VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00040
Package ID: USCOURTS-cofc-1_16-vv-00040
Petitioner: Ann Stoneburner
Filed: 2016-01-08
Decided: 2016-10-06
Vaccine: influenza
Vaccination date: 2014-09-09
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 150843

AI-assisted case summary:
Ann Stoneburner filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a left shoulder injury as a result of receiving a high-dose influenza vaccine on September 9, 2014. The respondent, the Secretary of Health and Human Services, conceded that Ms. Stoneburner's injury was consistent with shoulder injury related to vaccine administration (SIRVA) and that it was caused-in-fact by the flu vaccine. The respondent also stated that no other causes for the SIRVA were identified and that the injury had sequelae for more than six months. Based on the respondent's concession and the evidence, the Chief Special Master ruled that Ms. Stoneburner was entitled to compensation. Subsequently, the parties submitted a proffer on the award of compensation. The respondent proffered that Ms. Stoneburner should be awarded $150,843.84, representing all elements of compensation available under the Act, and Ms. Stoneburner agreed with this amount. The decision awarded Ms. Stoneburner a lump sum payment of $150,843.84.

Theory of causation field:
Off-Table

Public staged source text:

================================================================================
DOCUMENT 1: USCOURTS-cofc-1_16-vv-00040-0
Date issued/filed: 2016-09-26
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/23/2016) regarding 14 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:16-vv-00040-UNJ Document 34 Filed 09/26/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-0040V
Filed: March 23, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANN STONEBURNER, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Influenza (“Flu”) Vaccine; Shoulder
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”); Special
AND HUMAN SERVICES, * Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Diana Sedar, Maglio Christopher and Toale, PA, for petitioner.
Darryl Wishard, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On January 8, 2016, Ann Stoneburner (“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 as a result
of receiving the high-dose influenza (“flu”) vaccine on September 9, 2014, she suffered
an injury to her left shoulder. Petition at 1-3. The case was assigned to the Special
Processing Unit (“SPU”) of the Office of Special Masters.
On March 23, 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 she received on September 9, 2014. Id. at 3. Respondent
further stated that she did not identify any other causes for petitioner’s SIRVA, and 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 1:16-vv-00040-UNJ Document 34 Filed 09/26/16 Page 2 of 2
the records show that she has suffered the sequela of this injury for more than six
months. Id. Therefore, based on the record as it now stands, petitioner has satisfied all
legal prerequisites for compensation under the Act. Id. at 4.
In view of respondent’s concession and the evidence of record, the
undersigned finds that petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
2

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_16-vv-00040-1
Date issued/filed: 2016-10-06
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 08/05/2016) regarding 26 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:16-vv-00040-UNJ Document 35 Filed 10/06/16 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-040V
Filed: August 5, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
ANN STONEBURNER, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Influenza (“Flu”) Vaccine; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Diana Sedar, Maglio Christopher and Toale, PA, for petitioner.
Darryl Wishard, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On January 8, 2016, Ann Stoneburner (“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 as a result of receiving
the high-dose influenza (“flu”) vaccine on September 9, 2014, she suffered an injury to
her left shoulder. Petition at 1-3. The case was assigned to the Special Processing
Unit (“SPU”) of the Office of Special Masters.
On March 23, 2016, the undersigned issued a ruling on entitlement finding
petitioner entitled to compensation for a shoulder injury related to vaccine administration
(“SIRVA”). On August 4, 2016, respondent filed a proffer on award of compensation
(“Proffer”) indicating petitioner should be awarded $150,843.84. Proffer at 1. In the
Proffer, respondent represented that petitioner agrees with the proffered award. Id.
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 1:16-vv-00040-UNJ Document 35 Filed 10/06/16 Page 2 of 4
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 $150,843.84 in the form of a check payable to
petitioner, Ann Stoneburner. 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 1:16-vv-00040-UNJ Document 35 Filed 10/06/16 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
ANN STONEBURNER, )
)
Petitioner, ) No. 16-40V ECF
)
v. ) Chief Special Master Dorsey
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
___________________________________ )
PROFFER ON AWARD OF COMPENSATION1
I. Procedural History
On January 8, 2016, Ann Stoneburner (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -
34, as amended. She alleges that, as a result of receiving the high-dose influenza (“flu”) vaccine
on September 9, 2014, she suffered from a left shoulder injury. Petition at 1-3.
On March 23, 2016, respondent filed her Vaccine Rule 4(c) report, conceding causation-
in-fact for petitioner’s shoulder injury related to vaccine administration (“SIRVA”). On that
same day, the Chief Special Master issued a ruling on entitlement, finding that petitioner was
entitled to compensation for SIRVA.
II. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
$150,843.84, which represents all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to
discuss after the Damages Decision is issued.

Case 1:16-vv-00040-UNJ Document 35 Filed 10/06/16 Page 4 of 4
III. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $150,843.84, in the form of a check payable to petitioner.2
Petitioner agrees.
Respectfully submitted,
BENJAMIN C. MIZER
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Acting Deputy Director
Torts Branch, Civil Division
ALTHEA WALKER DAVIS
Senior Trial Counsel
Torts Branch, Civil Division
/s/Darryl R. Wishard
DARRYL R. WISHARD
Senior Trial Attorney
Torts Branch, Civil Division
U. S. Department of Justice
P.O. Box l46, Benjamin Franklin Station
Washington, D.C. 20044-0146
Direct dial: (202) 616-4357
Dated: August 4, 2016 Fax: (202) 616-4310
2 Should petitioner die prior to entry of judgment, respondent would oppose any award
for future medical expenses, future lost earnings, and future pain and suffering, and the parties
reserve the right to move the Court for appropriate relief.
2