VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_14-vv-01057
Package ID: USCOURTS-cofc-1_14-vv-01057
Petitioner: H.S.
Filed: 2014-10-29
Decided: 2015-10-20
Vaccine: DTaP
Vaccination date: 2012-07-25
Condition: syncope and a skull fracture
Outcome: compensated
Award amount USD: 60212

AI-assisted case summary:
On October 29, 2014, Gregory and Sandra Simpson, as parents and natural guardians for their minor son H.S., filed a petition for compensation under the National Vaccine Injury Compensation Program. They alleged that H.S., born February 7, 2001, received DTaP and meningococcal vaccines on July 25, 2012, and subsequently experienced syncope, fell, and fractured his skull and C1 vertebra. The case was assigned to the Special Processing Unit. Initially, the respondent disputed that H.S. experienced residual effects for at least six months. However, following a ruling on March 13, 2015, by Chief Special Master Denise Kathryn Vowell, which determined the injury persisted for at least six months, the respondent conceded entitlement on May 18, 2015. The respondent agreed that H.S. suffered a syncopal episode within a temporally appropriate timeframe following his vaccinations and experienced six months of residual injuries without evidence of an unrelated factor. Chief Special Master Vowell issued a ruling on entitlement finding H.S. entitled to compensation. The case was reassigned to Chief Special Master Nora Beth Dorsey. The parties continued to negotiate damages, eventually reaching an impasse on pain and suffering, and submitted simultaneous briefs. On September 25, 2015, they filed a joint stipulation agreeing that the only item of compensation besides pain and suffering was $212.40 for past expenses. The undisputed facts indicated that after his vaccinations on July 25, 2012, H.S. experienced syncope and hit the back of his head. A head CT showed a nondisplaced right occipital skull fracture, and a neck CT showed a fracture along the right lateral mass of the C1 vertebra. H.S. was hospitalized overnight and discharged with a hard neck collar. His pediatrician, Dr. Richard Fuchs, indicated in August 2012 that H.S. would need the neck brace through mid-September and would require a one-on-one aid at school for six to eight weeks after the brace was removed due to the risk of re-injury. H.S. experienced a second syncopal episode on September 6, 2012, which was attributed by Dr. Stuart Tashman at a later visit to the neck collar being too tight. Dr. Tashman noted that H.S. was not allowed to play, ride a bike, or play sports for the following year. H.S. saw Dr. Michael Tobias for follow-up on April 1, 2013, and was cleared to return to gym class. He was cleared to resume all activities without restriction on September 30, 2013. The respondent suggested an award of $50,000.00, emphasizing H.S.'s full recovery and the lifting of restrictions after about a year. The petitioners argued for an award greater than de minimis, citing ongoing psychological and emotional pain, isolation from friends and interests, and a year of uncertainty due to doctors' warnings about re-injury. They also asserted, based on H.S.'s mother's declaration, that he was still barred from contact sports and experienced anxiety related to needles. Chief Special Master Dorsey awarded $60,000.00 for pain and suffering, stating this amount accounted for the head trauma, concussion, skull and C1 vertebra fractures, the six-week requirement of a cervical immobilizing brace, and restrictions from gym, play, or sports until April 1, 2013, with full activity resumption by September 30, 2013. The decision noted that claims of ongoing restriction from contact sports and continued emotional stress were not substantiated by the medical records. The total award for pain and suffering and past expenses was $60,212.40. This award was issued on October 20, 2015. Subsequently, on March 9, 2016, the parties filed a stipulation for attorneys' fees and costs. On May 11, 2016, Chief Special Master Dorsey awarded $23,500.00 for attorneys' fees and costs, and $3,322.90 for petitioner's costs, totaling $26,822.90.

