VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00102
Package ID: USCOURTS-cofc-1_17-vv-00102
Petitioner: Maria Peters
Filed: 2017-01-23
Decided: 2018-10-18
Vaccine: influenza
Vaccination date: 2015-10-13
Condition: left shoulder injury
Outcome: compensated
Award amount USD: 91901

AI-assisted case summary:
Maria Peters filed a petition for compensation under the National Vaccine Injury Compensation Program on January 23, 2017, alleging she suffered a left shoulder injury as a result of an influenza vaccine received on October 13, 2015. The respondent, the Secretary of Health and Human Services, denied that the vaccine caused the alleged injury. Despite this denial, the parties filed a joint stipulation on May 31, 2018, agreeing to a settlement. Chief Special Master Nora Beth Dorsey reviewed the stipulation and adopted it as the decision of the court. The decision awarded Maria Peters a lump sum of $91,901.18, payable by check to the petitioner. This amount was stipulated to represent compensation for all items of damages available under the Vaccine Act, 42 U.S.C. § 300aa-15(a). The case was settled as a "Table claim" for Shoulder Injury Related to Vaccine Administration (SIRVA). The stipulation also noted that the parties would submit to further proceedings to award reasonable attorneys' fees and costs. The decision stated that the stipulation represents a full and complete negotiated settlement of liability and damages, except for attorneys' fees, litigation costs, and past unreimbursable expenses. It was explicitly stated that the stipulation is not an admission by the United States or the Secretary of Health and Human Services that the influenza vaccine caused the petitioner's alleged left shoulder injury or any other injury. The public decision does not describe the specific onset of symptoms, medical tests, treatments, or expert witnesses involved in this case. Petitioner was represented by Amber Diane Wilson of Maglio Christopher & Toale, PA, and respondent was represented by Ann Donohue Martin of the U.S. Department of Justice.

Theory of causation field:
Petitioner Maria Peters received an influenza vaccine on October 13, 2015, and alleged a left shoulder injury, specifically a Shoulder Injury Related to Vaccine Administration (SIRVA), which persisted for more than six months. The respondent denied causation. The parties reached a settlement via joint stipulation, agreeing to an award of $91,901.18. This case was settled as a "Table claim" under the Vaccine Injury Table. The public decision does not detail the specific mechanism of injury, expert testimony, or clinical findings. The stipulation explicitly states it is not an admission of causation by the respondent. The decision was made by Chief Special Master Nora Beth Dorsey on October 18, 2018, based on the joint stipulation filed May 31, 2018. Petitioner's counsel was Amber Diane Wilson, and respondent's counsel was Ann Donohue Martin.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00102-1
Date issued/filed: 2018-10-18
Pages: 7
Docket text: PUBLIC DECISION (Originally filed: 05/31/2018) regarding 34 DECISION Stipulation/Proffer (Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 1 of 7
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0102V
Filed: May 31, 2018
UNPUBLISHED
MARIA PETERS,
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.
Amber Diane Wilson, Maglio Christopher & Toale, PA, Washington, DC, for petitioner.
Ann Donohue Martin, U.S. Department of Justice, Washington, DC, for respondent.
DECISION ON JOINT STIPULATION1
Dorsey, Chief Special Master:
On January 23, 2017, Maria Peters (“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 left shoulder injury as
the result of an influenza (“flu”) vaccine she received on October 13, 2015. Petition at 1;
Stipulation, filed May 31, 2018, at ¶ 1, 3. Petitioner further alleges that her vaccine
related injuries have last for more than six months. Petition at 3; Stipulation at ¶ 4.
“Respondent denies that the influenza vaccine caused petitioner to suffer a left shoulder
injury, or any other injury.” Stipulation at ¶ 6.
Nevertheless, on May 31, 2018, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. The undersigned
finds the stipulation reasonable and adopts it as the decision of the Court in awarding
damages, on the terms set forth therein.
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 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 2 of 7
Pursuant to the terms stated in the attached Stipulation, the undersigned
awards the following compensation:
A lump sum of $91,901.18, 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

Case 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 3 of 7
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
MARIA PETERS, )
)
Petitioner, )
) No. 17-102V
v. ) Chief Special Master Dorsey
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
STIPULATION
The parties hereby stipulate to the following matters:
1. Petitioner filed a petition for vaccine compensation under the National Vaccine Injury
Compensation Program, 42 U.S.C. §§ 300aa-10 to -34 (the “Vaccine Program”). The petition
seeks compensation for injuries allegedly related to petitioner’s receipt of the influenza vaccine,
which vaccine is contained in the Vaccine Injury Table (the “Table”), 42 C.F.R. § 100.3(a).
2. Petitioner received her influenza immunization on October 13, 2015.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she suffered a left shoulder injury as a result of the influenza
vaccine. Petitioner further alleges that she experienced the residual effects of her left shoulder
injury for more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages on her behalf as a result of her condition.
6. Respondent denies that the influenza vaccine caused petitioner to suffer aleft
shoulder injury, or any other injury.

Case 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 4 of 7
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(1), the Secretary of Health and Human Services will issue a
lump sum payment of $91,901.18in the form of a check payable to petitioner. This amount
represents compensation for all damages that would be available under 42 U.S.C. § 300aa-15(a).
9. As soon as practicable after the entry of judgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to
42 U.S.C. § 300aa-21(a)(1), and an application, the parties will submit to further proceedings
before the special master to award reasonable attorneys’ fees and costs incurred in proceeding
upon this petition.
10. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C. §
1396 et seq.)), or by entities that provide health services on a pre-paid basis.
11. Payment made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-15(i), subject
to the availability of sufficient statutory funds.
2

Case 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 5 of 7
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys’ fees, litigation costs, and past unreimbursable expenses, the money provided
pursuant to this Stipulation will be usedsolely for the benefit of petitioner as contemplated by a
strict construction of 42 U.S.C. §§ 300aa-15(a) and (d), and subject to the conditions of
42U.S.C. §§ 300aa-15(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements, judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300aa-10 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from, the influenza vaccination administered on October 13,
2015,as alleged by petitioner in a petition for vaccine compensation filed on or about January
23,2017,in the United States Court of Federal Claims as petition No. 17-102V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court onbehalf of either or both of the parties.
15. If the special master fails to issue a decision in complete conformity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties’
settlement and this Stipulation shall be voidable at the sole discretion of either party.
3

Case 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 6 of 7
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties’ respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the influenza vaccine caused petitioner’s alleged
left shoulder injury, or any other injury.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner’s
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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Case 1:17-vv-00102-UNJ Document 45 Filed 10/18/18 Page 7 of 7