VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-01337
Package ID: USCOURTS-cofc-1_16-vv-01337
Petitioner: Marguerite Acker
Filed: 2016-10-13
Decided: 2018-08-14
Vaccine: influenza
Vaccination date: 2015-10-16
Condition: shoulder injury related to vaccine administration
Outcome: compensated
Award amount USD: 104107.77

AI-assisted case summary:
Marguerite Acker filed a petition for compensation on October 13, 2016, alleging she suffered shoulder injuries from an influenza vaccination administered on October 16, 2015. The respondent filed a Rule 4(c) Report on May 12, 2017, conceding that Ms. Acker was entitled to compensation. The respondent's medical personnel concluded that Ms. Acker's alleged injury was consistent with a shoulder injury related to vaccine administration (SIRVA), and no other causes for the injury were identified. The respondent also noted that Ms. Acker's medical records demonstrated satisfaction of the statutory six-month sequela requirement. Based on the respondent's concession and the evidence of record, Chief Special Master Nora Beth Dorsey issued a ruling on entitlement on May 12, 2017, finding Ms. Acker entitled to compensation. Subsequently, on April 11, 2018, the respondent filed a proffer on the award of compensation. The proffer indicated that Ms. Acker should be awarded $100,000.00, representing all elements of compensation under § 15(a) of the Vaccine Act, plus funds to satisfy the State of Michigan Medicaid lien in the amount of $182.31, and funds to satisfy the Molina Healthcare of MI Medicaid lien in the amount of $3,925.46. The respondent represented that Ms. Acker agreed with the proffered award. Chief Special Master Dorsey issued a decision awarding damages on August 14, 2018, based on the proffer. The award included a lump sum payment of $100,000.00 to Ms. Acker, a lump sum payment of $182.31 payable jointly to Ms. Acker and the Michigan Department of Health and Human Services to satisfy the Medicaid lien, and a lump sum payment of $3,925.46 payable jointly to Ms. Acker and Equian, LLC to satisfy the Molina Healthcare of MI Medicaid lien. Ms. Acker is a competent adult. Petitioner's counsel was Paul R. Brazil of Muller Brazil, LLP. Respondent's counsel was Althea Walker Davis of the U.S. Department of Justice. Chief Special Master Nora Beth Dorsey presided over the case.

Theory of causation field:
Petitioner Marguerite Acker filed a petition alleging shoulder injuries from an influenza vaccination administered on October 16, 2015. The respondent conceded entitlement, finding the injury consistent with Shoulder Injury Related to Vaccine Administration (SIRVA), a condition covered under the National Childhood Vaccine Injury Act's "Table" of injuries. No other causes were identified, and the six-month sequela requirement was met. The case proceeded as a Table claim. Chief Special Master Nora Beth Dorsey ruled on entitlement on May 12, 2017. On April 11, 2018, a proffer on award was filed, stipulating a total award of $104,107.77, comprising $100,000.00 for all elements of compensation, $182.31 to satisfy the State of Michigan Medicaid lien, and $3,925.46 to satisfy the Molina Healthcare of MI Medicaid lien. Chief Special Master Dorsey issued the final decision awarding damages on August 14, 2018. Petitioner's counsel was Paul R. Brazil; respondent's counsel was Althea Walker Davis.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-01337-0
Date issued/filed: 2017-12-13
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/12/2017) regarding 18 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
--------------------------------------------------------------------------------
Case 1:16-vv-01337-UNJ Document 38 Filed 12/13/17 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-1337V
Filed: May 12, 2017
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
MARGUERITE ACKER, *
*
Petitioner, * Ruling on Entitlement (Non-Table);
v. * Concession; Influenza (“Flu”) Vaccine;
* Shoulder Injury Related to Vaccine
SECRETARY OF HEALTH * Administration (“SIRVA”); Special
AND HUMAN SERVICES, * Processing Unit (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for petitioner.
Althea W. Davis, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On October 13, 2016, Marguerite Acker (“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 shoulder
injuries from an influenza (“flu”) vaccination administered on October 16, 2015. Petition
at preamble. The case was assigned to the Special Processing Unit (“SPU”) of the
Office of Special Masters.
On May 12, 2017, respondent filed a Rule 4(c) Report conceding that petitioner is
entitled to compensation. Rule 4(c) Rep. at 1. Based on the opinion of the medical
personnel at the Division of Injury Compensation Programs, Department of Health and
Human Services (“DICP”), respondent has concluded that petitioner’s alleged injury is
consistent with a shoulder injury related to vaccine administration (“SIRVA”). Id. at 4.
No other causes for petitioner’s injury were identified. Id. In addition, petitioner’s
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-01337-UNJ Document 38 Filed 12/13/17 Page 2 of 2
medical records demonstrate satisfaction of the statutory six-month sequela
requirement. Id. Based on the record as it now stands, respondent believes entitlement
to Vaccine Act compensation is appropriate. Id.
In view of respondent’s concession and the evidence of record, 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-01337-1
Date issued/filed: 2018-08-14
Pages: 6
Docket text: PUBLIC DECISION (Originally filed: 04/11/2018) regarding 47 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:16-vv-01337-UNJ Document 56 Filed 08/14/18 Page 1 of 6
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-1337V
Filed: April 11, 2018
UNPUBLISHED
MARGUERITE ACKER,
Special Processing Unit (SPU);
Damages Decision Based on Proffer;
Petitioner,
Influenza (Flu) Vaccine; Shoulder
v.
Injury Related to Vaccine
Administration (SIRVA)
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for petitioner.
Althea Walker Davis, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On October 13, 2016, Marguerite Acker (“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 shoulder
injuries from an influenza (“flu”) vaccination administered on October 16, 2015. Petition
at preamble. The case was assigned to the Special Processing Unit (“SPU”) of the
Office of Special Masters.
On May 12, 2017, a ruling on entitlement was issued, finding petitioner entitled to
compensation for her shoulder injuries. On April 11, 2018, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $100,000.00,
which represents all elements of compensation to which petitioner would be entitled
under § 15(a); funds to satisfy in full the State of Michigan Medicaid lien in the amount
of $182.31, and funds to satisfy in full the Molina Healthcare of MI Medicaid lien in the
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-01337-UNJ Document 56 Filed 08/14/18 Page 2 of 6
amount of $3,925.46. Proffer at 1-2. 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
the following compensation:
1. A lump sum payment of $100,000.00 in the form of a check payable to
petitioner, Marguerite Acker. This amount accounts for all elements of
compensation under § 15(a) to which petitioner would be entitled; and
2. A lump sum payment of $182.31, representing compensation for satisfaction of
the State of Michigan Medicaid lien, payable jointly to petitioner and to:
Michigan Department of Health and Human Services
P.O. Box 30435
Lansing, MI 48909-7979
Attn: 3rd Party Liability Division
Member: Marguerite Acker
Medicaid ID#: 0021504523
Petitioner agrees to endorse this payment to the Michigan Department of Health
and Human Services; and
3. A lump sum payment of $3,925.46, representing compensation for satisfaction
of the Molina Healthcare of MI Medicaid lien, payable jointly to petitioner and to:
Equian, LLC
P.O. Box 771932
Detroit, MI 48277-1932
Member: Marguerite Acker
Equian File No.: 822569-113017
Petitioner agrees to endorse this payment to Equian, LLC.
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-01337-UNJ Document 56 Filed 08/14/18 Page 3 of 6
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
MARGUERITE ACKER, )
)
Petitioner, ) No. 16-1337V
) Chief Special Master
v. ) Nora Beth Dorsey
) ECF
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT'S PROFFER ON AWARD OF COMPENSATION
On October 13, 2016, Marguerite Acker (“petitioner”) filed a petition for
compensation (“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42
U.S.C. §§ 300aa-1 to -34 (“Vaccine Act” or “Act”), as amended. Respondent conceded
petitioner’s entitlement to compensation in his Rule 4(c) Report filed on May 12, 2017.
Based on Respondent’s Rule 4(c) Report, that same day, the Chief Special Master found
petitioner entitled to compensation.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be
awarded $100,000.00, which represents all elements of compensation to which petitioner
would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Respondent further proffers that petitioner, Marguerite Acker, should be awarded
funds to satisfy, in full, the State of Michigan Medicaid lien in the amount of $182.31,
which funds represent satisfaction of any right of subrogation, assignment, claim, lien, or
cause of action the State of Michigan may have against any individual as a result of any
Medicaid payments the State of Michigan has made to or on behalf of Marguerite Acker
1

