VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-01435
Package ID: USCOURTS-cofc-1_16-vv-01435
Petitioner: Jerald Smith
Filed: 2016-10-31
Decided: 2017-12-08
Vaccine: influenza
Vaccination date: 2016-01-08
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 140000

AI-assisted case summary:
Jerald Smith filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he sustained a shoulder injury related to vaccine administration (SIRVA) from an influenza vaccination he received on January 8, 2016. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) Report conceding that Mr. Smith is entitled to compensation. The respondent agreed that Mr. Smith experienced SIRVA of the right upper extremity, which was more likely than not caused by the January 8, 2016, flu vaccination, and no other causes were identified. The medical records also demonstrated satisfaction of the statutory six-month sequela requirement. Based on the respondent's concession and the evidence of record, the Chief Special Master found Mr. Smith entitled to compensation. Subsequently, a decision awarding damages was issued. The respondent had previously proffered an award of $140,000.00, with which Mr. Smith agreed. The court awarded Mr. Smith a lump sum payment of $140,000.00 as compensation for all damages available under the Vaccine Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-01435-0
Date issued/filed: 2017-12-06
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/07/2017) regarding 15 Ruling on Entitlement ( Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:16-vv-01435-UNJ Document 27 Filed 12/06/17 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-1435V
Filed: April 7, 2017
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
JERALD SMITH, *
*
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. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Jeffrey S. Pop, Attorney at Law, Beverly Hills, CA, for petitioner.
Lisa A. Watts, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On October 31, 2016, Jerald Smith (“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 he sustained a shoulder injury related
to vaccine administration (“SIRVA”) from an influenza (“flu”) vaccination he received on
January 8, 2016. Petition at 1. The case was assigned to the Special Processing Unit
(“SPU”) of the Office of Special Masters.
On April 7, 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 agrees “that petitioner experienced SIRVA of the
right upper extremity[,] … more likely than not caused by the January 8, 2016, flu
vaccination.” Id. at 4. No other causes for petitioner’s injury were identified. Id. In
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-01435-UNJ Document 27 Filed 12/06/17 Page 2 of 2
addition, petitioner’s 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-01435-1
Date issued/filed: 2017-12-08
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 04/07/2017) regarding 16 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey.)(mpj) Copy to parties.
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Case 1:16-vv-01435-UNJ Document 28 Filed 12/08/17 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-1435V
Filed: April 7, 2017
Unpublished
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
JERALD SMITH, *
*
Petitioner, * Damages Decision Based on Proffer;
v. * Influenza (“Flu”) Vaccine; Shoulder
* Injury Related to Vaccine Administration
SECRETARY OF HEALTH * (“SIRVA”); Special Processing Unit
AND HUMAN SERVICES, * (“SPU”)
*
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Jeffrey S. Pop, Attorney at Law, Beverly Hills, CA, for petitioner.
Lisa A. Watts, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On October 31, 2016, Jerald Smith (“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 he sustained a shoulder injury related
to vaccine administration (“SIRVA”) from an influenza (“flu”) vaccination he received on
January 8, 2016. The case was assigned to the Special Processing Unit (“SPU”) of the
Office of Special Masters.
On April 7, 2017, the undersigned issued a ruling on entitlement finding petitioner
entitled to compensation for SIRVA. On April 7, 2017, respondent filed a proffer on
award of compensation (“Proffer”) in his Rule 4(c) Report indicating petitioner should be
awarded $140,000.00. Rule 4(c) Rep. at 4-5. In the Proffer, respondent represented
that petitioner agrees with the proffered award. Id. Based on the record as a whole, the
undersigned finds that petitioner is entitled to an award as stated 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-01435-UNJ Document 28 Filed 12/08/17 Page 2 of 2
Pursuant to the terms stated in the Proffer,3 the undersigned awards petitioner
a lump sum payment of $140,000.00 in the form of a check payable to petitioner,
Jerald Smith. 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.4
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3 The Proffer is not attached to this decision because it was included in the Rule 4(c) Report, which
contains confidential medical information.
4 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