James Young v. HHS - Influenza, Shoulder injury related to vaccine administration (SIRVA) (2019)
Case summary [AI summaries can sometimes make mistakes]
James Young, a 50-year-old physician, filed a petition for compensation under the National Vaccine Injury Compensation Program on October 23, 2015. He alleged that an influenza vaccination he received on October 24, 2013, caused a left shoulder injury, specifically adhesive capsulitis, leading to severe pain and limited range of motion.
The respondent, the Secretary of Health and Human Services, contested entitlement, arguing a lack of evidence for vaccine causation and a significant gap between vaccination and formal treatment. The public decision does not describe the petitioner's counsel or respondent's counsel by name.
Dr. Young's medical history included Hodgkin's Lymphoma in remission, retinitis, and a fall on his left shoulder three years prior to the vaccination, which had resolved.
Approximately five months after the vaccination, on March 24, 2014, Dr. Young sought medical evaluation for a painful upper left arm, reporting that the pain began the day of the injection and had never resolved.
He had been self-treating with NSAIDs and a Medrol Dose Pak without improvement. His pain was rated 10/10, constant, and interfering with daily functions, limiting his ability to lift his arm, don his shirt, or reach his back.
Examination revealed asymmetry of the left shoulder, some atrophy of the left deltoid, and mild point tenderness with abduction limited to 45 degrees and pain. An MRI on March 28, 2014, showed findings consistent with adhesive capsulitis and mild subscapularis tendinosis.
On April 15, 2014, Dr. Ikard noted the pain started around the time of the flu shot and assessed left shoulder pain and adhesive capsulitis.
Dr. Prine administered a steroid injection.
Petitioner began physical therapy on April 15, 2014, reporting that his shoulder pain and adhesive capsulitis began after the flu shot. He was discharged from physical therapy on June 27, 2014, feeling "100% better" with improved range of motion but some residual posterior shoulder pain and tightness.
In October 2014, Dr. Young received the intranasal FluMist and alleged new inflammation and loss of range of motion in his right shoulder, and aggravation of his left shoulder injury.
As of February 2017, he reported pain with his right shoulder and right knee, with no mention of left shoulder issues. Chief Special Master Nora Beth Dorsey issued a ruling on entitlement on January 10, 2018, finding that Dr.
Young met the criteria for SIRVA (Shoulder Injury Related to Vaccine Administration). The Special Master found that the onset of pain began within 24 hours of the October 24, 2013 vaccination, that the pain and reduced range of motion were limited to the left shoulder, and that no other condition explained the symptoms.
The Special Master concluded that there was a logical sequence of cause and effect and a proximate temporal relationship between the vaccination and the injury, satisfying the Althen criteria for off-Table claims. Subsequently, on February 19, 2019, Chief Special Master Dorsey issued a decision awarding compensation.
Dr. Young was awarded a total of $102,293.15, consisting of $100,000.00 for actual pain and suffering and $2,293.15 for past unreimbursable medical expenses.
Petitioner decided not to pursue a claim for future medical expenses.
Theory of causation
Petitioner James Young, age 50, received an influenza vaccine on October 24, 2013, and alleged a left shoulder injury, specifically adhesive capsulitis, consistent with SIRVA (Shoulder Injury Related to Vaccine Administration). Although SIRVA was not added to the Vaccine Injury Table until after the petition was filed, the Special Master applied SIRVA criteria. The petitioner demonstrated no prior history of shoulder pain or dysfunction that would explain the subsequent symptoms. Onset of pain occurred within 24 hours of vaccination, as reported by the petitioner and noted in contemporaneous medical records, satisfying the proximate temporal relationship prong of Althen. Pain and reduced range of motion were limited to the left shoulder where the vaccine was administered. No other condition explained the symptoms. The Special Master found a logical sequence of cause and effect, satisfying the second Althen prong. The medical records, including petitioner's reports to nurse Martha Greishaw and Dr. Stephen Ikard, and his physical therapy questionnaire, supported the onset of pain and adhesive capsulitis shortly after the vaccination. The respondent argued a lack of evidence and a significant gap between vaccination and treatment, but the Special Master found the petitioner's self-treatment and busy schedule explained the delay in seeking formal medical care. The Special Master concluded that the petitioner met the criteria for SIRVA and was entitled to compensation. The award was $100,000.00 for pain and suffering and $2,293.15 for past unreimbursable medical expenses, totaling $102,293.15. Chief Special Master Nora Beth Dorsey issued the entitlement ruling on January 10, 2018, and the damages decision on February 19, 2019. Petitioner's counsel was Edward M. Kraus, and respondent's counsel was Robert Paul Coleman, III.
Source PDFs
USCOURTS-cofc-1_15-vv-01241