VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-00993
Package ID: USCOURTS-cofc-1_15-vv-00993
Petitioner: Lou Ann Hare
Filed: 2015-12-10
Decided: 2017-02-13
Vaccine: Tdap
Vaccination date: 2014-10-31
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 530130

AI-assisted case summary:
Lou Ann Hare filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered shoulder injuries caused by a Tdap vaccine she received on October 31, 2014. The respondent, the Secretary of Health and Human Services, conceded that petitioner's alleged injury was consistent with shoulder injury related to vaccine administration (SIRVA) and that it was caused in fact by the Tdap vaccine. Based on this concession and the evidence, the court found petitioner entitled to compensation. Subsequently, the parties submitted a proffer on the award of compensation. The court awarded Lou Ann Hare a total of $530,130.83. This amount included $525,000.00 for all elements of compensation and $5,130.83 to satisfy a State of Iowa Medicaid lien. The award was to be paid as two lump sum payments, with the Medicaid lien payment payable jointly to Ms. Hare and Iowa Medicaid Enterprise.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-00993-0
Date issued/filed: 2016-04-27
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/10/2016) regarding 16 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-00993-UNJ Document 22 Filed 04/27/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-993V
Filed: December 10, 2015
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
LOU ANN HARE, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Tetanus, Diphtheria, acellular Pertussis;
* (“Tdap”) Vaccine; Adhesive Capsulitis;
SECRETARY OF HEALTH * Injection Pain; Shoulder Injury Related
AND HUMAN SERVICES, * to Vaccine Administration (“SIRVA”);
* Special Processing Unit (“SPU”)
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Richard Moeller, Berenstein, Moore, et. al, Sioux City, IA, for petitioner.
Traci Patton, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On September 9, 2015, Lou Ann Hare (“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 shoulder injuries caused by tetanus, diphtheria, acellular pertussis (“Tdap”)
vaccine she received on October 31, 2014. Petition at 1. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On December 8, 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 conceded that “petitioner’s alleged injury is
consistent with shoulder injury related to vaccine administration (“SIRVA”), and that it
was caused in fact by the Tdap vaccine she received on or about October 31, 2014.”
Id. at 6.
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-00993-UNJ Document 22 Filed 04/27/16 Page 2 of 2
In view of respondent’s concession to which petitioner agrees 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-00993-1
Date issued/filed: 2017-02-13
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 10/21/2016) regarding 39 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-00993-UNJ Document 50 Filed 02/13/17 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-993V
Filed: October 21, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
LOU ANN HARE, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Tetanus, Diphtheria, acellular Pertussis
* (“Tdap”) Vaccine; Adhesive Capsulitis;
SECRETARY OF HEALTH * Injection Pain; Shoulder Injury Related
AND HUMAN SERVICES, * to Vaccine Administration (“SIRVA”);
* Special Processing Unit (“SPU”)
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Richard H. Moeller, Moore, Heffernan, et al., Sioux City, IA, for petitioner.
Lynn E. Ricciardella, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On September 9, 2015, Lou Ann Hare (“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 alleged that she
suffered shoulder injuries caused by tetanus, diphtheria, acellular pertussis (“Tdap”)
vaccine she received on October 31, 2014. Pet. at 1. The case was assigned to the
Special Processing Unit (“SPU”) of the Office of Special Masters.
On December 10, 2015, the undersigned issued a ruling on entitlement finding
petitioner entitled to compensation for a shoulder injury related to vaccine administration
(“SIRVA”). On October 21, 2016, respondent filed an amended proffer on award of
compensation 3 (“Proffer”) indicating petitioner should be awarded $530,130.83, which
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).
3 An earlier proffer, filed on October 19, 2016, contained an error.

Case 1:15-vv-00993-UNJ Document 50 Filed 02/13/17 Page 2 of 5
amount represents $525,000.00 for all elements of compensation to which petitioner
would be entitled under § 300aa-15(a), and $5,130.83 to satisfy, in full, the State of
Iowa Medicaid lien. Proffer at 1. In the Proffer, respondent represented that petitioner
agrees with the proffered award. Id. 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 the following compensation:
(1) A lump sum payment of $525,000.00 in the form of a check payable to
petitioner, Lou Ann Hare. This amount accounts for all elements of
compensation under § 300aa-15(a) to which petitioner would be entitled; and
(2) A lump sum payment of $5,130.83, representing compensation for
satisfaction of the State of Iowa Medicaid lien, payable jointly to
petitioner and
Iowa Medicaid Enterprise
Revenue Collections/Lien Recovery Unit
P.O. Box 36446
Des Moines, Iowa 50315
Petitioner agrees to endorse this payment to Iowa Medicaid Enterprise.
The clerk of the court is directed to enter judgment in accordance with this
decision.4
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
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

Case 1:15-vv-00993-UNJ Document 50 Filed 02/13/17 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
LOU ANN HARE,
Petitioner, No. 15-993V
Chief Special Master Dorsey
v. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S AMENDED PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items:
Respondent proffers that, based on the evidence of record, petitioner, Lou Ann Hare,
should be awarded $525,000.00. This amount represents all elements of compensation to which
petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Respondent further proffers that petitioner, Lou Ann Hare, should be awarded funds to
satisfy, in full, the State of Iowa Medicaid lien in the amount of $5,130.83, which represents
satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the State of
Iowa may have against any individual as a result of any Medicaid payments the State of Iowa has
made to or on behalf of Lou Ann Hare from the date of her eligibility for benefits through the
date of judgment in this case as a result of her vaccine-related injury, under Title XIX of the
Social Security Act.
1

Case 1:15-vv-00993-UNJ Document 50 Filed 02/13/17 Page 4 of 5
II. Form of the Award:
The parties recommend that the compensation provided to Lou Ann Hare should be made
through two lump sum payments as described below, and request that the special master’s
decision and the Court’s judgment award the following:1
(1) A lump sum payment of $525,000.00 in the form of a check payable to petitioner,
Lou Ann Hare. This amount accounts for all elements of compensation under 42
U.S.C. § 300aa-15(a) to which petitioner would be entitled; and
(2) A lump sum payment of $5,130.83, representing compensation for satisfaction of the
State of Iowa Medicaid lien, payable jointly to petitioner and to:
Iowa Medicaid Enterprise
Revenue Collections/Lien Recovery Unit
P.O. Box 36446
Des Moines, Iowa 50315
Petitioner agrees to endorse this payment to Iowa Medicaid Enterprise.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BENJAMIN C. MIZER
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Acting Deputy Director
Torts Branch, Civil Division
ALTHEA W. DAVIS
Senior Trial Counsel
Torts Branch, Civil Division
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

Case 1:15-vv-00993-UNJ Document 50 Filed 02/13/17 Page 5 of 5
/s/ Lynn E. Ricciardella
LYNN E. RICCIARDELLA
Senior 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) 616-4356
Dated: October 21, 2016
3