VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01261
Package ID: USCOURTS-cofc-1_15-vv-01261
Petitioner: Deborah Kaiser
Filed: 2015-10-27
Decided: 2018-01-23
Vaccine: influenza
Vaccination date: 2012-11-19
Condition: Guillain-Barre Syndrome (GBS)
Outcome: compensated
Award amount USD: 825000

AI-assisted case summary:
Deborah Kaiser filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered Guillain-Barre Syndrome (GBS) caused by her influenza vaccination on November 19, 2012. She further alleged that she experienced residual effects for more than six months. Respondent denied that the flu vaccine caused her alleged GBS and residual effects. Despite this denial, the parties filed a joint stipulation agreeing to a settlement. The court awarded compensation totaling $825,000, consisting of a lump sum of $200,000 payable to Ms. Kaiser and $625,000 to purchase an installment refund annuity contract for her benefit. This award represents compensation for all damages available under the Vaccine Act. The case proceeded as a Table claim, as GBS is listed on the Vaccine Injury Table for the flu vaccine. The stipulation also addressed the terms for purchasing the annuity, including requirements for the life insurance company and the structure of the payments. The parties agreed that this stipulation represented a full and complete negotiated settlement of liability and damages, except for potential attorneys' fees and litigation costs, which would be addressed in further proceedings.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-01261-0
Date issued/filed: 2018-01-23
Pages: 9
Docket text: PUBLIC DECISION (Originally filed: 7/19/2017) regarding 40 DECISION Stipulation/Proffer. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 1 of 9
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1261V
Filed: July 19, 2017
UNPUBLISHED
DEBORAH KAISER,
Special Processing Unit (SPU); Joint
Stipulation on Damages; Influenza
Petitioner,
(Flu) Vaccine; Guillain-Barre
v.
Syndrome (GBS)
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jerome A. Konkel, Samster, Konkel & Safran, S.C., Milwaukee, WI, for petitioner.
Voris Edward Johnson, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On October 27, 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 she suffered Guillain-Barre Syndrome (“GBS”)
caused by her November 19, 2012 influenza (“flu”) vaccination. Petition at 5;
Stipulation, filed July 19, 2017, at ¶ 4. Petitioner further alleges that she experienced
the residual effects of her injury for more than six months and that there has been no
prior award or settlement of a civil action for damages as a result of her condition.
Petition at 5; Stipulation at ¶¶ 4-5. “Respondent denies that the flu vaccine caused
petitioner’s alleged GBS and residual effects, or any other injury. ” Stipulation at ¶ 6.
Nevertheless, on July 19, 2017, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. The undersigned
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-01261-UNJ Document 46 Filed 01/23/18 Page 2 of 9
finds the stipulation reasonable and adopts it as the decision of the Court in awarding
damages, on the terms set forth therein.
Pursuant to the terms stated in the attached Stipulation, the undersigned
awards the following compensation:
• A lump sum of $200,000.00 in the form of a check payable to
petitioner, Deborah Kaiser; and,
• An amount of $625,000.00 to purchase the installment refund annuity
contract described in paragraph 10 of the stipulation, paid to the life
insurance company from which the annuity will be purchased (the
“Life Insurance Company”).
These amounts represent compensation for all items of damages that would be
available under 42 U.S.C. § 300aa-15(a). Stipulation at ¶ 8
The undersigned approves the requested amount for petitioner’s compensation.
In the absence of a motion for review filed pursuant to RCFC Appendix B, 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-01261-UNJ Document 46 Filed 01/23/18 Page 3 of 9
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
__________________________________________
)
DEBORAH KAISER, )
)
Petitioner, )
) No. 15-1261V (ECF)
v. ) Chief Special Master Dorsey
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
__________________________________________)
STIPULATION
The parties hereby stipulate to the following matters:
1. Deborah Kaiser (“petitioner”) filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §§ 300aa-10 to -34 (the “Vaccine
Program”). The petition seeks compensation for injuries allegedly sustained following
petitioner’s receipt of the influenza (“flu”) vaccine, which vaccine is contained in the Vaccine
Injury Table (the “Table”), 42 C.F.R. §100.3(a).
2. Petitioner received a flu vaccine on November 19, 2012.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she subsequently suffered Guillain-Barré syndrome
(“GBS”), which petitioner alleges was caused-in-fact by her receipt of the flu vaccine. Petitioner
further alleges that she experienced the residual effects of her injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil
action for damages as a result of her condition.
6. Respondent denies that the flu vaccine caused petitioner’s alleged GBS and

Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 4 of 9
residual effects, or any other injury.
7. Maintaining their above-stated positions, the parties nevertheless now agree that
the issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent
with the terms of this Stipulation, and after petitioner has filed an election to receive
compensation pursuant to 42 U.S.C. § 300aa-21(a)(1), the Secretary of Health and Human
Services will issue the following vaccine compensation payments:
a. A lump sum of $200,000.00 in the form of a check payable to
petitioner, Deborah Kaiser; and,
b. An amount of $625,000.00 to purchase the installment refund
annuity contract described in paragraph 10 below, paid to the life
insurance company from which the annuity will be purchased (the
“Life Insurance Company”).
These amounts represent compensation for all damages that would be available under 42
U.S.C. § 300aa-15(a).
9. The Life Insurance Company must have a minimum of $250,000,000.00
capital and surplus, exclusive of any mandatory security valuation reserve. The Life
Insurance Company must have one of the following ratings from two of the following
rating organizations:
a. A.M. Best Company: A++, A+, A+g, A+p, A+r, or A+s;
b. Moody’s Investor Service Claims Paying Rating: Aa3, Aa2, Aa1, or Aaa;
c. Standard and Poor’s Corporation Insurer Claims-Paying Ability Rating:
AA-, AA, AA+, or AAA;
d. Fitch Credit Rating Company, Insurance Company Claims Paying Ability
Rating: AA-, AA, AA+, or AAA.
2

Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 5 of 9
10. The Secretary of Health and Human Services agrees to purchase an annuity contract from
the Life Insurance Company for the benefit of petitioner, pursuant to which the Life Insurance
Company will agree to make payments periodically to petitioner as follows:
The installment refund annuity contract will pay $2,979.04 per month, continuing
for the life of Deborah Kaiser, and the installment refund period. The purchase
price of the annuity shall be $625,000.00. In the event that the cost of the annuity
payments set forth above varies from $625,000.00, the monthly payments outlined
above shall be adjusted up or down to ensure the total Annuity Premium of the
installment refund annuity contract shall remain fixed at exactly $625,000.00 and
not more or less than that amount.
Upon the death of Deborah Kaiser, any installment refund periodic payments remaining due and
owing shall be paid to the United States Department of Health and Human Services. Written
notice shall be provided to the Secretary of Health and Human Services and to the Life Insurance
Company within twenty (20) days of Deborah Kaiser’s death.
11. The annuity contract will be owned solely and exclusively by the Secretary of
Health and Human Services and will be purchased as soon as practicable following the entry of a
judgment in conformity with this Stipulation. The parties stipulate and agree that the Secretary of
Health and Human Services and the United States of America are not responsible for the
payment of any sums other than the amounts set forth in paragraph 8 herein and the amounts
awarded pursuant to paragraph 12 herein, and that they do not guarantee or insure any of the
future annuity payments. Upon the purchase of the annuity contract, the Secretary of Health and
Human Services and the United States of America are released from any and all obligations with
respect to future annuity payments.
12. As soon as practicable after the entry of judgment on entitlement in this case, and
after petitioner has filed both a proper and timely election to receive compensation pursuant to
3

Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 6 of 9
42 U.S.C. § 300aa-21(a)(1), and an application, the parties will submit to further proceedings
before the special master to award reasonable attorneys’ fees and costs incurred in proceeding
upon this petition.
13. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act, 42 U.S.C. § 1396
et seq.), or by entities that provide health services on a pre-paid basis.
14. Payments made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 12 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-15(i),
subject to the availability of sufficient statutory funds.
15. The parties and their attorneys further agree and stipulate that, except for any
award for attorneys’ fees and litigation costs, the money provided pursuant to this Stipulation
will be used solely for the benefit of petitioner, as contemplated by a strict construction of 42
U.S.C. § 300aa-15(a) and (d), and subject to the conditions of 42 U.S.C. § 300aa-15(g) and (h).
16. In return for the payments described in paragraphs 8 and 12, petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the Secretary of
Health and Human Services and the United States of America from any and all actions or causes
of action (including agreements, judgments, claims, damages, loss of services, expenses and all
demands of whatever kind or nature) that have been brought, could have been brought, or could
4

Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 7 of 9
be timely brought in the Court of Federal Claims, under the National Vaccine Injury
Compensation Program, 42 U.S.C. § 300aa-10 et seq., on account of, or in any way growing out
of, any and all known or unknown, suspected or unsuspected personal injuries to, or death of,
petitioner resulting from, or alleged to have resulted from, the flu vaccine administered on
November 19, 2012, as alleged by petitioner in a petition for vaccine compensation filed on or
about October 27, 2015, in the United States Court of Federal Claims as petition No. 15-1261V.
17. If petitioner should die prior to entry of judgment, this agreement shall be
voidable upon proper notice to the Court on behalf of either or both of the parties.
18. If the special master fails to issue a decision in complete conformity with the
terms of this Stipulation, or if the Court of Federal Claims fails to enter judgment in conformity
with a decision that is in complete conformity with the terms of this Stipulation, then the parties’
settlement and this Stipulation shall be voidable at the sole discretion of either party.
19. This Stipulation expresses a full and complete negotiated settlement of liability
and damages claimed under the National Vaccine Injury Act of 1986, as amended, except as
otherwise noted in paragraph 12 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties’ respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
20. This Stipulation shall not be construed as an admission by the United States of
America or the Secretary of Health and Human Services that petitioner’s alleged GBS and
5

Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 8 of 9
residual effects, or any other injury, were caused-in-fact by the flu vaccine.
21. All rights and obligations of petitioner hereunder shall apply equally to
petitioner’s heirs, successors and/or assigns.
END OF STIPULATION
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Case 1:15-vv-01261-UNJ Document 46 Filed 01/23/18 Page 9 of 9