Megan C. McFadden v. HHS - Influenza, Shoulder Injury Related to Vaccination Administration (SIRVA) (2023)
Case summary [AI summaries can sometimes make mistakes]
On September 23, 2016, Megan C. McFadden filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she received an influenza vaccine on September 28, 2013, and subsequently suffered from a Shoulder Injury Related to Vaccination Administration (SIRVA).
Following a ruling on onset, which found that her shoulder pain began within 24 hours of the vaccination, the respondent conceded entitlement, agreeing that McFadden had satisfied the criteria for SIRVA. The case then proceeded to the damages phase.
McFadden, born February 19, 1988, was 35 years old at the time of the decision. Her medical history included prior cervical muscle spasms.
She gave birth on September 19, 2013, and her infant required significant medical care for sleep apnea. McFadden received the influenza vaccine on September 28, 2013, in Okinawa, Japan, reporting immediate discomfort that progressed to pain within hours, localized high on her left deltoid.
She did not seek formal treatment for her shoulder for approximately six months, attributing the pain to compensating for certain ranges of motion and believing it would resolve, while prioritizing other more pressing medical issues. On March 7, 2014, she reported four months of left shoulder pain, rated 4 out of 10, with tenderness and abnormal motion.
After a procedure by a friend, she reported feeling pain-free and was referred to physical therapy. She attended physical therapy from March 18 to April 4, 2014, reporting pain reduced to 2 out of 10 and improvement in her ability to perform daily activities.
An examination on April 30, 2014, by Dr. Montgomery assessed arthralgia of the left shoulder, with SIRVA considered a likely diagnosis.
An MRI on May 2, 2014, showed mild tendinopathy of the rotator cuff and mild muscle edema, with an impression of a small intrinsic tear/strain to the subscapularis. McFadden continued physical therapy in Okinawa from July 29 to September 15, 2014, reporting pain between zero and 5 out of 10, and was discharged with zero pain, stating she was doing better and swimming freestyle without pain.
For over five years, from September 15, 2014, to June 12, 2020, the only medical records filed were for an annual flu vaccine and a physical examination where she reported engaging in regular exercise without shoulder complaints. In October 2021, memoranda from a physician and physical therapist indicated she received a steroid injection in March 2018 and physical therapy in 2018-2019, but no supporting medical records were filed.
On June 12, 2020, she presented with increased pain attributed to chronic overuse from exercise, with an MRI revealing mild subscapularis calcific tendinopathy and a new SLAP tear. She received a glenohumeral injection and underwent physical therapy from July 30 to October 28, 2020, reporting improvement and return to full activities.
A follow-up on April 20, 2021, noted left shoulder pain provoked by overhead activity, with findings of subacromial impingement and subscapularis tendinopathy. Surgery was discussed but deemed less reliable given her history.
Petitioner argued for an award of at least $170,000.00 for past pain and suffering, citing various cases and suggesting an average monthly award of $5,200.00 based on her alleged 85 months of pain. Respondent proposed an award of $62,500.00, citing comparative cases with less extensive treatment gaps.
Special Master Mindy Michaels Roth reviewed the medical records, noting significant gaps in treatment and periods where McFadden reported being pain-free or engaging in strenuous activities. The Special Master found that the evidence supported approximately 17-20 months of treatment, pain, suffering, and inability to engage in normal daily activities, rather than the 85 months claimed.
Considering the duration and severity of pain and suffering, the impact of caring for a newborn, and comparing to similar cases, the Special Master awarded McFadden $75,000.00 for past pain and suffering. No award was made for future pain and suffering due to the history of overuse injuries, significant treatment gaps, and the uncertain prognosis for surgery.
The decision was issued by Special Master Mindy Michaels Roth on November 6, 2023.
Theory of causation
Megan C. McFadden, born February 19, 1988, received an influenza vaccine on September 28, 2013. She alleged a Shoulder Injury Related to Vaccination Administration (SIRVA). The Special Master found that her shoulder pain began within 24 hours of the vaccination, satisfying the Table criteria for SIRVA. Respondent conceded entitlement. The case proceeded to damages. McFadden experienced shoulder pain starting within hours of the vaccination, which fluctuated in severity. She sought treatment intermittently, with significant gaps in medical records between September 2014 and June 2020. Medical records from 2014 indicated mild tendinopathy and a small tear/strain of the subscapularis. Later records in 2020 noted mild subscapularis calcific tendinopathy and a new SLAP tear, with pain attributed to chronic overuse and exercise. McFadden received two steroid injections and attended physical therapy sessions between 2014 and 2020. The Special Master awarded $75,000.00 for past pain and suffering, finding that the evidence supported approximately 17-20 months of continuous pain and debility, rather than the 85 months claimed, due to significant gaps in treatment and periods of improvement. No award was made for future pain and suffering. Decision by Special Master Mindy Michaels Roth on November 6, 2023. Petitioner counsel: Alexander Laufer, Esq. Respondent counsel: Mark Hellie, Esq.