Theory of causation field:
Petitioner H.S., a minor born February 7, 2001, received DTaP and meningococcal vaccines on July 25, 2012. The petition alleged syncope and a skull fracture resulting from these vaccinations. The respondent conceded entitlement, agreeing that H.S. suffered a syncopal episode within a temporally appropriate timeframe following vaccination and experienced six months of residual injuries without evidence of an unrelated factor. The Special Processing Unit determined H.S.'s injury persisted for at least six months. Chief Special Master Vowell ruled on entitlement on May 18, 2015. Chief Special Master Dorsey subsequently awarded $60,000.00 for pain and suffering and $212.40 for past expenses, totaling $60,212.40, on October 20, 2015. The award accounted for head trauma, skull and C1 vertebra fractures, and a period of medical restrictions including a neck brace and limitations on activities for approximately one year. The Special Master found this amount fair for a significant but non-permanent injury, noting that claims of ongoing psychological effects and restrictions were not substantiated by medical records. Attorneys' fees and costs of $26,822.90 were awarded on May 11, 2016. The theory of causation was based on the respondent's concession, aligning with the Vaccine Injury Table for syncope.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_14-vv-01057-0
Date issued/filed: 2015-04-06
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 03/13/2015) regarding 22 Findings of Fact & Conclusions of Law (Signed by Chief Special Master Denise Kathryn Vowell. )(mpj) Copy to parties.
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Case 1:14-vv-01057-UNJ Document 23 Filed 04/06/15 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-1057V
Filed: March 13, 2015
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
H.S., by his parents and natural *
guardians, GREGORY and SANDRA *
SIMPSON, *
*
Petitioner, * Finding of Fact; Six Month Requirement;
v. * Special Processing Unit (SPU)
*
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renee Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for petitioner.
Alexis Babckock, U.S. Department of Justice, Washington, D.C., for respondent.
ORDER and RULING ON FACTS1
Vowell, Special Master:
On October 29, 2014, Gregory and Sandra Simpson [“petitioners”] filed a petition
for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C.
§300aa-10, et seq, [the “Vaccine Act” or “Program”] on behalf of their minor son, H.S.
The petition alleges that following the administration of tentanus, diptheria and acellular
pertussis (“Tdap”) and meningococcal vaccines on July 25, 2012, H.S. experienced
syncope and fell to the floor fracturing his skull. Petition at 1. The case was assigned to
the Special Processing Unit [“SPU”].
I. Procedural History
On November 20, 2014, an initial status conference was held with the staff
attorney managing this case. During the status conference, it was noted that the
1 Because this unpublished ruling contains a reasoned explanation for the action in this case, it will be
posted 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 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-01057-UNJ Document 23 Filed 04/06/15 Page 2 of 4
records filed to that date did not readily identify any physical manifestation of H.S.’s
injury lasting at least six months. See Order, February 2, 2015 (ECF No. 20).
Petitioner’s counsel confirmed that petitioners were relying on the fact that H.S. was
under medical restriction from certain physical activities to meet the Vaccine Act’s
statutory six month threshold. (Id.) Petitioners subsequently completed the record and
filed their statement of completion on January 9, 2015. See Statement of Completion
(ECF No. 18).
On January 12, 2015, respondent’s counsel informally requested a fact
determination indicating whether H.S.’s injury persisted for at least six months. See
ECF No. 20. On February 2, 2015, I ordered the parties to file a joint statement
indicating what facts are agreed upon and what facts, if any, are in dispute. Id. The
parties filed their report on March 12, 2015. See Joint Status Report (ECF No. 21).
II. Fact History
According to the parties’ joint report, the following facts are undisputed (see ECF
No. 21):
H.S. received his Tdap and meningococcal vaccinations on July 25, 2015. Ex. 4-
1, p. 14. After receiving those vaccinations, he experienced an episode of syncope and
hit the back of his head. Id., p. 36. At urgent care, a head CT showed a nondisplaced
right occipital skull fracture without bleeding and a neck CT showed a fracture along the
right lateral mass of C1 vertebra, extending into vertebral foramen. Id., pp. 38-39. The
latter finding was considered questionable. Id.
