VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00103
Package ID: USCOURTS-cofc-1_17-vv-00103
Petitioner: Devora Stamm
Filed: 2017-01-23
Decided: 2018-10-23
Vaccine: influenza
Vaccination date: 2016-03-08
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 86203

AI-assisted case summary:
Devora Stamm filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she received an influenza vaccine on March 8, 2016, and subsequently suffered a shoulder injury related to vaccine administration (SIRVA). The respondent conceded that the evidence established that the injury was caused-in-fact by the vaccine and that petitioner met all legal prerequisites for compensation. A ruling on entitlement was issued on September 26, 2017. Subsequently, on January 19, 2018, a decision awarding damages was entered, granting petitioner $86,203.71, which included $1,147.01 for unreimbursed past expenses and $85,000.00 for past and future pain and suffering, plus $56.70 to satisfy a State of New Jersey Medicaid lien. Later, on October 23, 2018, an additional award of $28.76 was granted to correct an overpayment related to the Medicaid lien, bringing the total compensation to $86,232.47.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00103-0
Date issued/filed: 2018-02-08
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 9/26/2017) regarding 20 Ruling on Entitlement. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00103-UNJ Document 32 Filed 02/08/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0103V
Filed: September 26, 2017
UNPUBLISHED
DEVORA STAMM,
Special Processing Unit (SPU);
Petitioner, Ruling on Entitlement; Concession;
v. Causation-In-Fact; Influenza (Flu)
Vaccine; Shoulder Injury Related to
SECRETARY OF HEALTH AND Vaccine Administration (SIRVA)
HUMAN SERVICES,
Respondent.
Lawrence R. Cohan, Anapol Weiss, Philadelphia, PA, for petitioner.
Daniel Anthony Principato, U.S. Department of Justice, Washington, DC, for
respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On January 23, 2017, Devora Stamm (“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 received an
influenza (“flu”) vaccine on March 8, 2016, and thereafter suffered from a shoulder injury
that was caused-in-fact by the flu vaccine. Petition at 1. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
On September 26, 2017, respondent filed his Rule 4(c) report in which he
concedes that petitioner is entitled to compensation in this case. Respondent’s Rule
4(c) Report at 1. Specifically, respondent “has concluded that a preponderance of the
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 1:17-vv-00103-UNJ Document 32 Filed 02/08/18 Page 2 of 2
evidence establishes that the injury to petitioner’s left shoulder was caused-in-fact by
the administration of the flu vaccine on March 8, 2016, petitioner’s injury is not due to
factors unrelated to the administration of the flu vaccine, and petitioner has suffered the
sequela of her injury for more than six months.” Id. at 2. Respondent further states that
in light of the information contained in petitioner’s medical records, he has concluded
that petitioner has satisfied all legal prerequisites for compensation under the Vaccine
Act. Id.
In view of respondent’s position 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

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DOCUMENT 2: USCOURTS-cofc-1_17-vv-00103-1
Date issued/filed: 2018-04-26
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 1/19/2018) regarding 28 DECISION Stipulation/Proffer. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00103-UNJ Document 33 Filed 04/26/18 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0103V
Filed: January 19, 2018
UNPUBLISHED
DEVORA STAMM,
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.
Lawrence R. Cohan, Anapol Weiss, Philadelphia, PA, for petitioner.
Daniel Anthony Principato, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On January 23, 2017, Devora Stamm (“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 received an
influenza (“flu”) vaccine on March 9, 2016, and thereafter suffered from a shoulder injury
related to vaccine administration (“SIRVA”). Petition at 1. The case was assigned to
the Special Processing Unit of the Office of Special Masters.
On September 26, 2017, a ruling on entitlement was issued, finding petitioner
entitled to compensation for SIRVA. On January 19, 2018, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $86,203.71.
Proffer at 2. In the Proffer, respondent represented that petitioner agrees with 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 1:17-vv-00103-UNJ Document 33 Filed 04/26/18 Page 2 of 5
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
petitioner the following:
A. a lump sum payment of $86,147.01 (representing $1,147.01 for
unreimbursed past expenses and $85,000.00 for past and future pain and
suffering) in the form of a check payable to petitioner, Devora Stamm.
B. a lump sum payment of $56.70 to satisfy the State of New Jersey Medicaid
lien, which represents full satisfaction of any right of subrogation, assignment,
claim, lien, or cause of action the State of New Jersey had made to or on behalf
of Devora Stamm from the date of her eligibility for benefits through the date of
judgment in this case as a result of her vaccine-related injury suffered on or
about March 8, 2016, under Title XIX of the Social Security Act. Reimbursement
of the State of New Jersey lien shall be made through a lump sum payment of
$56.70, representing compensation for satisfaction of the State of New Jersey
lien, payable jointly to petitioner, and
Treasurer, State of New Jersey
Health Management Systems, Inc.
P.O. Box 416522
Boston, MA 02241-6522
Petitioner agrees to endorse this payment to the State of New Jersey. These
amounts 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.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-00103-UNJ Document 33 Filed 04/26/18 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
____________________________________
)
DEVORA STAMM, )
)
Petitioner, ) No. 17-103V
) Chief Special Master Dorsey
v. ) ECF
)
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
)
PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On September 26, 2017, respondent filed a Vaccine Rule 4(c) report concluding
that petitioner suffered an injury that is compensable under the National Childhood
Vaccine Injury Act of 1986, as amended, 42 U.S.C. §§ 300aa-10 to -34. Accordingly, on
September 26, 2017, the Chief Special Master issued a Ruling on Entitlement.
Respondent now proffers that, based on the evidence of record, petitioner should
be awarded $86,203.71. This amount represents all elements of compensation to which
petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Items of Compensation and Form of the Award
The parties recommend that the compensation provided to petitioner should be
made through lump sum payments described below, and request that the Chief Special
Master’s decision and the Court’s judgment award the following: 1
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, future pain and suffering, and future lost wages.

