted by Special Master Nora Beth Dorsey on October 23, 2019. The total award was $646,339, comprising a lump sum of $522,882, payments totaling $123,458 for Florida Medicaid liens, and funds for an annuity contract covering future medical expenses, ancillary services, equipment, medications, attendant care, and transportation. The public decision does not detail the specific mechanism of injury, expert testimony, or clinical findings. Petitioner was represented by Renee J. Gentry, and respondent by Ryan D. Pyles.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_14-vv-00982-0
Date issued/filed: 2017-07-10
Pages: 5
Docket text: PUBLIC RULING (Originally filed: 06/02/2017) regarding 56 Findings of Fact & Conclusions of Law. Signed by Special Master Brian H. Corcoran. (sb) Copy to parties.
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Case 1:14-vv-00982-UNJ Document 57 Filed 07/10/17 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-982V
(not to be published)
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* Special Master Corcoran
TESHA SMITH, *
* Filed: June 2, 2017
Petitioner, *
* Proof of Vaccination; Ruling
v. * on Record.
*
SECRETARY OF HEALTH AND *
HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renée Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for Petitioner.
Ryan Pyles, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING ON PROOF OF VACCINATION1
In this petition, initially filed on October 14, 2014, Tesha Smith seeks to establish that the
influenza (“flu”) vaccine that she alleges to have received sometime in February 2012 caused her
to develop Guillain-Barré syndrome (“GBS”). To date, however, Petitioner has been unable to
locate documentary proof of vaccination, opting instead to attempt to bolster the record with
circumstantial evidence of vaccination, prompting Respondent to move for a ruling on that issue or
a dismissal of the matter. See Motion for Ruling on Record with Regard to Vaccine Administration,
dated November 15, 2016 (ECF No. 45). After my review of the evidence submitted, I find that
Petitioner has established adequate proof of vaccination.
1 Although his Ruling has been formally designated “not to be published,” it will nevertheless be posted on the Court
of Federal Claims’s 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)). As provided by 42 U.S.C. § 300aa-12(d)(4)(B),
however, the parties may object to the inclusion of certain kinds of confidential information. To do so, Vaccine Rule
18(b) provides that 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). Otherwise, the ruling will be available to the public. Id.

Case 1:14-vv-00982-UNJ Document 57 Filed 07/10/17 Page 2 of 5
I. Factual Background
Petitioner alleges that she received a flu vaccine in February 2012 through her employer,
Pilgrim’s Pride Corporation in Live Oak, Florida. Petition at 1. Approximately two months later,
on April 10, 2012, Ms. Smith was seen at Doctor’s Memorial Hospital (“DMH”) in Perry, Florida
complaining of lower back and neck pain. Ex. 1 at 10. The records indicate that Ms. Smith’s doctors
believed the cause of the pain was “unknown chronic” and reported that she was unemployed. Id.
at 10-12. Before being discharged the following day, Ms. Smith underwent a complete blood count
(CBC), a urine analysis, and a comprehensive metabolic panel (CMP)—all of which produced
normal results. Id. at 14-16.
Shortly thereafter, on April 18, 2012, Ms. Smith was taken by ambulance to DMH for “left
arm and leg weakness and feels like mouth is twisted for a few hours,” stating further that she
thought she had suffered a seizure. Ex. 1 at 18-19. Despite again being noted as unemployed, a note
from this visit indicated “p[atien]t took a nap after patient got home from work yesterday- woke up
with a heavy feeling on left side-woke up this am to go to work and [had] the continued heaviness
and slurred speech.” Id. at 19. Petitioner was then transferred to Tallahassee Memorial Hospital
(“TMH”) where her condition worsened to complete paralysis, but eventually slowly improved
throughout her three month stay at TMH, during which time she was also formally diagnosed with
GBS. Ex. 3 at 1. Ultimately, Petitioner was discharged to Miller Nursing Home in July 2012, where
she used a wheelchair to get around and continued to have slurred speech. Ex. 2 at 834. The records
from Miller Nursing Home extend through October 2014, after which new records have not been
filed.
II. Exhibits Filed to Establish Proof of Vaccination
After Ms. Smith filed the medical records referenced above, she offered letters from family
members attempting to bolster her assertion that she received the flu vaccine in February 2012.
Because I found that these letters established at least a circumstantial case in her favor, I ordered
Respondent to file his Rule 4(c) Report, which he did on January 15, 2016. Thereafter, the parties
began engaging in settlement discussions hung up on the issue of lack of proof of vaccination. On
November 15, 2016, Respondent filed a Motion for Ruling on the Record and a Motion to Dismiss
based on the proof of vaccination issue. ECF No. 45.
I allowed Petitioner the opportunity to have more time to propound additional exhibits,
which would support her claim that she received the flu vaccine in February 2012. This process
continued until May 30, 2017, when I held a status conference to discuss progress in obtaining
additional that evidence. At this time, Petitioner informed me that she had completed filing all the
additional items she was able to obtain.
2