H.S. was referred to Westchester Medical Center for further evaluation and was
hospitalized overnight. See generally Ex. 3. A brain MRI was normal and a C-Spine
MRI showed mild disk space desiccation which was thought to be unrelated to his
syncope episode. Id., pp. 23-24. Following observation, Dr. Michael Tobias discharged
H.S. home with a hard neck collar. Id., p. 3. His injuries were believed to be most likely
caused by a reaction to Menactra. Id., p. 44.
In a letter dated August 15, 2012, H.S.’s pediatrician, Dr. Richard Fuchs,
indicated that H.S. would remain in a neck brace through the middle of September of
that year. Ex. 6, p. 23. Dr. Fuchs further noted that “Following [H.S.]’s confinement to
the neck brace, it will still be medically necessary to excuse him from gym, recess and
sports for an additional six to eight week period . . .Due to the risk of serious
consequences if H.S. were to be reinjured, it will be medically necessary to provide a
one-on-one aid for H.S. while he is in school for the initial six-eight weeks after his
immobilizing brace is removed.” Id.
On September 6, 2012, H.S. experienced a second episode of syncope while at
school. Ex. 2, pp. 16-18. He was sent to the hospital, but was discharged after a normal
physical examination. Id. At a subsequent well-child visit on October 27, 2012, Dr.
Stuart Tashman felt that the September syncope episode was caused by H.S.’s neck

Case 1:14-vv-01057-UNJ Document 23 Filed 04/06/15 Page 3 of 4
collar being too tight and compromising circulation. Ex. 1, p. 2. Although H.S. had no
headaches, weakness, neck pain, and was not taking any medication, Dr. Tashman
noted that H.S. “is not allowed to play, gym, ride a bike or play any sports for the
following year.” Id.
H.S. saw Dr. Tobias for a follow-up on April 1, 2013. Ex. 6, p. 5. He was doing
well clinically and had recovered from his injury. Id. Dr. Tobias cleared H.S. to return to
gym class at that time. Id. H.S. was later cleared to resume all activities without
restriction on September 30, 2013. Ex. 1, p. 12.
III. Discussion
Under the Vaccine Act, a petition for compensation must contain “supporting
documentation, demonstrating that the person who suffered [a vaccine related injury] ...
suffered the residual effects or complications of such illness, disability, injury, or
condition for more than 6 months after the administration of the vaccine.” 42 U.S.C. §
300aa–11(c)(1)(D)(i). The burden of establishing, by a preponderance of the evidence,
the persistence of a vaccine-caused injury for longer than six months is borne by
petitioners. Song v. Sec'y of Health & Human Servs., 31 Fed. Cl. 61, 65–66, aff'd, 41
F.3d 1520 (Fed.Cir.1994).
I have previously noted that “an increased risk of a recurrence without an actual
recurrence of a condition is not medically recognized as a ‘residual effect’ and is not a
residual effect within the meaning of § 300aa-11(c)(1)(D)(i) of the Vaccine Act.” Parsley
v. Sec’y of Health & Human Servs., 08-781V, 2011 WL 2463539, *5 (Fed. Cl. Spec.
Mstr., May 27, 2011). In Parsley, petitioners’ child experienced an intussusception
following a rotovirus vaccination that resolved without surgical intervention in fewer than
six months. Id., *4. Petitioners argued that, despite the lack of any recurrence of
intussusception, their child remained at an increased risk for developing the condition
again in the future, and that this risk constituted a “residual effect” of the injury. Id., *5. I
disagreed.
More recently, however, a fellow special master has persuasively noted that
“because determining the existence, or lack thereof, of clinical symptoms of a disease is
the most obvious and logical means of evaluating the duration of the ‘residual effects or
complications’ of that disease, it is understandable that the concepts are often
conflated. However, ‘residual effects or complications’ and ‘symptomatic’ are not
synonymous; one can suffer from a disease without exhibiting any clinical signs
thereof.” Faup v. Sec’y of Health & Human Servs., 12-87V, 2015 WL 443802, *4 (Fed.
