VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-01149
Package ID: USCOURTS-cofc-1_16-vv-01149
Petitioner: Jean Kusiak
Filed: 2017-07-18
Decided: 2018-01-25
Vaccine: influenza
Vaccination date: 2013-10-04
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 65000

AI-assisted case summary:
Jean Kusiak filed a petition for compensation under the National Vaccine Injury Compensation Program on July 18, 2017, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of her October 4, 2013 influenza vaccination. She further alleged that she suffered residual effects of her injury for more than six months and that there had been no prior award or settlement of a civil action for damages on her behalf. The respondent denied that the flu vaccine caused petitioner's alleged SIRVA or any other injury or her current condition. Nevertheless, on July 18, 2017, the parties filed a joint stipulation for compensation. Chief Special Master Nora Beth Dorsey found the stipulation reasonable and adopted it as the decision of the Court. Pursuant to the stipulation, Ms. Kusiak was awarded $65,000.00 as a lump sum payment, representing compensation for all items of damages available under the Vaccine Act. Paul S. Cantor, Esq. represented the petitioner, and Althea Walker Davis represented the respondent. The public decision does not describe the onset, specific symptoms, diagnostic tests, treatments, or expert witnesses.

Theory of causation field:
Petitioner Jean Kusiak alleged a shoulder injury related to vaccine administration (SIRVA) following an October 4, 2013 influenza vaccination. The respondent denied causation. The parties filed a joint stipulation for compensation, which was approved by Chief Special Master Nora Beth Dorsey. The stipulation resulted in an award of $65,000.00. The public text indicates the case falls under the "Table" category for theory of causation, but does not provide further details on the specific mechanism, expert testimony, or the breakdown of damages. Petitioner was represented by Paul S. Cantor, Esq., and respondent by Althea Walker Davis. The decision date was January 25, 2018.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-01149-0
Date issued/filed: 2018-01-25
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 7/18/2017) regarding 26 DECISION Stipulation/Proffer. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:16-vv-01149-UNJ Document 29 Filed 01/25/18 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-1149V
Filed: July 18, 2017
UNPUBLISHED
JEAN KUSIAK,
Special Processing Unit (SPU); Joint
Stipulation on Damages; Influenza
Petitioner,
(Flu) Vaccine; Shoulder Injury
v.
Related to Vaccine Administration
(SIRVA)
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Paul S. Cantor, Esq., Providence, RI, for petitioner.
Althea Walker Davis, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On September 15, 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 4, 2013 influenza (“flu”) vaccination.
Petition at 1; Stipulation, filed July 18, 2017, at ¶ 4. Petitioner further alleges that she
suffered residual effect of her injury for more than six months and that there has been
no prior award or settlement of a civil action for damages on her behalf as a result of her
condition. Petition at 3; Stipulation at ¶¶ 4-5. “Respondent denies that the flu vaccine
caused petitioner’s alleged SIRVA or any other injury or her current condition. ”
Stipulation at ¶ 6.
Nevertheless, on July 18, 2017, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. The undersigned
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-01149-UNJ Document 29 Filed 01/25/18 Page 2 of 7
finds the stipulation reasonable and adopts it as the decision of the Court in awarding
damages, on the terms set forth therein.
Pursuant to the terms stated in the attached Stipulation, the undersigned
awards the following compensation:
A lump sum of $65,000.00 in the form of a check payable to petitioner.
Stipulation at ¶ 8. 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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