Case 1:16-vv-01337-UNJ Document 56 Filed 08/14/18 Page 4 of 6
from the date of her eligibility for benefits through the date of judgment in this case as a
result of her vaccine-related injury, under Title XIX of the Social Security Act. In
addition, respondent proffers that petitioner, Marguerite Acker, should be awarded funds
to satisfy, in full, the Molina Healthcare of MI Medicaid lien in the amount of $3,925.46,
which funds represent satisfaction of any right of subrogation, assignment, claim, lien, or
cause of action the Molina Healthcare of MI may have against any individual as a result
of any Medicaid payments the Molina Healthcare of MI has made to or on behalf of
Marguerite Acker from the date of her eligibility for benefits through the date of judgment
in this case as a result of her vaccine-related injury, under Title XIX of the Social Security
Act.
II. Form of the Award
The parties recommend that the compensation provided to Marguerite Acker
should be made through three lump sum payments as described below, and request that
the special master’s decision and the Court’s judgment award the following:1
(1) A lump sum payment of $100,000.00 in the form of a check payable to
petitioner, Marguerite Acker. This amount accounts for all elements of
compensation under 42 U.S.C. § 300aa-15(a) to which petitioner would be
entitled; and
(2) A lump sum payment of $182.31, representing compensation for satisfaction
of the State of Michigan Medicaid lien, payable jointly to petitioner and to:
Michigan Department of Health and Human Services
P. O. Box 30435
Lansing, MI 48909-7979
Attn: 3rd Party Liability Division
Member: Marguerite Acker
Medicaid ID#: 0021504523
1 Should petitioner die prior to entry of judgment, the parties reserve the right to move
the Court for appropriate relief. In particular, respondent would oppose any award for
future medical expenses and future pain and suffering.
2

Case 1:16-vv-01337-UNJ Document 56 Filed 08/14/18 Page 5 of 6
Petitioner agrees to endorse this payment to the Michigan Department of Health and
Human Services; and
(3) A lump sum payment of $3,925.46, representing compensation for satisfaction
of the Molina Healthcare of MI Medicaid lien, payable jointly to petitioner and
to:
Equian, LLC
P. O. Box 771932
Detroit, MI 48277-1932
Member: Marguerite Acker
Equian File No.: 822569-113017
Petitioner agrees to endorse this payment to Equian, LLC.
Petitioner is a competent adult. Evidence of guardianship is not required in this
case.
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
HEATHER L. PEARLMAN
Assistant Director
Torts Branch, Civil Division
3

Case 1:16-vv-01337-UNJ Document 56 Filed 08/14/18 Page 6 of 6
s/Althea Walker Davis
ALTHEA WALKER DAVIS
Senior Trial Counsel
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-0515
DATED: 11 April 2018
4