Case 1:14-vv-00982-UNJ Document 57 Filed 07/10/17 Page 3 of 5
The first of the filed items is the sworn affidavit from Petitioner herself. Ex. 11. In it she
states, that she remembered seeing flyers all around Pilgrim’s Pride offering the flu shot to
employees. Id. at 1. Ms. Smith recalled telling her coworker, Fallon Steadman, that she was going
to receive the flu shot and that Ms. Steadman advised her against it, but that Ms. Smith felt safe
receiving the vaccine as she had done in previous years. Ex. 11 at ¶3.
Petitioner also filed an affidavit from Ms. Steadman, who often drove Ms. Smith to work
and was at Pilgrim’s Pride the day that Ms. Smith purportedly received her flu shot. Ex. 10. Like
Ms. Smith, Ms. Steadman stated in her affidavit that she remembered seeing flyers in the locker
room at Pilgrim’s Pride promoting the flu shot for free to employees. Id. at 1. She stated that she
had a specific memory of this event because she was scared to receive a flu shot and did not want
Ms. Smith to receive one. Id. Nonetheless, Ms. Steadman recalled meeting up with Ms. Smith after
a break, at which time Ms. Smith told her that she had received the flu vaccine. Id. Although Ms.
Steadman could not place this event to a specific day, she recalled that it occurred in mid-February
2012. Id.
Despite repeatedly contacting Pilgrim’s Pride directly, Petitioner has been unable to obtain
direct proof of the date that Pilgrim’s Pride provided the vaccine, or if Ms. Smith received the
vaccine, as the nurse who administered the vaccine retired and could not be located for a statement.
Nonetheless, Petitioner filed a statement from Pilgrim’s Pride listing the lot number for the flu
vaccine that it had administered. See generally Ex. 9. As mentioned previously, Petitioner also
provided several brief witness statements and Ms. Smith’s pay history, as well as her request for
medical leave to “have her health assessed” in early March 2012. See e.g., Exs. 4 and 6. The
statements were provided by Ms. Smith’s daughter, mother, and Fallon Steadman.2 Each statement
was unsworn, and recalled that Ms. Smith had received the flu vaccine in February 2012 and
thereafter began to experience health problems. Ex. 4.
III. Analysis
A Vaccine Act petitioner must, as a threshold matter in advancing a claim for damages,
establish by a preponderance of the evidence receipt of “a vaccine set forth in the Vaccine Injury
Table.” § 300aa–11(c)(1)(A). The preponderance of the evidence standard means that an allegation
is established to be “more likely than not.” Moberly v. Sec’y of Health & Human Servs., 592 F.3d
1315, 1322 n.2 (Fed. Cir. 2010).
Although contemporaneous documentation of vaccination from a healthcare provider is the
best evidence that a vaccination occurred, it is not absolutely required in all cases. Centmehaiey v.
Sec’y of Health & Human Servs., 32 Fed. Cl. 612, 621 (1995) (“[t]he lack of contemporaneous
2 The statement by Fallon Steadman is substantively the same as her later sworn testimony but the former was not an
affidavit and not made under penalty of perjury.
3