Cl. Spec. Mstr., January 23, 2015). In Faup, the parties agreed that the petitioner was
asymptomatic at least in part because she was being medicated to prevent the
recurrence of her symptoms. The special master concluded that the ongoing need for
medication to prevent a relapse constituted a “residual effect” of her injury. Id.

Case 1:14-vv-01057-UNJ Document 23 Filed 04/06/15 Page 4 of 4
In the instant case, H.S. remained in a neck collar only for about 12 weeks, or
until October of 2012, well shy of the 6 months necessary. Ex. 1, p. 2; Ex. 7, p. 6. After
that, there is no evidence that he experienced any headaches, pain or outward sign of
injury. Nothing in the medical records, however, indicates that his doctors believed that
the removal of the neck brace constituted the resolution of his injury. Indeed, at the
time the collar was removed his doctor indicated based on a CT scan that “the fracture
appears to be healing.” Ex. 7, p. 6. As of April 1, 2013, well beyond six months after the
implicated vaccination, H.S.’s medical records still indicated that a further CT scan was
viewed as necessary to confirm whether the fracture site had fully healed. Ex. 7, p. 8.
Moreover, H.S.’s doctors stressed that he was to remain restricted from activity
after his neck collar was removed. Ex. 6, p. 23; Ex. 7, p. 6. His pediatrician in particular
noted that this was “medically necessary” and that the precautions being taken were
“due to the risk of serious consequences if H.S. were to be reinjured.” Ex. 6, p. 23.
Although H.S.’s restriction from activity was initially only to last 6 to 8 weeks, it was
subsequently extended to one year (ex. 1, p. 2) and indeed was not fully and finally
lifted until September 30, 2013 (ex. 1, p. 12). Thus, H.S.’s doctors clearly believed that
H.S. remained in a vulnerable state and had not returned to his pre-vaccination
condition of health long after he was allowed to remove the neck collar.
These facts indicate that, like the Faup case, H.S.’s lack of outward symptoms of
his injury are not indicative of the length of time his injury persisted. Rather, the records
make clear that H.S.’s doctors were concerned about the presence of his skull fracture
long after he stopped being symptomatic. That is, like Faup, H.S.’s doctors believed
that the restriction from activity was medically necessary as part of H.S.’s treatment
precisely to ensure that further consequences of his injury would not manifest in the
future. In that sense, H.S.’s restriction from certain physical activities is precisely
analogous to the Faup petitioner’s ongoing need for medication.
Despite the reference in the records to a “risk” of re-injury, this case is far
different from Parsley. In Parsley, the petitioners sought to rely on the increase in risk
itself as a residual effect of their child’s injury. Here, the medical restriction due to
increased risk of re-injury constitutes evidence that H.S.’s doctors did not believe his
skull fracture had fully resolved in the first instance.
Thus, I find based on the record as a whole that petitioners have
established that H.S. suffered residual effects of his skull fracture for longer than
six months.
IT IS SO ORDERED.
s/Denise K. Vowell
Denise K. Vowell
Chief Special Master

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DOCUMENT 2: USCOURTS-cofc-1_14-vv-01057-1
Date issued/filed: 2015-06-08
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/18/2015) regarding 26 Ruling on Entitlement (Signed by Chief Special Master Denise Kathryn Vowell.)(mpj) Copy to parties.
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Case 1:14-vv-01057-UNJ Document 29 Filed 06/08/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-1057V
Filed: May 18, 2015
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
H.S., by his parents and natural *
Guardians GREGORY and SANDRA *
SIMPSON, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Diptheria Tetanus and acellular
* Pertussis (“DTaP”); Meningococcal;
SECRETARY OF HEALTH * Syncope; Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renee Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for petitioner.
