Denise Goring v. HHS - Tdap, shoulder injury related to vaccine administration (SIRVA) (2019)

On November 4, 2016, Denise Goring, a 60-year-old adult, filed a petition for compensation under the National Vaccine Injury Compensation Program. She alleged that she suffered a left shoulder injury, specifically Shoulder Injury Related to Vaccine Administration (SIRVA), caused by a Tetanus Diphtheria acellular Pertussis (Tdap) vaccination she received on October 19, 2015.

On the same date, she also received influenza and shingles vaccines in her left arm. Ms.

Goring reported experiencing immediate pain and inflammation in her left shoulder following the vaccinations, which worsened over the subsequent days, leading to significant pain and limited range of motion. She sought medical treatment, including physical therapy, which provided substantial relief, although some residual limitations persisted.

The respondent, the Secretary of Health and Human Services, argued that the petition was filed before SIRVA was added to the Vaccine Injury Table, requiring Ms. Goring to prove causation-in-fact rather than relying on a presumed link.

The parties also disputed whether the Tdap vaccine or the shingles vaccine was the cause of the injury. Chief Special Master Nora Beth Dorsey issued a ruling on entitlement on May 6, 2019, finding that Ms.

Goring had established a prima facie case that the Tdap vaccine caused her SIRVA. The Special Master determined that the respondent bore the burden of proving that unrelated factors caused the injury and had not met this burden.

This ruling was based on applying the Althen test for causation-in-fact, considering the SIRVA Qualifications and Aids to Interpretation (QAI) as persuasive, and finding that Ms. Goring met all three prongs of the Althen test: a medical theory connecting the vaccine and injury, a logical sequence of cause and effect, and a proximate temporal relationship.

The Special Master also found that a lipoma on Ms. Goring's back was not a cause of her shoulder symptoms.

Following the entitlement ruling, a decision on damages was issued on November 15, 2019. The Special Master awarded Ms.

Goring $75,200.00 in damages. This award comprised $75,000.00 for pain and suffering and $200.00 for past unreimbursable medical expenses.

The Special Master noted that Ms. Goring experienced moderate to severe symptoms for approximately six months, with substantial improvement after physical therapy, but retained some residual limitations.

The award was based on prior SIRVA cases with similar symptom severity and duration, and it was determined that Ms. Goring did not meet the burden for future pain and suffering, nor was the cost of a specific exercise machine deemed reasonably necessary.