Case 1:17-vv-00103-UNJ Document 33 Filed 04/26/18 Page 4 of 5
A. Petitioner’s Damages
A lump sum payment of $86,147.01 (representing $1,147.01 for unreimbursed
past expenses and $85,000.00 for past and future pain and suffering) in the form of a
check payable to petitioner, Devora Stamm.
B. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the State of
New Jersey Medicaid lien in the amount of $56.70, which represents full satisfaction of
any right of subrogation, assignment, claim, lien, or cause of action the State of New
Jersey had made to or on behalf of Devora Stamm from the date of her eligibility for
benefits through the date of judgment in this case as a result of her vaccine-related injury
suffered on or about March 8, 2016, under Title XIX of the Social Security Act.
Reimbursement of the State of New Jersey lien shall be made through a lump sum
payment of $56.70, representing compensation for satisfaction of the State of New Jersey
lien, payable jointly to petitioner, and
Treasurer, State of New Jersey
Health Management Systems, Inc.
P.O. Box 416522
Boston, MA 02241-6522
Petitioner agrees to endorse this payment to the State of New Jersey.
C. Guardianship
Petitioner is a competent adult. Evidence of guardianship is not required in this
case.
2

Case 1:17-vv-00103-UNJ Document 33 Filed 04/26/18 Page 5 of 5
III. Summary of Recommended Payments Following Judgment
A. Lump sum paid to petitioner $86,147.01
B. Reimbursement of Medicaid lien $56.70
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
GABRIELLE M. FIELDING
Assistant Director
Torts Branch, Civil Division
/s/ Daniel A. Principato
DANIEL A. PRINCIPATO
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Phone: (202) 616-3662
Fax: (202) 353-2988
Dated: January 19, 2018
3

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DOCUMENT 3: USCOURTS-cofc-1_17-vv-00103-2
Date issued/filed: 2018-10-23
Pages: 3
Docket text: PUBLIC DECISION (Originally filed: 08/10/2018) regarding 43 DECISION of Special Master ( Signed by Chief Special Master Nora Beth Dorsey. )(mpj) Service on parties made.
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Case 1:17-vv-00103-UNJ Document 45 Filed 10/23/18 Page 1 of 3
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0103V
Filed: August 10, 2018
UNPUBLISHED
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
DEVORA STAMM, *
*
Petitioner, * Special Processing Unit (SPU);
v. * Damages Decision Granting Additional
* Award; Influenza (Flu) Vaccine;
SECRETARY OF HEALTH * Shoulder Injury Related to Vaccine
AND HUMAN SERVICES, * Administration (SIRVA); RCFC 60(b)(6);
* Vaccine Rule 36
Respondent. *
*
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
Lawrence R. Cohan, Anapol Weiss, Philadelphia, PA, for petitioner.
Daniel Anthony Principato, U.S. Department of Justice, Washington, DC, for
respondent.
DECISION AWARDING ADDITIONAL DAMAGES1
Dorsey, Chief Special Master:
On August 7, 2018, petitioner filed a joint motion to amend (“Motion to Amend”)
the judgment pursuant to RCFC 60. Because petitioner has demonstrated
circumstances that justify relief under RCFC 60(b)(6), her motion for relief is granted
and judgment is entered as set forth in this decision.
I. Procedural History
On January 23, 2017, Devora Stamm (“petitioner”) filed a petition for
compensation under the National Vaccine Injury Compensation Program, 42 U.S.C.
§300aa-10, et seq.,(the “Vaccine Act”). Petitioner alleged that she suffered a shoulder
injury related to vaccine injury (“SIRVA”) as a result of an influenza (“flu”) vaccine she
received on March 9, 2016. Petition at 1. On January 19, 2018, a decision was entered
awarding compensation to petitioner based on respondent’s proffer. Judgment was
entered on January 23, 2018.
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.

