VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01002
Package ID: USCOURTS-cofc-1_15-vv-01002
Petitioner: Donizetti Goncalves
Filed: 2015-09-10
Decided: 2017-01-11
Vaccine: influenza
Vaccination date: 2014-01-20
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 141357

AI-assisted case summary:
Donizetti Goncalves filed a petition for compensation on September 10, 2015, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on January 20, 2014. The case was assigned to the Special Processing Unit. On February 3, 2016, respondent filed a Rule 4(c) report conceding that Mr. Goncalves was entitled to compensation. Respondent stated that the alleged injury was consistent with SIRVA and that Mr. Goncalves met all legal prerequisites for compensation under the National Vaccine Injury Compensation Program. Chief Special Master Nora Beth Dorsey issued a ruling on entitlement that day, finding Mr. Goncalves entitled to compensation. Subsequently, on October 13, 2016, respondent filed a proffer on award of compensation, proposing an award of $141,357.13. The petitioner agreed with this amount. On January 11, 2017, Chief Special Master Nora Beth Dorsey issued a decision awarding Mr. Goncalves a lump sum payment of $141,357.13, representing compensation for all damages available under the Act. Petitioner was represented by Maximillian J. Muller of Muller Brazil, LLP, and respondent was represented by Lara Ann Englund of the U.S. Department of Justice.

Theory of causation field:
Petitioner Donizetti Goncalves alleged a shoulder injury related to vaccine administration (SIRVA) following an influenza vaccine on January 20, 2014. The respondent conceded entitlement, finding the injury consistent with SIRVA and that petitioner met all legal prerequisites. The case proceeded to an award based on a joint proffer. Chief Special Master Nora Beth Dorsey issued a ruling on entitlement on February 3, 2016, and a decision awarding damages on January 11, 2017. The award was a lump sum of $141,357.13, representing compensation for all damages under 42 U.S.C. § 300aa-15(a). The specific mechanism of injury and medical experts were not detailed in the provided public text. The theory of causation was based on the Table of the National Vaccine Injury Compensation Program. Petitioner was represented by Maximillian J. Muller, and respondent by Lara Ann Englund.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-01002-0
Date issued/filed: 2016-05-05
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/03/2016) regarding 17 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-01002-UNJ Document 23 Filed 05/05/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1002V
Filed: February 3, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
DONIZETTI GONCALVES, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Influenza (“Flu”) Vaccine; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
Lara Ann Englund, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On September 10, 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 alleges that that he suffered from shoulder injuries as a result
of an influenza (“flu”) vaccine he received on January 20, 2014. Petition at 1. The case
was assigned to the Special Processing Unit of the Office of Special Masters.
On February 3, 2016, 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 3-4. Specifically, respondent states that “petitioner’s alleged injury is
consistent with a shoulder injury related to vaccine administration (SIRVA)… [based] on
the current record, petitioner has satisfied all legal prerequisites for compensation under
the Act Id. at 3.
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. 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-01002-UNJ Document 23 Filed 05/05/16 Page 2 of 2
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-01002-1
Date issued/filed: 2017-01-11
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 10/13/2016) regarding 34 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-01002-UNJ Document 38 Filed 01/11/17 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1002V
Filed: October 13, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
DONIZETTI GONCALVES, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Influenza (“Flu”) Vaccine; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Maximillian J. Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
Lara Ann Englund, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On September 10, 2015, Donizetti Goncalves (“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 alleges that he suffered from a
shoulder injury as a result of an influenza (“flu”) vaccine he received on January 20,
2014. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
On February 3, 2016, a ruling on entitlement was issued, finding petitioner
entitled to compensation for SIRVA. On October 13, 2016, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $141,357.13.
Proffer at 1. 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. 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-01002-UNJ Document 38 Filed 01/11/17 Page 2 of 4
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 $141,357.13 in the form of a check payable to
petitioner, Donizetti Goncalves. 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-01002-UNJ Document 38 Filed 01/11/17 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DONIZETTI GONCALVES, )
)
Petitioner, )
)
v. ) No. 15-1002V
) Chief Special Master Nora Beth Dorsey
SECRETARY OF )
HEALTH AND HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
Respondent proffers that, based on the evidence of record, petitioner should be awarded
$141,357.13. This amount represents all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a)(1); -15(a)(3)(A); and -15(a)(4). Petitioner agrees.
II. Form of the Award
The parties recommend that the compensation provided to petitioner should be made as a
lump sum payment of $141,357.13, in the form of a check payable to petitioner.1 Petitioner is a
competent adult. Evidence of guardianship is not required in this case. This amount accounts
for all elements of compensation under 42 U.S.C. § 300aa-15(a) to which petitioner would be
entitled.
Respectfully submitted,
BENJAMIN C. MIZER
Principal Deputy Assistant Attorney General
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-01002-UNJ Document 38 Filed 01/11/17 Page 4 of 4
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Acting Deputy Director
Torts Branch, Civil Division
LINDA S. RENZI
Senior Trial Counsel
Torts Branch, Civil Division
s/ LARA A. ENGLUND
LARA A. ENGLUND
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) 307-3013
E-mail: lara.a.englund@usdoj.gov
Dated: October 13, 2016
2