VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-00965
Package ID: USCOURTS-cofc-1_15-vv-00965
Petitioner: Amy H. Moritz
Filed: 2015-09-03
Decided: 2016-05-26
Vaccine: influenza
Vaccination date: 2014-10-09
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 207588

AI-assisted case summary:
Amy H. Moritz filed a petition for compensation under the National Vaccine Injury Compensation Program on September 3, 2015, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) caused by a trivalent influenza vaccine received on October 9, 2014. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) report conceding that petitioner was entitled to compensation. The respondent concluded that petitioner suffered a non-Table injury of SIRVA, causally related to the flu vaccination, and that she met all legal prerequisites for compensation. Based on the respondent's concession and the evidence, the Chief Special Master issued a ruling on entitlement on December 7, 2015, finding petitioner entitled to compensation. Subsequently, on May 26, 2016, the respondent filed a proffer on award of compensation, proposing an award of $207,588.80, which the petitioner agreed to. The Chief Special Master issued a decision awarding damages on June 27, 2016, granting petitioner a lump sum payment of $207,588.80, representing all elements of compensation available under the Act.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-00965-0
Date issued/filed: 2016-04-26
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/07/2015) regarding 19 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-00965-UNJ Document 26 Filed 04/26/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-965V
Filed: December 7, 2015
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
AMY H. MORITZ, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Trivalent Influenza (“Flu”) Vaccine;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”);
AND HUMAN SERVICES, * Special Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Robert Krakow, Law Office of Robert J. Krakow, P.C., New York, NY, for petitioner.
Douglas Ross, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On September 3, 2015, Amy H. Moritz (“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 related to vaccine administration (“SIRVA”) caused by the
trivalent influenza (“flu”) vaccine she received on October 9, 2014. Petition at ¶¶ 10, 13,
32. The case was assigned to the Special Processing Unit of the Office of Special
Masters.
On December 7, 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 at 1. Specifically, respondent “concluded that petitioner suffered a non-
Table injury of SIRVA and that the preponderance of the medical evidence indicates
that the injury was causally related to the flu vaccination she received on October 9,
1 Because this unpublished ruling 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 (2012).

Case 1:15-vv-00965-UNJ Document 26 Filed 04/26/16 Page 2 of 2
2014.” Id. at 6. Respondent further agrees that “petitioner met the statutory
requirements by suffering the condition for more than six months . . . [and] has satisfied
all legal prerequisites for compensation under the Act.” Id.
In view of respondent’s concession and the evidence before me, the
undersigned finds that petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_15-vv-00965-1
Date issued/filed: 2016-06-27
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 05/27/2016) regarding 31 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-00965-UNJ Document 34 Filed 06/27/16 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-965V
Filed: May 27, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
AMY H. MORITZ, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Trivalent Influenza (“Flu”) Vaccine;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”);
AND HUMAN SERVICES, * Special Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Robert Krakow, Law Office of Robert J. Krakow, P.C., New York, NY, for petitioner.
Douglas Ross, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On September 3, 2015, Amy H. Moritz (“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 she suffered a shoulder
injury related to vaccine administration (“SIRVA”) caused by the trivalent influenza (“flu”)
vaccine she received on October 9, 2014. The case was assigned to the Special
Processing Unit (“SPU”) of the Office of Special Masters.
On December 7, 2015, the undersigned issued a ruling on entitlement finding
petitioner entitled to compensation for SIRVA. On May 26, 2016, respondent filed a
proffer on award of compensation (“Proffer”) indicating petitioner should be awarded
$207,588.80. Proffer at 1. In the Proffer, respondent represented that petitioner agrees
with the proffered award.
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-00965-UNJ Document 34 Filed 06/27/16 Page 2 of 4
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 $207,588.80 in the form of a check payable to
petitioner, Amy H. Moritz. 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

Case 1:15-vv-00965-UNJ Document 34 Filed 06/27/16 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
*
AMY MORITZ, *
*
Petitioner, *
*
v. * No. 15-965V (ECF)
* CHIEF SPECIAL MASTER
* NORA BETH DORSEY
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
In her December 7, 2015 decision, the Chief Special Master found that a preponderance
of the medical evidence indicates that petitioner suffered a shoulder injury related to vaccine
administration (“SIRVA”), which was causally related to the flu vaccination she received on
October 9, 2014. The parties have now addressed the amount of compensation to be awarded in
this case.
I. Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
a total lump sum of $207,588.80, which amount represents all elements of compensation to
which petitioner would be entitled under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
1 Should petitioner die prior to entry of judgment, respondent would oppose any award for future
medical expenses, future lost earnings, and future pain and suffering, and the parties reserve the
right to move the Court for appropriate relief.

Case 1:15-vv-00965-UNJ Document 34 Filed 06/27/16 Page 4 of 4
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made
through a lump sum payment of $207,588.80 in the form of a check payable to petitioner.
Petitioner agrees.
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
HEATHER L. PEARLMAN
Senior Trial Attorney
Torts Branch, Civil Division
/s/ DOUGLAS ROSS
DOUGLAS ROSS
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel.: (202) 616-3667
DATE: May 26, 2016
2