VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-00790
Package ID: USCOURTS-cofc-1_16-vv-00790
Petitioner: Katie Tambouris
Filed: 2016-11-03
Decided: 2018-04-05
Vaccine: influenza
Vaccination date: 2014-10-01
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 97921

AI-assisted case summary:
Katie Tambouris filed a petition for compensation under the National Vaccine Injury Compensation Program on November 3, 2016, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of her October 1, 2014 influenza vaccination. The respondent conceded that petitioner suffered a non-Table injury of SIRVA and that the preponderance of the medical evidence indicated the injury was causally related to the vaccination. The respondent also agreed that no other causes were identified and that petitioner met the statutory requirements for compensation. On November 3, 2016, a ruling on entitlement was issued, finding petitioner entitled to compensation. Subsequently, on March 17, 2017, the respondent filed a proffer on award of compensation. The parties agreed to a total award of $97,921.76, comprising $95,000.00 for pain and suffering, $2,866.00 for future expenses, and $55.76 for past expenses. This amount represents all elements of compensation to which petitioner would be entitled. A decision awarding damages was issued on April 5, 2018, granting the lump sum payment.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-00790-0
Date issued/filed: 2017-02-16
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/3/2016) 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-00790-UNJ Document 23 Filed 02/16/17 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-790V
Filed: November 3, 2016
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATIE TAMBOURIS, *
*
Petitioner, * Ruling on Entitlement; Concession;
v. * Influenza (“Flu”) Vaccination; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Ronald Craig Homer, Conway, Homer & Chin-Caplan, P.C., for petitioner.
Douglas Ross, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On July 1, 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 suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of her October 1, 2014 influenza (“flu”) vaccination.
Petition at 1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On November 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 has concluded “that petitioner suffered a non-
Table injury of SIRVA and that the preponderance of the medical evidence indicates
that the injury was causally related to the flu vaccination she received on October 1,
2014.” Id. at 4. Respondent further agrees that no other causes have been identified
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-00790-UNJ Document 23 Filed 02/16/17 Page 2 of 2
for petitioner’s injury and “petitioner met the statutory requirements by suffering the
condition for more than six months.” Id. Accordingly, respondent states that “based on
the record as it now stands, compensation is appropriate, as petitioner has satisfied all
legal prerequisites for compensation under the 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-00790-1
Date issued/filed: 2018-04-05
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 03/17/2017) regarding 27 DECISION Stipulation/Proffer ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Service on parties made.
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Case 1:16-vv-00790-UNJ Document 37 Filed 04/05/18 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-790V
Filed: March 17, 2017
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
KATIE TAMBOURIS, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Influenza (“Flu”) Vaccination;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”); Special
AND HUMAN SERVICES, * Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Ronald Craig Homer, Conway, Homer & Chin-Caplan, P.C., for petitioner.
Douglas Ross, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On July 1, 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 suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of her October 1, 2014 influenza (“flu”) vaccination.
Petition at 1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
On November 3, 2016, a ruling on entitlement was issued, finding petitioner
entitled to compensation for SIRVA. On March 17, 2017, respondent filed a proffer on
award of compensation (“Proffer”) indicating that petitioner should be awarded
compensation of $95,000.00 representing pain and suffering, $2,866.00 representing
future expenses, and $55.76 representing past expenses. Proffer at 1. In the Proffer,
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-00790-UNJ Document 37 Filed 04/05/18 Page 2 of 4
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 $97,921.76 which represents compensation for
pain and suffering ($95,000.00), future expenses ($2,866.00), and past expenses
($55.76), in the form of a check payable to petitioner, Katie Tambouris. 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-00790-UNJ Document 37 Filed 04/05/18 Page 3 of 4
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
*
KATIE TAMBOURIS, *
*
Petitioner, *
*
v. * No. 16-790V (ECF)
* CHIEF SPECIAL MASTER
* NORA BETH DORSEY
SECRETARY OF HEALTH *
AND HUMAN SERVICES, *
*
Respondent. *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
In her November 4, 2016 decision, the Chief Special Master found that a preponderance
of the medical evidence indicates that petitioner suffered a shoulder injury related to vaccine
administration (“SIRVA”), which was causally related to the flu vaccination she received on
October 1, 2014. 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 a lump sum of $97,921.76
should be awarded petitioner. This amount is comprised of: a) $95,000.00 for pain and
suffering; b) $2,866.00 in future expenses; and c) $55.76 for past expenses. This lump sum
amount represents 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-00790-UNJ Document 37 Filed 04/05/18 Page 4 of 4
II. Form of the Award
The parties recommend that the compensation provided should be made in the form of a
check for $97,921.76, payable to petitioner.
Respectfully submitted,
CHAD A. READLER
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
CATHARINE E. REEVES
Deputy Director
Torts Branch, Civil Division
LINDA S. RENZI
Senior Trial Counsel
Torts Branch, Civil Division
/s/ DOUGLAS ROSS
DOUGLAS ROSS
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel.: (202) 616-3667
DATE: March 17, 2017
2