Case 1:14-vv-00982-UNJ Document 57 Filed 07/10/17 Page 4 of 5
documentary proof of a vaccination . . . does not necessarily bar recovery”). Indeed, as Vaccine
Rule 2 states, “[i]f the required medical records are not submitted, the petitioner must include an
affidavit detailing the efforts made to obtain such records and the reasons for their unavailability.”
Vaccine Rule 2(c)(2)(B)(i). Furthermore, if a petitioner’s claim is “based in any part on the
observations or testimony of any person, the petitioner should include the substance of each person's
proposed testimony in a detailed affidavit(s) supporting all elements of the allegations made in the
petition.” Vaccine Rule 2(c)(2)(B)(ii).
Special masters have thus found that vaccine administration occurred even in the absence
of direct documentation. In such cases, preponderant evidence was provided in the form of other
medical records and/or witness testimony. For example, corroborative, though backward-looking,
medical notations have been found to tip the evidentiary scale in favor of vaccine receipt. Lamberti
v. Sec’y of Health & Human Servs., No. 99–507V, 2007 WL 1772058, at *7 (Fed. Cl. Spec. Mstr.
May 31, 2007) (finding multiple medical record references to vaccine receipt constituted adequate
evidence of administration); Groht v. Sec’y of Health & Human Servs., No. 00–287V, 2006 WL
3342222, at *2 (Fed. Cl. Spec. Mstr. Oct. 30, 2006) (finding a treating physician's note—“4/30/97—
Hep B. inj. # 1 (not given here) (pt. wanted this to be charted)”—to be sufficient proof of
vaccination); Wonish v. Sec'y of Health & Human Servs., No. 90–667V, 1991 WL 83959, at *4 (Cl.
Ct. Spec. Mstr. May 6, 1991) (finding parental testimony “corroborated strongly by medical records
[referring] back to the [vaccination]” to be sufficient to establish vaccine administration).
In addition to corroborative medical records, witness testimony can also help establish a
sufficient basis for a finding that a vaccine was administered as alleged. Alger v. Sec’y of Health &
Human Servs., No. 89–31V, 1990 WL 293408, at *2, 7 (Fed. Cl. Spec. Mstr. Mar. 14, 1990) (oral
testimony from a parent and the doctor who administered the vaccine was “more than adequate to
support a finding that the vaccine was administered”). The Court of Federal Claims has recognized
that special masters may base a finding of vaccination on lay testimony. Epstein v. Sec'y of Health
& Human Servs., 35 Fed. Cl. 467, 478 (Fed. Cl. 1996); see also Brown v. Sec'y of Health & Human
Servs., 18 Cl. Ct. 834, 839–40 (1989) (proof of vaccination in the absence of contemporaneous
medical records established via testimony of petitioner’s parent, her personal calendar, and
evidence of a charge for the vaccine on the physician's billing statement), rev’d on other grounds,
920 F.2d 918 (Fed. Cir. 1990).
In the present case, Petitioner has marshaled barely enough circumstantial evidence for me
to conclude that she more likely than not received the flu vaccine in February 2012. Petitioner
produced email correspondence from Pilgrim’s Pride indicating that they provided vaccinations to
employees—albeit not confirming a time period—along with the vaccine lot number for the vaccine
that was given. Exs. 6 and 9. Ms. Smith also filed her own sworn affidavit, as well as the affidavit
of Fallon Steadman, both confirming that Ms. Smith received the vaccine in February 2012. Ms.
4

