VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00178
Package ID: USCOURTS-cofc-1_16-vv-00178
Petitioner: Kathleen Theobald
Filed: 2016-02-04
Decided: 2016-09-26
Vaccine: influenza
Vaccination date: 2014-10-20
Condition: left shoulder injury
Outcome: compensated
Award amount USD: 77000

AI-assisted case summary:
Kathleen Theobald filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a left shoulder injury caused by an influenza vaccine she received on October 20, 2014. She stated that she received the vaccination in the United States, suffered residual effects for more than six months, and had not previously received an award. The case was assigned to the Special Processing Unit. The respondent filed a Rule 4(c) report conceding that Ms. Theobald's injury was consistent with Shoulder Injury Related to Vaccine Administration (SIRVA) and was caused by the flu vaccine. The respondent agreed that Ms. Theobald had satisfied all legal prerequisites for compensation. Based on the respondent's concession and the evidence, the court found Ms. Theobald entitled to compensation. Subsequently, in a damages decision, the respondent included a proffer for an award of $77,000.00, which Ms. Theobald agreed to. The court awarded Ms. Theobald a lump sum payment of $77,000.00 as compensation for all available damages.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-00178-0
Date issued/filed: 2016-08-16
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/30/2016) regarding 14 Ruling on Entitlement (Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:16-vv-00178-UNJ Document 20 Filed 08/16/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-178V
Filed: June 30, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATHLEEN THEOBALD, *
*
v. *
Petitioner, * Ruling on Entitlement; Concession;
* Influenza Vaccination;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”);
AND HUMAN SERVICES, * Special Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Maximillian Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
Amy Kokot, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On February 4, 2016, Kathleen Theobald (“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 she
suffered a left shoulder injury caused in fact by the influenza vaccine she received on
October 20, 2014. Petition at 1, ¶ 15. Petitioner further alleges that she received the
vaccination in the United States, suffered the residual effects of her injury for more than
six months, and has never received an award or settlement for her injury, alleged as
vaccine caused. Id. at ¶¶ 2, 15, 18. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
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 (2012)). 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-00178-UNJ Document 20 Filed 08/16/16 Page 2 of 2
On June 30, 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) Report3
at 1. Specifically, respondent “has concluded that petitioner’s alleged injury is
consistent with SIRVA and that it was caused-in-fact by the flu vaccine she received on
October 20, 2014.” Id. at 4. Respondent further agrees that “based on the record as it
now stands, petitioner has satisfied all legal prerequisites for compensation under the
Vaccine Act.” Id.
In view of respondent’s concession and the evidence before me, I find that
petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 Respondent filed the Rule 4(c) Report in conjunction with a Proffer, titling the document
“RESPONDENT’S RULE 4(c) REPORT AND PROFFER ON DAMAGES.”
2

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DOCUMENT 2: USCOURTS-cofc-1_16-vv-00178-1
Date issued/filed: 2016-08-16
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 06/30/2016) regarding 15 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:16-vv-00178-UNJ Document 21 Filed 08/16/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-178V
Filed: June 30, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATHLEEN THEOBALD, *
*
Petitioner, * Damages Decision Based on Proffer;
* Influenza Vaccine (“Flu Vaccine”);
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”);
AND HUMAN SERVICES, * Special Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Maximillian Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
Amy Kokot, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On February 4, 2016, Kathleen Theobald (“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 she
suffered a left shoulder injury caused in fact by the influenza vaccine she received on
October 20, 2014. Petition at 1, ¶ 15. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On June 30, 2016, the undersigned issued a ruling on entitlement, finding
petitioner entitled to compensation. In her June 30, 2016 Rule 4(c) Report, respondent
included a proffer on award of compensation, stating that petitioner should be awarded
$77,000.00. Respondent’s Rule 4(c) Report and Proffer at 4. Respondent represented
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-00178-UNJ Document 21 Filed 08/16/16 Page 2 of 2
that petitioner agrees with the proffered award. Id. at 5. Based on the record as a
whole, the undersigned finds that petitioner is entitled to an award as stated in the
Respondent’s Rule 4(c) Report and Proffer.
Pursuant to the terms stated in the Respondent’s Rule 4(c) Report and Proffer,3
the undersigned awards petitioner a lump sum payment of $77,000.00 in the form
of a check payable to petitioner, Kathleen Theobald. 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.4
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 Because Respondent’s Rule 4(c) Report and Proffer contains detailed medical information, it will not be
attached to this decision.
4 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

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DOCUMENT 3: USCOURTS-cofc-1_16-vv-00178-2
Date issued/filed: 2016-09-26
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/30/2016) regarding 14 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:16-vv-00178-UNJ Document 27 Filed 09/26/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-178V
Filed: June 30, 2016
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATHLEEN THEOBALD, *
*
v. *
Petitioner, * Ruling on Entitlement; Concession;
* Influenza Vaccination;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”);
AND HUMAN SERVICES, * Special Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Maximillian Muller, Muller Brazil, LLP, Dresher, PA, for petitioner.
Amy Kokot, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On February 4, 2016, Kathleen Theobald (“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 she
suffered a left shoulder injury caused in fact by the influenza vaccine she received on
October 20, 2014. Petition at 1, ¶ 15. Petitioner further alleges that she received the
vaccination in the United States, suffered the residual effects of her injury for more than
six months, and has never received an award or settlement for her injury, alleged as
vaccine caused. Id. at ¶¶ 2, 15, 18. The case was assigned to the Special Processing
Unit of the Office of Special Masters.
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 (2012)). 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-00178-UNJ Document 27 Filed 09/26/16 Page 2 of 2
On June 30, 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) Report3
at 1. Specifically, respondent “has concluded that petitioner’s alleged injury is
consistent with SIRVA and that it was caused-in-fact by the flu vaccine she received on
October 20, 2014.” Id. at 4. Respondent further agrees that “based on the record as it
now stands, petitioner has satisfied all legal prerequisites for compensation under the
Vaccine Act.” Id.
In view of respondent’s concession and the evidence before me, I find that
petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 Respondent filed the Rule 4(c) Report in conjunction with a Proffer, titling the document
“RESPONDENT’S RULE 4(c) REPORT AND PROFFER ON DAMAGES.”
2