Alexis Babcock, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Vowell, Chief Special Master:
On October 29, 2014, Gregory and Sandra Simpson filed a petition for
compensation on behalf of their minor son, H.S., under the National Vaccine Injury
Compensation Program, 42 U.S.C. §300aa-10, et seq.,2 [the “Vaccine Act” or
“Program”]. Petitioners allege that As a result of receiving DTaP and meningococcal
vaccines on July 25, 212, H.S. experienced syncope, fell to the floor and fractured his
skull. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
On May 18, 2015, respondent filed her Rule 4(c) report in which she concedes
that petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report
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-01057-UNJ Document 29 Filed 06/08/15 Page 2 of 2
at 1. Specifically, respondent “agrees that the record reflects that H.S. suffered a
syncopal episode following his July 25, 2012 vaccinations, that his episode occurred
within a temporally appropriate timeframe following his vaccinations, and that he
suffered six months of residual injuries.”3 Id. at 4. Respondent further notes “the lack of
any evidence of a factor unrelated that would otherwise explain H.S.’s syncope.” Id.
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
3 Respondent also noted that she initially disputed that H.S. experienced at least six months of residual effects prior
to my order of March 13, 2015, in which I made a factual determination that the injury did persist for at least six
months. Respondent’s Report at 3-4.

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DOCUMENT 3: USCOURTS-cofc-1_14-vv-01057-2
Date issued/filed: 2015-10-20
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 09/25/2015) regarding 40 DECISION of Special Master ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:14-vv-01057-UNJ Document 41 Filed 10/20/15 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-1057V
Filed: September 25, 2015
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
H.S., by his parents and natural *
guardians, GREGORY and SANDRA *
SIMPSON, *
*
Petitioner, * Finding of Fact; Damages;
v. * Pain and Suffering; Syncope;
* Skull Fracture: C1 vertebra Fracture;
SECRETARY OF HEALTH * Medical Restriction; Special
AND HUMAN SERVICES, * Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renee Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for petitioner.
Alexis Babckock, U.S. Department of Justice, Washington, D.C., for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Special Master:
On October 29, 2014, Gregory and Sandra Simpson [“petitioners”] filed a petition
for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C.
§300aa-10, et seq, [the “Vaccine Act” or “Program”] on behalf of their minor son, H.S.
The petition alleges that following the administration of tentanus, diptheria and acellular
pertussis (“Tdap”) and meningococcal vaccines on July 25, 2012, H.S. experienced
syncope and fell to the floor fracturing his skull. Petition at 1. The case was assigned to
the Special Processing Unit [“SPU”].
1 Because this unpublished ruling contains a reasoned explanation for the action in this case, it will be
posted 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 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-01057-UNJ Document 41 Filed 10/20/15 Page 2 of 5
I. Procedural History
On November 20, 2014, an initial status conference was held with the staff
attorney managing this case. During the status conference, it was noted that the
records filed to that date did not readily identify any physical manifestation of H.S.’s
injury lasting at least six months. See Order, February 2, 2015 (ECF No. 20). On
January 12, 2015, respondent’s counsel informally requested a fact determination
indicating whether H.S.’s injury persisted for at least six months. See ECF No. 20.
On February 2, 2015, Chief Special Master Vowell ordered the parties to file a
joint statement indicating what facts are agreed upon and what facts, if any, are in
dispute. Id. The parties filed their report on March 12, 2015. See Joint Status Report
(ECF No. 21). On March 13, 2015, Chief Special Master Vowell ruled that H.S.’s injury
persisted for at least six months. See Finding of Fact and Conclusion of Law, March 12,
2015 (ECF No. 22). Respondent subsequently conceded entitlement and a ruling on
entitlement was issued on May 18, 2015, finding petitioners entitled to compensation.
See Ruling on Entitlement, May 18, 2015 (ECF No. 26).
The case was reassigned to my docket on September 4, 2015. See Notice of
Reassignment, September 4, 2015 (ECF No. 34).