Case 1:17-vv-00103-UNJ Document 45 Filed 10/23/18 Page 2 of 3
On August 7, 2018, petitioner filed a joint motion requesting relief from judgment
by amending the judgment to account for a correction in the amount of a state Medicaid
lien. In support of this motion, petitioner states that after judgment was entered in this
case, petitioner’s counsel received a letter from New Jersey Medicaid that revised the
amount of the Medicaid lien. The letter indicated that after its pro-rata reduction, the
final lien amount was $27.94, instead of $56.70 that was originally quoted. The parties
request the opportunity to account for this overpayment by refunding the additional
funds to respondent. Petitioner represents that respondent has no objection to this
motion. Therefore, petitioner’s motion is GRANTED for the reasons set forth below.
II. Applicable Legal Standards
Under Vaccine Rule 36, Appendix B, RCFC, a party may seek relief from
judgment pursuant to the United States Court of Federal Claims, Rule 60. RCFC
60(b)(1)-(6). Rule 60(b) provides an “exception to finality,’ that ‘allows a party to seek
relief from a final judgment, and request reopening of his case, under a limited set of
circumstances.’” Kennedy v. Sec’y of Health & Human Servs., 99 Fed. Cl. 535, 548
(2011) (quoting Gonzalez v. Crosby, 545 U.S. 524, 529 (2005)). “The court has
discretion regarding whether to grant relief under Rule 60(b), ‘and the court may weigh
equitable considerations in the exercise of its discretion.’” Curtis v. United States, 61
Fed. Cl. 511, 512 (Fed. Cl. 2004) (citing Dynacs. Eng’g Co. v. United States, 48 Fed. Cl.
240, 241-42 (2000)). Rule 60(b) as a remedial provision is to be “liberally construed for
the purpose of doing substantial justice,” Patton v. Sec’y of Health & Human Servs., 25
F.3d 1021, 1030 (Fed. Cir. 1994). The court may grant relief from a final judgment on
the following grounds:
(1) mistake, inadvertence, surprise, or excusable neglect;
(2) newly discovered evidence ..;
(3) fraud … misrepresentation, or misconduct by an opposing party;
(4) the judgment is void;
(5) the judgment has been satisfied, released, or discharged; it is based on an
earlier judgment that has been reversed or vacated; or applying it
prospectively is no longer equitable;
(6) any other reason that justifies relief.
RCFC 60(b).
III. The Motion to Amend Judgment
On August 7, 2018, petitioner filed a motion to amend the judgment after
petitioner received information from New Jersey Medicaid indicating that after
completing a pro-rata reduction of the Medicaid line, the final lien amount was $27.94,
instead of the $56.70 that was previously quoted. Therefore, petitioner requests that
2

Case 1:17-vv-00103-UNJ Document 45 Filed 10/23/18 Page 3 of 3
the undersigned issue a judgment/order allowing petitioner to issue a check in the
amount of $28.76 to respondent. Respondent has no objection to this request. The
catchall provision of Rule 60(b)(6) provides for relief from judgment upon “any other
ground that justifies relief.” RCFC 60(b)(6). The undersigned grants petitioner’s motion
and finds the grounds for this request are necessary to correct a clear error.
IV. Conclusion
The final Medicaid lien amount has been provided to petitioner and the judgment
must be corrected to reflect the final lien amount. Therefore, the undersigned GRANTS
petitioner’s request and directs the Clerk of Court to issue judgment in favor of respondent
to include the following information:
A lump sum payment of $28.76 to reimburse respondent for an overpayment made
to the State of New Jersey Medicaid to satisfy a Medicaid lien. The check should
be made payable to:
U.S. Department of Health and Human Services
Memo: Devora Stamm, Case No. 17-0103
The check should be sent to:
Ms. Cheryl Lee
Division of Vaccine Injury Compensation/HRSA
5600 Fishers Lane, Mail Stop 08N194B
Rockville, MD 20857
IT IS SO ORDERED.
s/Nora Beth Dorsey
Nora Beth Dorsey
Chief Special Master
3