VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01009
Package ID: USCOURTS-cofc-1_15-vv-01009
Petitioner: Pedro De Jesus
Filed: 2016-01-05
Decided: 2016-05-06
Vaccine: influenza
Vaccination date: 2014-11-26
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 75928

AI-assisted case summary:
Pedro De Jesus filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that he suffered shoulder injuries caused by an influenza vaccine he received on November 26, 2014. The respondent conceded that Mr. De Jesus's injury was consistent with a shoulder injury related to vaccine administration (SIRVA) and that it was not due to factors unrelated to the vaccination. The respondent agreed that the injury was compensable as a 'caused-in-fact' injury. The court issued a ruling on entitlement, finding that Mr. De Jesus was entitled to compensation. Subsequently, the parties submitted a proffer on the award of compensation. The respondent proposed an award of $75,000.00 for pain and suffering and $928.00 for past unreimbursable expenses, totaling $75,928.00. Mr. De Jesus agreed to this proposed award. The court awarded Mr. De Jesus a lump sum payment of $75,928.00, representing compensation for pain and suffering and past unreimbursable expenses.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-01009-0
Date issued/filed: 2016-05-03
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 01/05/2016) 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-01009-UNJ Document 33 Filed 05/03/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1009V
Filed: January 5, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
PEDRO DE JESUS, *
*
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 Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
Justine Walters, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On September 11, 2015, Pedro De Jesus (“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 he
suffered “shoulder injuries which were caused in fact” by the influenza vaccine he
received on November 26, 2014. Petition at 1.
On January 4, 2016, respondent filed her Rule 4(c) report in which she concedes
that “petitioner is entitled to compensation for the left shoulder injury he sustained
following his receipt of the flu vaccination on November 26, 2014.” Respondent’s Rule
4(c) Report at 1. Specifically, respondent “has concluded that a preponderance of the
evidence establishes that petitioner’s injury is consistent with a shoulder injury related to
vaccine administration (“SIRVA”), and that petitioner’s injury is not due to factors
unrelated to his November 26, 2014, flu vaccination.” Id. at 3. Respondent agrees that
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-01009-UNJ Document 33 Filed 05/03/16 Page 2 of 2
petitioner’s injury should be compensated “as a ‘caused-in-fact’ injury.” Id. at 3-4.
Respondent further agrees that the petition was timely filed, that petitioner received, in
the United States, a vaccine listed on the Vaccine Injury Table, that petitioner suffered
the effects of his injury for more than six months, and that petitioner “avers that no civil
action or proceedings have been pursued in connection with the vaccine-related injury.”
Id. at 4.
In view of respondent’s concession and the evidence before me, the
undersigned finds that petitioner is entitled to compensation. Additionally, the
January 15, 2016 deadline for respondent’s status report is deemed moot and
terminated.
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-01009-1
Date issued/filed: 2016-05-06
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 02/17/2016) regarding 23 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-01009-UNJ Document 34 Filed 05/06/16 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1009V
Filed: February 17, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
PEDRO DE JESUS, *
*
Petitioner, * Damages Decision Based on Proffer;
* Influenza (“Flu”) Vaccine;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”);
AND HUMAN SERVICES, * Special Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Maximillian Muller, Muller Brazil, LLP, Philadelphia, PA, for petitioner.
Justine Walters, U.S. Department of Justice, Washington, DC for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On September 11, 2015, Pedro De Jesus (“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 he
suffered “shoulder injuries which were caused in fact” by the influenza vaccine he
received on November 26, 2014. Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On January 5, 2016, the undersigned issued a ruling on entitlement, finding that
petitioner was entitled to compensation. On February 17, 2016, respondent filed a
proffer on award of compensation [“Proffer”] stating that petitioner should be awarded
$75,000.00 for actual and projected pain and suffering and $928.00 for past
unreimburseable expenses for a total award of $75,928.00. Proffer at 2-3. According to
1 Because this unpublished decision 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 (2012).

Case 1:15-vv-01009-UNJ Document 34 Filed 05/06/16 Page 2 of 5
respondent’s Proffer, petitioner agrees to the proposed award of compensation. Id. at
2.
Pursuant to the terms stated in the attached Proffer, the undersigned awards
petitioner a lump sum payment of $75,928.00 in the form of a check payable to
petitioner, Pedro De Jesus, representing $75,000.00 for actual and projected pain
and suffering and $928.00 for past unreimburseable expenses. 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 each party filing a notice
renouncing the right to seek review.
2

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IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
PEDRO DE JESUS, )
)
Petitioner, )
)
v. ) No. 15-1009V
) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND ) SPU
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On September 11, 2015, petitioner, Pedro De Jesus, filed a petition for compensation
under the National Childhood Vaccine Injury Act, 42 U.S.C. §§ 300aa-10 to -34 (“Vaccine
Act”), alleging that he developed shoulder injuries as a result of receiving a seasonal influenza
(“flu”) vaccine on November 26, 2014. On January 4, 2016, respondent filed her Rule 4(c)
Report stating that petitioner’s arm injury is consistent with a shoulder injury related to vaccine
administration (“SIRVA”) and conceding that his SIRVA is compensable under the Vaccine Act.
Accordingly, on January 5, 2016, Chief Special Master Dorsey issued a Ruling on Entitlement
finding that petitioner is entitled to compensation for SIRVA.
I. Items of Compensation
For the purposes of this proffer, the term “vaccine-related” is as described in
Respondent’s Rule 4(c) Report filed on January 4, 2016.
A. Future Unreimbursable Expenses
The parties agree that based upon the evidence of record, petitioner will not require future
care for his vaccine-related injury. Therefore, respondent proffers that petitioner should be

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awarded no future unreimbursable expenses under 42 U.S.C. § 300aa-15(a)(1).
Petitioner agrees.
B. Lost Earnings
The parties agree that based upon the evidence of record, petitioner has not incurred and
will not incur any loss of earnings as a result of his vaccine injury. Therefore, respondent
proffers that petitioner should be awarded no actual or anticipated loss of earnings under
42 U.S.C. § 300aa-15(a)(3)(A). Petitioner agrees.
C. Pain and Suffering
Respondent proffers that petitioner should be awarded $75,000.00 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). Petitioner agrees.
D. Past Unreimbursable Expenses
Evidence supplied by petitioner documents his expenditure of past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $928.00. Petitioner agrees.
E. Medicaid Lien
Petitioner represents that there are no outstanding Medicaid liens against him.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
a lump sum payment as described below and request that the Chief Special Master’s decision
-2-

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and the Court’s judgment award the following:1
A. A lump sum payment of $75,928.00, representing compensation for pain and
suffering and past unreimbursable expenses, in the form of a check payable to petitioner.
III. Summary of Recommended Payment Following Judgment
A. Lump sum paid to petitioner: $75,928.00
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
LINDA S. RENZI
Senior Trial Counsel
Torts Branch, Civil Division
s/ Justine Walters__________
JUSTINE WALTERS
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) 307-6393
DATE: February 16, 2016
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, future lost earnings, and future pain and suffering.
-3-