The parties continued to negotiate regarding the appropriate amount of damages
until September 8, 2015, at which time the parties submitted a joint status report
indicating that they were at an impasse regarding the appropriate compensation for
H.S.’s pain and suffering and requested a ruling on that issue. See Joint Status Report,
September 8, 2015 (ECF No. 35). I ordered the parties to file simultaneous briefs
regarding pain and suffering, which they did on September 15, 2015. See Order (Non-
PDF), September 10, 2015; Brief Regarding Pain and Suffering, September 15, 2015
(ECF No. 36); Memorandum, September 15, 2015 (ECF No. 37). On September 25,
2015, the parties filed a joint stipulation indicating that “Other than Pain & Suffering
there is only one other item of compensation: Past Expenses of $212.40.” See Joint
Status Report, September 25, 2015 (ECF No. 39).
The case is now ripe for a determination regarding H.S.’s pain and suffering and
an award of damages.
II. Fact History
According to the parties’ joint report, the following facts are undisputed (see ECF
No. 21):
H.S. was born on February 7, 2001. He received his Tdap and meningococcal
vaccinations on July 25, 2015. Ex. 4-1, p. 14. After receiving those vaccinations, he
experienced an episode of syncope and hit the back of his head. Id., p. 36. At urgent
care, a head CT showed a nondisplaced right occipital skull fracture without bleeding

Case 1:14-vv-01057-UNJ Document 41 Filed 10/20/15 Page 3 of 5
and a neck CT showed a fracture along the right lateral mass of C1 vertebra, extending
into vertebral foramen. Id., pp. 38-39.
H.S. was referred to Westchester Medical Center for further evaluation and was
hospitalized overnight. See generally Ex. 3. A brain MRI was normal. Id., pp. 23-24.
Following observation, Dr. Michael Tobias discharged H.S. home with a hard neck
collar. Id., p. 3. His injuries were believed to be most likely caused by a reaction to
Menactra. Id., p. 44.
In a letter dated August 15, 2012, H.S.’s pediatrician, Dr. Richard Fuchs,
indicated that H.S. would remain in a neck brace through the middle of September of
that year. Ex. 6, p. 23. Dr. Fuchs further noted that “Following [H.S.]’s confinement to
the neck brace, it will still be medically necessary to excuse him from gym, recess and
sports for an additional six to eight week period. .Due to the risk of serious
consequences if H.S. were to be reinjured, it will be medically necessary to provide a
one-on-one aid for H.S. while he is in school for the initial six-eight weeks after his
immobilizing brace is removed.” Id.
On September 6, 2012, H.S. experienced a second episode of syncope while at
school. Ex. 2, pp. 16-18. He was sent to the hospital, but was discharged after a normal
physical examination. Id. At a subsequent well-child visit on October 27, 2012, Dr.
Stuart Tashman felt that the September syncope episode was caused by H.S.’s neck
collar being too tight and compromising circulation. Ex. 1, p. 2. Although H.S. had no
headaches, weakness, neck pain, and was not taking any medication, Dr. Tashman
noted that H.S. “is not allowed to play, gym, ride a bike or play any sports for the
following year.” Id.
H.S. saw Dr. Tobias for a follow-up on April 1, 2013. Ex. 6, p. 5. He was doing
well clinically and had recovered from his injury. Id. Dr. Tobias cleared H.S. to return to
gym class at that time. Id. H.S. was later cleared to resume all activities without
restriction on September 30, 2013. Ex. 1, p. 12.
III. Contentions of the Parties
Respondent stresses that based on the record of this case, it appears that H.S.
fully recovered. ECF No. 36 at 6. Respondent notes that H.S. was pronounced to be
doing well and was said to have recovered from his injury after only three months and
that all of his medical restrictions were lifted after about a year. Id. Respondent also
points out that it was not even clear that H.S. had 6 months of sequelae until the chief
special master ruled that the medical restriction was evidence that the skull fracture had
not fully healed despite the lack of any outward symptoms. Id. at 6, fn. 3. Respondent
suggests an award of $50,000.00. Id. at 8.
