VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_15-vv-01487
Package ID: USCOURTS-cofc-1_15-vv-01487
Petitioner: Andrew Potts
Filed: 2016-03-03
Decided: 2016-09-23
Vaccine: influenza
Vaccination date: 2014-10-25
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 85000

AI-assisted case summary:
Andrew Potts filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that he suffered a shoulder injury caused by his October 25, 2014 influenza vaccination. The case was assigned to the Special Processing Unit. On March 2, 2016, the respondent conceded that Mr. Potts' injury was consistent with shoulder injury related to vaccine administration (SIRVA) and was caused by the flu vaccine. The respondent also agreed that no other cause was identified and that Mr. Potts suffered sequelae for more than six months, satisfying all legal prerequisites. A ruling on entitlement was issued on March 3, 2016, finding Mr. Potts entitled to compensation. Subsequently, on April 25, 2016, the respondent filed a proffer of damages, recommending an award of $85,000.00 for pain and suffering, which Mr. Potts agreed to. The parties stipulated that the injury did not impair his earning capacity and that there were no past unreimbursable expenses. On September 23, 2016, a decision was issued awarding Mr. Potts a lump sum payment of $85,000.00 for pain and suffering.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_15-vv-01487-0
Date issued/filed: 2016-05-10
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/03/2016) regarding 15 Ruling on Entitlement (Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:15-vv-01487-UNJ Document 23 Filed 05/10/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1487V
Filed: March 3, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANDREW POTTS, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Influenza;
* Shoulder Injury (“SIRVA”);
SECRETARY OF HEALTH * Special Processing Unit (“SPU”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Danielle Strait, Maglio Christopher and Toale, PA, Washington, DC, for petitioner.
Alexis Babcock, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On December 8, 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” or “Program”]. Petitioner alleges that he suffered a shoulder injury that
was caused-in-fact by his October 25, 2014 influenza vaccination. Petition at 1-2. The
case was assigned to the Special Processing Unit of the Office of Special Masters.
On March 2, 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 “concluded that petitioner’s alleged injury is consistent
with shoulder injury related to vaccine administration (“SIRVA”), and that it was caused
in fact by the flu vaccine he received on October 23, 2014.” Id. at 3. Respondent
further agrees that no other cause of petitioner’s injury has been identified, 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. 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-01487-UNJ Document 23 Filed 05/10/16 Page 2 of 2
petitioner suffered sequela of his injury for more than six months, and that petitioner has
satisfied all legal prerequisites under the Vaccine 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

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_15-vv-01487-1
Date issued/filed: 2016-09-23
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 04/25/2016) regarding 19 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:15-vv-01487-UNJ Document 28 Filed 09/23/16 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 15-1487V
Filed: April 25, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANDREW POTTS, *
*
Petitioner, * Damages Decision Based on Proffer;
* Influenza;
* Shoulder Injury (“SIRVA”);
SECRETARY OF HEALTH * Special Processing Unit (“SPU”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Danielle Strait, Maglio, Christopher & Toale, PA, Washington, DC, for petitioner.
Alexis Babcock, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On December 8, 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 he suffered a shoulder injury caused-in-fact by
his October 25, 2014 influenza vaccination. Petition at 1-2. The case was assigned to
the Special Processing Unit of the Office of Special Masters.
On March 3, 2016, a ruling on entitlement was issued, finding petitioner entitled
to compensation for a shoulder injury related to vaccine administration (“SIRVA”). On
April 25, 2016, respondent filed a proffer on award of compensation (“Proffer”) indicating
petitioner should be awarded $85,000.00 in actual and projected pain and suffering.
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-01487-UNJ Document 28 Filed 09/23/16 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 $85,000.00 in the form of a check payable to
petitioner, Andrew Potts. 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-01487-UNJ Document 28 Filed 09/23/16 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
__________________________________________
)
ANDREW POTTS, )
)
Petitioner, )
) No. 15-1487
v. ) Chief Special Master Dorsey
)
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
__________________________________________)
RESPONDENT’S PROFFER OF DAMAGES
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 March 2, 2016.
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $85,000.00 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.
B. Past Unreimbursable Expenses
Respondent proffers that petitioner should not be awarded any past unreimbursable
expenses related to his vaccine injury. Petitioner agrees.
C. Lost Wages
The parties agree that based upon the evidence of record, petitioner’s vaccine-related
injury has not impaired his earning capacity. Therefore, respondent proffers that petitioner
should be awarded no lost future earnings as provided under the Vaccine Act, 42 U.S.C. § 300aa-
15(a)(3)(A). Petitioner agrees.
1

Case 1:15-vv-01487-UNJ Document 28 Filed 09/23/16 Page 4 of 4
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
and the Court’s judgment award the following:1
A lump sum payment of $85,000.00, which represents all elements of
compensation to which petitioner would be entitled under 42 U.S.C. § 300aa-
15(a), in the form of a check payable to petitioner.
Respectfully submitted,
BENJAMIN C. MIZER
Principal Deputy Assistant Attorney General
RUPA BHATTACHARYYA
Director
Torts Branch, Civil Division
VINCENT J. MATANOSKI
Deputy Director
Tort Branch, Civil Division
HEATHER L. PEARLMAN
Senior Trial Attorney
Torts Branch, Civil Division
s/ Alexis B. Babcock
ALEXIS B. BABCOCK
Senior Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Dated: April 25, 2016 Telephone: (202) 616-7678
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 and future pain and suffering.
2