VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-00295
Package ID: USCOURTS-cofc-1_15-vv-00295
Petitioner: Ann Wyborski
Filed: 2015-03-23
Decided: 2016-05-04
Vaccine: influenza
Vaccination date: 2013-09-13
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 267999

AI-assisted case summary:
Ann Wyborski filed a petition for compensation under the National Vaccine Injury Compensation Program on March 23, 2015, alleging that an influenza vaccination on September 13, 2013, caused her to suffer a shoulder injury related to vaccine administration (SIRVA). The respondent conceded that the petitioner's SIRVA was more likely than not caused by the flu vaccination and that she met all legal prerequisites for compensation. A ruling on entitlement was issued on June 4, 2015. Subsequently, on December 3, 2015, the parties filed a proffer on award of compensation, agreeing to a total award of $236,492.00. This amount represented projected vaccine-related injury expenses, past lost earnings, pain and suffering, and past unreimbursable expenses. The decision awarding damages was issued on April 25, 2016. On January 19, 2016, petitioner filed a motion for attorneys' fees and costs, and on February 1, 2016, the parties stipulated to an award of $30,412.75 in attorneys' fees and $1,093.86 in costs, plus $56.49 for petitioner's own costs. The final decision on attorneys' fees and costs was issued on May 4, 2016, granting the stipulated amounts.

Theory of causation field:
Table

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_15-vv-00295-0
Date issued/filed: 2015-06-25
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/04/2015) regarding 12 Ruling on Entitlement ( Signed by Chief Special Master Denise Kathryn Vowell.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:15-vv-00295-UNJ Document 14 Filed 06/25/15 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-0295V
Filed: June 4, 2015
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANN WYBORSKI, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Influenza (“flu”) vaccine; Shoulder Injury
v. * Related to Vaccine Administration
* (“SIRVA”); Special Processing Unit
* (“SPU”)
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renee J. Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for petitioner.
Lisa A. Watts, U.S. Department of Justice, Washington, DC, for respondent.
1
RULING ON ENTITLEMENT
Vowell, Chief Special Master:
On March 23, 2015, Ann Wyborski 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”]. The petition alleges that as a result of an Influenza (“flu”)
vaccination on September 13, 2013, petitioner suffered a shoulder injury related to
vaccine administration (“SIRVA”). The case was assigned to the Special Processing
Unit of the Office of Special Masters.
On June 4, 2015, respondent filed her Rule 4(c) report [“Respondent’s Report”],
in which she concedes that petitioner is entitled to compensation in this case.
Respondent’s Report at 1. Specifically, respondent “agrees that petitioner’s SIRVA was
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 1:15-vv-00295-UNJ Document 14 Filed 06/25/15 Page 2 of 2
more likely than not caused by the September 13, 2013, flu vaccination.” Id. at 4.
Respondent stated that “based on the record as it now stands, petitioner has satisfied
all legal prerequisites for compensation under the [Vaccine] Act” 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
2

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_15-vv-00295-1
Date issued/filed: 2016-04-25
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 12/03/2015) regarding 25 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:15-vv-00295-UNJ Document 36 Filed 04/25/16 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-295V
Filed: December 3, 2015
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANN WYBORSKI, *
*
Petitioner, * Damages Decision Based on Proffer;
* Influenza (“flu”) vaccine; Shoulder Injury;
* Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Renee J. Gentry, Shoemaker, Gentry & Knickelbein, Vienna, VA, for petitioner.
Lisa A. Watts, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On March 23, 2015, Ann Wyborski 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”]. The petition alleges that as a result of an Influenza (“flu”)
vaccination on September 13, 2013, petitioner suffered a shoulder injury related to
vaccine administration (“SIRVA”). Petition at 2. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On June 4, 2015, a ruling on entitlement was issued, finding petitioner entitled to
compensation for her SIRVA. On December 3, 2015, respondent filed a proffer on
award of compensation [“Proffer”] indicating petitioner should be awarded $236,492.00.
Proffer at 2. In the Proffer, respondent represented that petitioner agrees with the
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, 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, 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 (2006).