Petitioners do not indicate any proposed award, but stress that it should be more
than de minimis. Id. at 3. Though acknowledging that H.S. no longer experiences

Case 1:14-vv-01057-UNJ Document 41 Filed 10/20/15 Page 4 of 5
physical pain from his fracture, they claim that he has ongoing psychological and
emotional pain. ECF No. 37 at 4. They stress that H.S. experienced a year of
uncertainty caused by his doctors telling him of severe consequences of re-injury. Id. at
5. They also stress that throughout his recovery he experienced isolation from friends
and interests and that such isolation was particularly difficult for a junior-high student
such as H.S. Id.
Despite the lifting of all restrictions noted in the medical records, petitioners
assert, based on a declaration by H.S.’s mother, that H.S. is still is barred from contact
sports. Id. at 4. They also assert, again based the same declaration, that H.S. now
experiences ongoing anxiety and emotional distress related to needles, asserting one
instance where in H.S. was allegedly given Diazapam (valium) prior to a contrast
injection for MRI. Id.
IV. Discussion
After review of the entire record as well as the parties’ briefing, I find that
$60,000.00 represents a fair and appropriate amount of compensation for H.S.’s past
and future pain and suffering. This amount accounts for the fact that H.S. had head
trauma, concussion, and skull and C1 vertebra fractures, requiring a hard plastic
cervical immobilizing brace for six weeks, as evidenced by Dr. Fuch's records (Ex. 4 at
13; see also Ex. 4 at 35, 38). Moreover, it also reflects the fact that he was restricted
from gym, play or sports until April 1, 2013, and unable to return to all activities until
September 20, 2013.
Furthermore, this finding is in accord with prior awards within the Vaccine
Program. Compensation for syncope claims in the Vaccine Program range from
$25,000.00 to $175,000.00.2 See Doenges v. HHS, 11-893v (Fed. Cl. Spec. Mstr. May
22, 2014) (awarding $25,000.00 for postural orthostatic tachycardia syndrome (POTS),
syncope, neurologic impairments, including a seizure disorder, physical impairments,
conversion disorder, and/or other injuries.), and Stark v. HHS, No. 13-115V, 2014 WL
346450 (Fed. Cl. Spec. Mstr. Jan. 6, 2014) (awarding $175,000.00 for syncope resulting
in severe head trauma, right subdural hemotoma, non-depressed skull fracture, seizure
disorder, post-traumatic cognitive and physical impairments, headaches, fatigue,
dizziness).
Significantly, however, many of the prior syncope cases resulted in either
permanent injury or significant future medical expenses, neither of which is present in
the instant case. See, e.g. Stark, supra; see also DiTomasso v. HHS, No. 09-611V,
2011 WL 1490343 (Fed. Cl. Spec. Mstr. Mar. 29, 2011) (awarding $70,000.00 for
syncope and fall with injury to face, including damage to several teeth requiring future
dental care), Neff v. HHS, No. 08-0906V, 2010 WL 2710646 (Fed. Cl. Spec. Mstr. June
2 Respondent cited an additional case, Klug v. HHS, No. 10-574V, 2012 WL 5210575
(Fed. Cl. Spec. Mstr. Sept. 24, 2012), which awarded $20,000.00. That case, however,
does not appear to involve syncope or skull fracture.

Case 1:14-vv-01057-UNJ Document 41 Filed 10/20/15 Page 5 of 5
15, 2010) (awarding $110,000.00 for syncope resulting in concussion, intracranial
hemorrhage and ongoing loss of sense of smell.) Prior syncope cases without apparent
ongoing or future medical issues had awards ranging from $25,000.00 to $40,000.00.
See, e.g. Doenges, supra; see also Jones v. HHS, 09-670v (Fed. Cl. Spec. Mstr. Mar.
12, 2012) (awarding $40,000.00 for syncope, allergic reaction, and symptoms of
orthostatic hypotension). 3
Petitioners have stressed that the instant case is not simply one of syncope, but
also skull fracture, a serious injury with accompanying restrictions and emotional stress.
