VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01098
Package ID: USCOURTS-cofc-1_15-vv-01098
Petitioner: Carletta Bober
Filed: 2016-01-19
Decided: 2016-05-04
Vaccine: Dtap
Vaccination date: 2013-12-13
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 50491

AI-assisted case summary:
Carletta Bober filed a petition for compensation under the National Vaccine Injury Compensation Program on January 19, 2016, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of a Dtap vaccine received on December 13, 2013. The respondent conceded that the petitioner's injury was consistent with SIRVA and was caused-in-fact by the Dtap vaccine. The respondent also agreed that no other causes were identified and that the petitioner suffered sequelae for more than six months, satisfying the legal prerequisites for compensation. Based on the respondent's concession and the evidence, the court found entitlement. Subsequently, on May 4, 2016, a decision awarding damages was issued. The respondent proffered an award of $50,000.00 for all elements of compensation and an additional $491.53 to satisfy the State of Hawaii Medicaid lien. Petitioner agreed with the proffered award. The court awarded Carletta Bober a total of $50,491.53.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-01098-0
Date issued/filed: 2016-05-04
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 01/19/2016) regarding 14 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:15-vv-01098-UNJ Document 23 Filed 05/04/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1098V
Filed: January 19, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
CARLETTA BOBER, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Diphtheria-Tetanus-Acellular Pertussis
* (“Dtap”) Vaccine; Shoulder Injury
SECRETARY OF HEALTH * Related to Vaccine Administration
AND HUMAN SERVICES, * (“SIRVA”); Special Processing Unit
* (“SPU”)
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
John Robert Howie, Jr., Howie Law, P.C., Dallas, TX, for petitioner.
Althea Walker Davis, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On September 30, 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 she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of a diphtheria-tetanus-acellular pertussis (“Dtap”)
vaccine she received on December 13, 2013. Petition at 1. The case was assigned to
the Special Processing Unit of the Office of Special Masters.
On January 15, 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 1. Specifically, respondent states that petitioner’s “alleged injury is
consistent with shoulder injury related to vaccine administration (SIRVA), and that it was
caused-in-fact by the Dtap vaccine she received on December 13, 2013.” Id. at 3.
Respondent further agrees that no other causes were identified for petitioner’s SIRVA
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-01098-UNJ Document 23 Filed 05/04/16 Page 2 of 2
and that she has suffered the sequela of her injury for more than six months and
therefore 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-01098-1
Date issued/filed: 2016-05-04
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 01/19/2015) regarding 15 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:15-vv-01098-UNJ Document 24 Filed 05/04/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1098V
Filed: January 19, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
CARLETTA BOBER, *
*
Petitioner, * Damages Decision Based on Proffer;
* Diphtheria-Tetanus-Acellular Pertussis
* (“Dtap”) Vaccine; Shoulder Injury
SECRETARY OF HEALTH * Related to Vaccine Administration
AND HUMAN SERVICES, * (“SIRVA”); Special Processing Unit
* (“SPU”)
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
John Robert Howie, Jr., Howie Law, P.C., Dallas, TX, for petitioner.
Althea Walker Davis, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On September 30, 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 she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of a diphtheria-tetanus-acellular pertussis (“Dtap”)
vaccine she received on December 13, 2013. Petition at 1. The case was assigned to
the Special Processing Unit of the Office of Special Masters.
On January 19, 2016, the undersigned issued ruling on entitlement finding
petitioner entitled to compensation. In the Rule 4(c) report filed by respondent on
January 15, 2016, respondent set forth a proffer on award of compensation stating that
petitioner should be awarded $50,000.00, which represents all elements of
compensation which petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Rule 4
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 (2012).

Case 1:15-vv-01098-UNJ Document 24 Filed 05/04/16 Page 2 of 2
Report at 4-5. Respondent also proffered that petitioner should be awarded funds to
satisfy the State of Hawaii Medicaid lien in the amount of $491.53, which represents full
satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the
State of Hawaii may have against any individual as a result of any Medicaid payments
the State of Hawaii has made to or on behalf of Carletta Bober from the date of her
eligibility for benefits through the date of judgment in this case as a result of her
vaccine-related injury suffered on or about December 13, 2013, under Title XIX of the
Social Security Act. Id. In the Rule 4(c) report, respondent represented that petitioner
agrees with the proffered award. Id. at 4.
Based on the record as a whole, the undersigned finds that petitioner is entitled
to an award as stated in the Rule 4(c) report and the Proffer contained within it.
Pursuant to the terms stated in the attached Rule 4(c) report and Proffer, the
undersigned awards petitioner the following:
A. A lump sum payment of $50,000.00, in the form of a check payable to
petitioner, Carletta Bober. This amount represents compensation for all
damages that would be available under § 300aa-15(a).
B. A lump sum payment of $491.53, representing compensation for satisfaction of
the State of Hawaii Medicaid lien, payable jointly to petitioner and
State of Hawaii
Department of Human Services
Med-Quest Division
Finance Office – TPL Unit
1001 Kamokila Blvd., Suite 317
Kapolei, Hawaii 96707
Insured: Carletta Bober (ID: 002001560)
Attn: Gary Ojiri
Petitioner agrees to endorse this payment to the Commonwealth.
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