Case 1:14-vv-00982-UNJ Document 57 Filed 07/10/17 Page 5 of 5
Steadman’s affidavit provides sufficient corroboration of Ms. Smith’s allegations to accept these
allegations as likely true.
Admittedly the medical records herein do not indicate that Ms. Smith had received a flu
vaccine. It appears however, that the lack of evidence in the medical records may have been due to
Petitioner’s inability to communicate her medical history when she was hospitalized at TMH. She
reported extremity weakness and heaviness deteriorating to the point of her needing intubation to
breath, eventually resulting in temporary full paralysis, and allowing her to communicate only by
eye movements. Such a physical state would make it very difficult to accurately report a medical
history and any recent vaccinations. While it appears from the records that the doctors were able to
receive a more complete medical history from Petitioner at some point after her admission, I do not
find it entirely implausible that a flu vaccine received two months prior to hospitalization could
have been accidently omitted by Petitioner when reciting her medical history under the
circumstances. Taking all the evidence presented as a whole, I find that there is enough
circumstantial evidence in the record to suggest that Ms. Smith received a flu vaccination in
February 2012 as Petitioner alleges.
CONCLUSION
Based upon my review of the record, including the affidavits and witness statements, and
the legal arguments of the parties, I find that Petitioner has established by preponderant evidence
that she received the flu vaccination on an unspecified date in February 2012.
This ruling makes no determination of any kind as to whether Ms. Smith’s alleged damages
are a result of an adverse reaction to the flu vaccination. That will be the subject of future
proceedings.
IT IS SO ORDERED.
/s/ Brian H. Corcoran
Brian H. Corcoran
Special Master
5

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DOCUMENT 2: USCOURTS-cofc-1_14-vv-00982-1
Date issued/filed: 2019-11-19
Pages: 11
Docket text: PUBLIC DECISION (Originally filed: 10/23/2019) regarding 89 DECISION Stipulation. Signed by Special Master Nora Beth Dorsey. (mjf) Service on parties made.
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Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 1 of 11
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
Filed: October 23, 2019
* * * * * * * * * * * * * * * * * * *
TESHA SMITH, * UNPUBLISHED
*
*
Petitioner, * No. 14-982
*
v. * Special Master Dorsey
*
SECRETARY OF HEALTH * Decision Based on Stipulation;
AND HUMAN SERVICES, * Influenza (Flu) Vaccine;
* Guillain-Barré Syndrome (“GBS”)
Respondent. *
*
* * * * * * * * * * * * * * * * * * *
Renee J. Gentry, The Law Office of Renee J. Gentry, Washington, DC, for petitioner.
Ryan D. Pyles, US Department of Justice, Washington, DC, for respondent.
DECISION BASED ON STIPULATION1
On October 14, 2014, Tesha Smith (“petitioner”) filed a petition in the National Vaccine
Injury Compensation Program.2 Petitioner alleged that as a result of an influenza (“flu”) vaccine
administered to her in February 2012, petitioner suffered from Guillain-Barré Syndrome
(“GBS”). Petition at 1.
1 Because this Decision contains a reasoned explanation for the action in this case, the
undersigned is required to post it on the United States Court of Federal Claims’ website in
accordance with the E-Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal
Management and Promotion of Electronic Government Services). This means the Decision will
be available to anyone with access to the Internet. 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, the undersigned
agrees that the identified material fits within this definition, the undersigned will redact such
material from public access.
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 (2012) (“Vaccine Act” or “the Act”). All citations in this
decision to individual sections of the Vaccine Act are to 42 U.S.C. § 300aa.
1