ECF No. 37 at 3. Respondent, on the other hand, has stressed that H.S. has made a
complete physical recovery. ECF No. 36 at 6. An award of $60,000.00 in this case,
falling below the amounts previously awarded where permanent injury is at issue, but
above the lesser amounts previously awarded, reflects that H.S. experienced a
significant, but non-permanent injury. To the extent petitioners argued that H.S. has
ongoing restriction from contact sports and continued emotional stress, those assertions
do not appear to be substantiated by any medical records filed in this case.
V. Conclusion
For all of the reasons described above, and based on consideration of the record
as a whole, I find that $60,000.00 represents a fair and appropriate amount of
compensation for H.S.’s past and future pain and suffering. In addition, I find based on
the parties’ joint stipulation, that petitioner is also entitled to compensation for $212.40
in past unreimbursable medical expenses.
Therefore, I award petitioner a lump sum payment of $60,212.40 in the form
of a check payable to petitioners, Gregory and Sandra Simpson as
guardians/conservators of H.S., for the benefit of H.S. 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.4
s/ Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 I am also mindful of the fact that these lesser prior awards were based upon
agreements reached by the parties rather than being the result of reasoned decisions in
contested cases. Some of these awards may have reflected factors related to litigative
risk or other unstated considerations.
4 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by each party
filing a notice renouncing the right to seek review.

================================================================================
DOCUMENT 4: USCOURTS-cofc-1_14-vv-01057-3
Date issued/filed: 2016-05-11
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 03/25/2016) regarding 50 DECISION Fees Stipulation/Proffer, ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:14-vv-01057-UNJ Document 53 Filed 05/11/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 14-1057V
Filed: March 25, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
H.S., by his parents and natural *
Guardians GREGORY and SANDRA *
SIMPSON *
*
Petitioner, *
v. *
* Attorneys’ Fees and Costs; Stipulation
SECRETARY OF HEALTH * Special Processing Unit (“SPU”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renee Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for petitioner.
Alexis Babcock, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON ATTORNEYS’ FEES AND COSTS1
Dorsey, Chief Special Master:
On October 29, 2014, 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”]. Petitioner alleged that H.S. suffered syncope and a skull fracture
following administration of his July 25, 2012 DTaP and meningococcal vaccinations. On
September 25, 2015, the undersigned issued a decision awarding compensation to
petitioner.
On March 9, 2016, the parties filed a Stipulation of Fact Concerning Attorneys’
Fees and Costs. According to the stipulation, the parties stipulate to a total award of
1 Because this unpublished decision contains a reasoned explanation for the action in this case, the
undersigned intends 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). 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 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-01057-UNJ Document 53 Filed 05/11/16 Page 2 of 2
$23,500.00 for attorneys’ fees and costs. In accordance with General Order #9,
petitioner’s counsel represents that petitioner incurred $3,322.90 in out-of-pocket
expenses.
The Vaccine Act permits an award of reasonable attorneys’ fees and costs.
§ 15(e). Based on the reasonableness of petitioner’s request and the lack of any
objection by respondent, the undersigned GRANTS the request for approval and
payment of attorneys’ fees and costs.
Accordingly, the undersigned awards the total of $26,822.903 as follows:
• A lump sum of $23,500.00, representing reimbursement for
attorneys’ fees and costs, in the form of a check payable jointly to
petitioner and petitioner’s counsel, Renee J. Gentry; and
• A lump sum of $3,322.90, representing reimbursement for
petitioner’s costs, in the form of a check payable to petitioner.
The clerk of the court shall enter judgment in accordance herewith.4
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 This amount is intended to cover all legal expenses incurred in this matter. This award encompasses all
charges by the attorney against a client, “advanced costs” as well as fees for legal services rendered.
Furthermore, § 15(e)(3) prevents an attorney from charging or collecting fees (including costs) that would
be in addition to the amount awarded herein. See generally Beck v. Sec’y of Health & Human Servs.,
924 F.2d 1029 (Fed. Cir.1991).
4 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.