VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_16-vv-01596
Package ID: USCOURTS-cofc-1_16-vv-01596
Petitioner: Donna F. Madej
Filed: 2016-12-01
Decided: 2018-03-01
Vaccine: influenza
Vaccination date: 2015-10-26
Condition: right shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 90694

AI-assisted case summary:
Donna F. Madej filed a petition for compensation under the National Vaccine Injury Compensation Program on December 1, 2016. She alleged that she suffered a right shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on October 26, 2015. She further alleged that she suffered the residual effects of this injury for more than six months. The respondent, the Secretary of Health and Human Services, denied that the flu vaccine caused petitioner’s alleged shoulder injury or any other injury. Nevertheless, the parties filed a joint stipulation agreeing that a decision should be entered awarding compensation. The court adopted the stipulation as the decision of the Court in awarding damages. Pursuant to the stipulation, Donna F. Madej was awarded a lump sum of $90,694.65, representing compensation for all items of damages available under the Vaccine Act. The case was resolved by stipulation, and the injury was presumed to be a Table injury.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_16-vv-01596-1
Date issued/filed: 2018-03-01
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 11/14/2017) regarding 40 DECISION Stipulation/Proffer. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:16-vv-01596-UNJ Document 48 Filed 03/01/18 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 16-1596V
Filed: November 14, 2017
UNPUBLISHED
DONNA F. MADEJ,
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.
Carol L. Gallagher, Carol L. Gallagher, Esquire, LLC, Linwood, NJ, for petitioner.
Ilene Clair Albala, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On December 1, 2016, Donna F. Madej (“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 right
shoulder injury related to vaccine administration (“SIRVA”) as a result of an influenza
(“flu”) vaccine she received on October 26, 2015. Petition at 1; Stipulation, filed
November 14, 2017, at ¶ 4. Petitioner further alleges that she suffered the residual
effects of this alleged injury for more than six months. Petition at 1; Stipulation at ¶ 4.
“Respondent denies that the flu vaccine caused petitioner’s alleged shoulder injury or
any other injury or her current condition.” Stipulation at ¶ 6.
Nevertheless, on November 13, 2017, the parties filed the attached joint
stipulation, stating that a decision should be entered awarding compensation. 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-01596-UNJ Document 48 Filed 03/01/18 Page 2 of 7
undersigned 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 $90,694.65, 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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