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 2 of 11
On October 22, 2019, the parties filed a stipulation recommending an award of
compensation to petitioner. Stipulation (ECF No. 88). Respondent denies that the flu vaccine
caused petitioner to suffer from GBS or any other injury. 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:
(1) An amount sufficient to purchase the annuity contract described in paragraph
10, paid to the life insurance company from which the annuity will be
purchased;
(2) A lump sum payment of $25,338.40, representing compensation for satisfaction
of a State of Florida Medicaid lien, payable jointly to petitioner and:
Optum
74 Remittance Drive, Ste 6019
Chicago, IL 60675-6019
Tax ID: 41-1858498
Petitioner agrees to endorse this payment to the State and/or State’s designee;
(3) A lump sum payment of $98,119.60, representing compensation for satisfaction
of a State of Florida Medicaid lien, payable jointly to petitioner and:
Agency for Health Care Administration
Florida Medicaid Casualty Recovery Program
P.O. Box 12188
Tallahassee, FL 32317-2188
Petitioner agrees to endorse this payment to the State and/or State’s designee;
and
(4) A lump sum of $522, 882.00 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). Stipulation at ¶ 8.
The undersigned approves the requested amount for petitioners’ compensation.
Accordingly, an award should be made consistent with the stipulation.
In the absence of a motion for review filed pursuant to RCFC Appendix B, the Clerk of
Court SHALL ENTER JUDGMENT in accordance with the terms of the parties’ stipulation.3
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 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 3 of 11
IT IS SO ORDERED.
s/Nora B. Dorsey
Nora B. Dorsey
Special Master
3

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 4 of 11
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
TESHA SMITH,
Petitioner,
No. 14-982V
v.
Special Master Nora Beth Dorsey
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. Tesha Smith ("petitioner") filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-l Oto 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of an influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the
"Table"), 42 C.F.R. § 100.3(a).
2. Petitioner alleges that she received a flu vaccine in February 2012. On June 2, 2017,
the Court ruled that petitioner received a covered flu vaccine "on an unspecified date in February
2012."
3. Petitioner alleges that the vaccine was administered within the United States.
4. Petitioner alleges that the flu vaccine caused her to develop Guillain-Barre Syndrome
("OBS") and that she experienced residual effects of this injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages as a result of her condition.

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 5 of 11

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 6 of 11
Petitioner agrees to endorse this payment to the State and/or the State's designee; and
d. A lump sum of $522,882.00 in the form of a check payable to petitioner. This amount
represents all remaining compensation for damages that would be available under 42
2
U.S.C. § 300aa-15(a).
9. The Life Insurance Company must have a minimum of $250,000,000 capital and
surplus, exclusive of any mandatory security valuation reserve. The Life Insurance Company
must have one of the following ratings from two of the following rating organizations:
a. A.M. Best Company: A++, A+, A+g, A+p, A+r, or A+s;
b. Moody's Investor Service Claims Paying Rating: Aa3, Aa2, Aal, or Aaa;
c. Standard and Poor's Corporation Insurer Claims-Paying Ability Rating: AA-,
AA, AA+, or AAA;
d. Fitch Credit Rating Company, Insurance Company Claims Paying Ability Rating:
AA-, AA, AA+, or AAA.
l0. The Secretary of Health and Human Services agrees to purchase an annuity contract
from the Life Insurance Company for the benefit of petitioner, pursuant to which the Life
Insurance Company will agree to make payments periodically to petitioner for the following
items of compensation:
a. For future medical insurance and medical care expenses, beginning on the first
anniversary of the date of judgment, an annual amount of $2,040.00 to be paid up to the
anniversary of the date of judgment in year 2036; then beginning on the anniversary of the date
of judgment in year 2036, an annual amount of $2,229.68 to be paid for the remainder of
petitioner's life, all amounts increasing at the rate of three percent (3%), compounded annually
from the date of judgment;
b. For future ancillary services, beginning on the first anniversary of the date of
judgment, an annual amount of$ 1,058.00 to be paid up to the anniversary of the date of
judgment in year 2024; then beginning on the anniversary of the date of judgment in year 2024
an annual amount of$98.00 to be paid up to the anniversary of the date of judgment in year
2036; then beginning on the anniversary of the date of judgment in year 2036 an annual amount
of$ 18.00 to be paid for the remainder of petitioner's life, all amounts increasing at the rate of
three percent (3%), compounded annually from the date of judgment;
2 This sum includes$ 141,882.00 for future life care plan expenses for the first year following
the entry of judgment.
3