Case 1:15-vv-00295-UNJ Document 36 Filed 04/25/16 Page 2 of 5
proffered award. Based on the record as a whole, the undersigned finds that petitioner
is entitled to an award as stated in the Proffer.
Pursuant to the terms stated in the attached Proffer, the undersigned awards
petitioner a lump sum payment of $236,492.00, representing the discounted
present value of petitioner’s projected vaccine-related injury expenses
($2,217.48), past lost earnings ($63,642.75), pain and suffering ($150,000.00), and
past un-reimbursable expenses ($20,631.77) in the form of a check payable to
petitioner, Ann Wyborski. 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
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 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.
2

CCaassee 11::1155--vvvv--0000229955--UUNNJJ DDooccuummeenntt 2346 FFiilleedd 1024//0235//1156 PPaaggee 13 ooff 35
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
________________________________________
ANN WYBORSKI, )
) ECF
Petitioner, )
)
v. ) No. 15-295V
) Chief Special Master
SECRETARY OF HEALTH AND HUMAN ) Nora Beth Dorsey
SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Items of Compensation
A. Life Care Items
Respondent proffers that, based on the evidence of record, petitioner should be awarded
$2,217.48 for projected unreimbursable medical expenses. This amount reflects that the award
for projected unreimbursable expenses has been reduced to net present value. See 42 U.S.C.
§ 300aa-15(a)(1), (f)(4)(A). Petitioner agrees.
B. Lost Earnings
The parties agree that based upon the evidence of record, it is unlikely that petitioner’s
vaccine-related injury will impact her future employment. Thus, future lost earnings under 42
U.S.C. § 300aa-15(a)(3)(A) are not appropriate in this case. However, petitioner did experience
a total past loss of earnings in the amount of $63,642.75, and respondent proffers that amount be
awarded to her. Petitioner agrees.
1

CCaassee 11::1155--vvvv--0000229955--UUNNJJ DDooccuummeenntt 2346 FFiilleedd 1024//0235//1156 PPaaggee 24 ooff 35
C. Pain and Suffering
Respondent proffers that petitioner should be awarded $150,000.00 in actual and
projected pain and suffering. This amount reflects that the award for projected pain and
suffering has been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4), (f)(4)(A).
Petitioner agrees.
D. Past Unreimbursable Expenses
Evidence supplied by petitioner documents her expenditure of past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioners should be
awarded past unreimbursable expenses in the amount of $20,631.77. Petitioner agrees.
E. Medicaid Lien
Petitioner represents that there are no Medicaid liens outstanding against her.
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made
through a lump sum payment as described below, and request that the Chief Special Master’s
decision and the Court’s judgment award the following:1
A. A lump sum payment of $236,492.00, representing the discounted present value
of petitioner’s projected vaccine-related injury expenses ($2,217.48), past lost
earnings ($63,642.75), pain and suffering ($150,000.00), and past un-reimbursable
expenses ($20,631.77) in the form of a check payable to petitioner.
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.
2

CCaassee 11::1155--vvvv--0000229955--UUNNJJ DDooccuummeenntt 2346 FFiilleedd 1024//0235//1156 PPaaggee 35 ooff 35
1. Guardianship
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
III. Summary of Recommended Payments Following Judgment
A. Lump sum paid to petitioner for future vaccine-related expenses,
past unreimbursable expenses, past lost earnings, and
pain and suffering: $236,492.00
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
GLENN A. MACLEOD
Senior Trial Counsel
Torts Branch, Civil Division
s/Lisa A. Watts
LISA A. WATTS
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) 616-4099
Dated: December 3, 2015.
3

================================================================================
DOCUMENT 3: USCOURTS-cofc-1_15-vv-00295-2
Date issued/filed: 2016-05-04
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 02/01/2016) regarding 33 DECISION Fees Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:15-vv-00295-UNJ Document 37 Filed 05/04/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-0295V
Filed: February 1, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANN WYBORSKI, *
*
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.
Lisa Watts, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON ATTORNEYS’ FEES AND COSTS1
Dorsey, Chief Special Master:
On March 23, 2015, 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 as a result of an Influenza (“flu”) vaccination on
September 13, 2013, she suffered a shoulder injury related to vaccine administration
(“SIRVA”). On December 3, 2015, the undersigned issued a decision awarding
compensation to petitioner based on respondent’s proffer.
On January 19, 2016, petitioner filed a motion for attorneys’ fees and costs. On
February 1, 2016, the parties filed a Stipulation of Fact Concerning Attorneys’ Fees and
Costs. According to the stipulation, the parties stipulate to an award of $30,412.75 in
attorneys’ fees and $1,093.86 in costs. In accordance with General Order #9, petitioner
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 1:15-vv-00295-UNJ Document 37 Filed 05/04/16 Page 2 of 2
represents that she is entitled to reimbursement of $56.49 payable directly to her for
costs incurred in this matter.
The Vaccine Act permits an award of reasonable attorneys’ fees and costs. 42
U.S.C. § 300 aa-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, and payment of petitioner’s own costs.
The undersigned awards the total of $56.49 as a lump sum in the form of a
check payable to petitioner for her own costs incurred in this matter.
The undersigned awards the total of $31,506.613 as a lump sum in the form
of a check jointly payable to petitioner and petitioner’s counsel Renee Gentry for
attorneys’ fees and costs.
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, 42 U.S.C. § 300aa-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, HHS, 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.
2