VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00470
Package ID: USCOURTS-cofc-1_16-vv-00470
Petitioner: Rebecca S. Melgares
Filed: 2016-04-13
Decided: 2016-11-17
Vaccine: influenza
Vaccination date: 2014-10-20
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 148363

AI-assisted case summary:
Rebecca S. Melgares filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 20, 2014. The respondent, the Secretary of Health and Human Services, conceded that Ms. Melgares' injury was consistent with SIRVA and that she met the statutory requirements for compensation, including experiencing the condition for more than six months. The case proceeded as a Table claim, as SIRVA is recognized under the Vaccine Injury Table. Following the concession of entitlement, the parties submitted a joint stipulation for damages. On November 17, 2016, the Chief Special Master awarded Ms. Melgares a total of $148,363.83 as compensation for all items of damages available under the Vaccine Act. This award was based on the stipulation and covered her SIRVA injury.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-00470-0
Date issued/filed: 2016-06-16
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/19/2016) regarding 9 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:16-vv-00470-UNJ Document 11 Filed 06/16/16 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-0470V
Filed: May 19, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
REBECCA S. MELGARES, *
*
Petitioner, * Ruling on Entitlement; Concession;
v. * Influenza (“Flu”) Vaccine; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Joseph Michael Russell, Von Briesen & Roper, S.C., Milwaukee, WI, for petitioner.
Heather Lynn Pearlman, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On April 13, 2016, Rebecca S. Melgares (“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 she suffered a shoulder
injury related to vaccine administration (“SIRVA”) as a result of an influenza (“flu”)
vaccine she received on October 20, 2014. Petition at 1. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On May 19, 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 states that petitioner’s alleged injury is consistent with
SIRVA. Id. at 3. Respondent further agrees that petitioner met the statutory
requirements by suffering the condition for more than six months, and thus, petitioner
has satisfied all legal prerequisites for compensation under the Vaccine Act. Id.
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).
1

Case 1:16-vv-00470-UNJ Document 11 Filed 06/16/16 Page 2 of 2
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-00470-1
Date issued/filed: 2016-11-17
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 09/16/2016) regarding 21 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:16-vv-00470-UNJ Document 25 Filed 11/17/16 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-0470V
Filed: September 16, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
REBECCA S. MELGARES, *
*
Petitioner, * Damages Decision Based on Stipulation
v. * Influenza (“Flu”) Vaccine; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Joseph Michael Russell, Von Briesen & Roper, S.C., Milwaukee, WI, for petitioner.
Voris Edward Johnson, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On April 13, 2016, Rebecca S. Melgares (“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 she suffered from a
shoulder injury related to an influenza (“flu”) vaccine she received on October 20, 2014.
Petition at 1; Stipulation, filed September 16, 2016, at ¶ 2, 4. Petitioner further alleged
that she experienced the residual effects of her injury for more than six months. Petition
at 18; Stipulation at ¶ 5. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On May 19, 2016, a ruling on entitled was issued, finding petitioner entitled to
compensation for SIRVA. On September 16, 2016, respondent filed a joint stipulation
by the parties stipulation that petitioner should be awarded $148,363.83. Stipulation at
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-00470-UNJ Document 25 Filed 11/17/16 Page 2 of 7
¶ 9. Based on the record as a whole, the undersigned finds that petitioner is entitled to
an award as stated in the stipulation.
Pursuant to the terms stated in the attached stipulation, the undersigned
awards petitioner a lump sum payment of $148,363.83, in the form of a check
payable to petitioner. Stipulation at ¶ 9. This amount represents compensation for all
items of damages that would be available under 42 U.S.C. § 300aa-15(a). Id.
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

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