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 7 of 11
c. For future equipment and supplies, beginning on the first anniversary of the date of
judgment, an annual amount of$ 2,370.86 to be paid up to the anniversary of the date of
judgment in year 2036; then beginning on the anniversary of the date of judgment in year 2036 a
one-time amount of$ 2,229.70; then beginning on the anniversary of the date of judgment in year
2037 an annual amount of$ 2,300.11 to be paid for the remainder of petitioner's life, all amounts
increasing at the rate of three percent (3%), compounded annually from the date of judgment;
d. For future medications, beginning on the first anniversary of the date of judgment, an
annual amount of$ 957.08 to be paid up to the anniversary of the date of judgment in year 2036,
then beginning on the anniversary of the date of judgment in year 2036, an annual amount of
$911.46 to be paid for the remainder of petitioner's life, all amounts increasing at the rate of
three percent (3%), compounded annually from the date of judgment;
e. For future attendant care and case management services, beginning on the first
anniversary of the date of judgment, an annual amount of$37,100.00 to be paid up to the
anniversary of the date of judgment in year 2036; then beginning on the anniversary of the date
of judgment in year 2036 an annual amount of$ 44,100.00 to be paid for the remainder of
petitioner's life, all amounts increasing at the rate of three percent (3% ), compounded annually
from the date of judgment; and
f. For future transportation expenses, beginning on the first anniversary of the date of
judgment, an annual amount of$ 6,600.00 to be paid for the remainder of petitioner's life, all
amounts increasing at the rate of three percent (3%), compounded annually from the date of
judgment.
At the sole discretion of the Secretary of Health and Human Services, the periodic
payments may be provided to petitioner in monthly, quarterly, annual or other installments. The
"annual amounts" set forth above describe only the total yearly sum to be paid to petitioner and
do not require that the payment be made in one annual installment. Petitioner will continue to
receive the annuity payments from the Life Insurance Company only so long as petitioner is
alive at the time that a particular payment is due. Written notice to the Secretary of Health and
Human Services and the Life Insurance Company shall be provided within twenty (20) days of
petitioner's death.
11. The annuity contract will be owned solely and exclusively by the Secretary of Health
and Human Services and will be purchased as soon as practicable following the entry of a
judgment in conformity with this Stipulation. The parties stipulate and agree that the Secretary
4

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 8 of 11
of Health and Human Services and the United States of America are not responsible for the
payment of any sums other than the amounts set forth in paragraph 8 herein, and that they do not
guarantee or insure any of the future annuity payments. Upon the purchase of the annuity
contract, the Secretary of Health and Human Services and the United States of America are
released from any and all obligations with respect to future annuity payments.
12. 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-2 I (a)( I), 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.
I3 . Petitioner and her attorney represent that they have identified to respondent all
known sources of payment for items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), including 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 entities that provide health services on a pre-paid basis.
14. Payments made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 12 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-15(i),
subject to the availability of sufficient statutory funds.
15. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys' fees and litigation costs, and past unreimbursable expenses, 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).
5

Case 1:14-vv-00982-UNJ Document 95 Filed 11/19/19 Page 9 of 11
16. In return for the payments described in paragraphs 8 and 12, petitioner, in her
individual capacity and on behalf of her heirs, executors, administrators, successors and/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 flu vaccine that the Court ruled
was administered in February 2012, as alleged by petitioner in a petition for vaccine
compensation fled on or about October 14, 2014, in the United States Court of Federal Claims
as petition No. 14-982V.
17. If petitioner should die prior to entry of the judgment, this agreement shall be
voidable upon proper notice to the Court on behalf of either or both of the parties.
18. 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.
19. 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 12 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
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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.
20. Petitioner hereby authorizes respondent to disclose documents filed by petitioner in
this case consistent with the Privacy Act and the routine uses described in the National Vaccine
Injury Compensation Program System of Records, No. 09-15-0056.
21. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that petitioner received a flu vaccine in 2012, and/or
that the alleged flu vaccine caused of petitioner's alleged GBS and/or any other injury.
22. All rights and obligations of petitioners hereunder shall apply equally to petitioners'
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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