VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00190
Package ID: USCOURTS-cofc-1_16-vv-00190
Petitioner: Kathryn Stacy
Filed: 2016-02-08
Decided: 2016-10-05
Vaccine: influenza
Vaccination date: 2014-10-15
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 160167

AI-assisted case summary:
Kathryn Stacy filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccination on October 15, 2014. The case was assigned to the Special Processing Unit. Respondent conceded that petitioner's injury was consistent with SIRVA and that she met the statutory requirements, including suffering the condition for more than six months. Respondent also agreed that petitioner satisfied all legal prerequisites for compensation. Consequently, a ruling on entitlement was issued, finding petitioner entitled to compensation. Subsequently, the parties addressed the amount of compensation. Respondent filed a proffer indicating that petitioner should be awarded a lump sum of $160,167.69. This amount included $140,000.00 for pain and suffering, $20,000.00 for future unreimbursable expenses, and $167.69 for past unreimbursable expenses. Petitioner agreed with this proffered award. The Chief Special Master issued a decision awarding petitioner the lump sum of $160,167.69, representing compensation for all damages available under the Vaccine Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-00190-0
Date issued/filed: 2016-05-19
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/11/2016) regarding 17 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:16-vv-00190-UNJ Document 21 Filed 05/19/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-190V
Filed: April 11, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATHRYN STACY, *
*
Petitioner, * Ruling on Entitlement; Concession;
* Influenza;
v.
* Shoulder Injury (“SIRVA”);
SECRETARY OF HEALTH * Special Processing Unit (“SPU”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Ronald Homer, Conway, Homer & Chin-Caplan, P.C., for petitioner.
Heather Pearlman, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On February 8, 2016, 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 experienced a shoulder injury related to
vaccine administration (“SIRVA”) as a result of receiving her October 15, 2014 influenza
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On April 11, 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 “agrees that petitioner’s alleged injury is consistent with
SIRVA” and further states that “petitioner met the statutory requirements by suffering
the condition for more than six months.” Id. at 3. Respondent further agrees 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-00190-UNJ Document 21 Filed 05/19/16 Page 2 of 2
petitioner has satisfied all legal prerequisites for compensation 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
2

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DOCUMENT 2: USCOURTS-cofc-1_16-vv-00190-1
Date issued/filed: 2016-10-05
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 07/22/2016) regarding 28 DECISION Stipulation/Proffer, ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:16-vv-00190-UNJ Document 35 Filed 10/05/16 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-190V
Filed: July 22, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATHRYN STACY, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Influenza;
* Shoulder Injury; SIRVA;
SECRETARY OF HEALTH * Special Processing Unit (“SPU”)
AND HUMAN SERVICES, *
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Ronald Craig Homer, Conway, Homer & chin-Caplan, Boston, MA, for petitioner.
Voris Edward Johnson, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On February 8, 2016, 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 experienced a shoulder injury related to
vaccine administration (“SIRVA”) as a result of receiving her October 15, 2014 influenza
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On April 11, 2016, a ruling on entitlement was issued, finding petitioner entitled to
compensation for SIRVA. On July 21, 2016, respondent filed a proffer on award of
compensation (“Proffer”) indicating petitioner should be awarded a lump sum of
$160,167.69, consisting of:
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-00190-UNJ Document 35 Filed 10/05/16 Page 2 of 4
• $140,000.00 for actual and projected pain and suffering;
• $20,000.00 for certain unreimbursable expenses petitioner will incur in the future
as a result of her vaccine-related injury; and
• $167.69 for past unreimbursable expenses.
Proffer at 1. In the Proffer, respondent represented that petitioner agrees with the
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 $160,167.69 in the form of a check payable to
petitioner, Kathryn Stacy. 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-00190-UNJ Document 35 Filed 10/05/16 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
__________________________________________
)
KATHRYN STACY, )
)
Petitioner, )
) No. 16-190V (ECF)
v. ) Chief Special Master Dorsey
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
__________________________________________)
RESPONDENT'S PROFFER ON AWARD OF COMPENSATION
In her Ruling on Entitlement issued on April 11, 2016, the Chief Special Master found
that a preponderance of the evidence indicates that petitioner, Kathryn Stacy, suffered a shoulder
injury related to vaccine administration (“SIRVA”), which was causally-related to the flu
vaccination she received on October 15, 2015. The parties have now addressed the amount of
compensation to be awarded in this case.
I. Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
a lump sum of $160,167.69, consisting of $140,000.00 for actual and projected pain and
suffering, $20,000.00 for certain unreimbursable expenses petitioner will incur in the future as a
result of her vaccine-related injury, and past unreimbursable expenses in the amount of $167.69.
These amounts represent all elements of compensation to which petitioner would be entitled
under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
1 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.

Case 1:16-vv-00190-UNJ Document 35 Filed 10/05/16 Page 4 of 4
II. Form of the Award
The parties recommend that the compensation provided should be made through a lump
sum payment in the form of a check for $160,167.69, payable to petitioner.
Respectfully submitted,
BENJAMIN C. MIZER
Principal Deputy Assistant Attorney General
RUPA BHATTACHARYYA
Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Acting Deputy Director
Torts Branch, Civil Division
LISA A. WATTS
Senior Trial Attorney
Torts Branch, Civil Division
s/Voris E. Johnson, Jr.
VORIS E. JOHNSON, JR.
Senior Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
(202) 616-4136
DATED: July 22, 2016
2