VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00289
Package ID: USCOURTS-cofc-1_17-vv-00289
Petitioner: Amall Ali
Filed: 2017-10-10
Decided: 2018-04-05
Vaccine: influenza
Vaccination date: 2016-01-15
Condition: distal rotator cuff tendinopathy of the right shoulder, subacromial bursitis, subdeltoid bursitis, adhesive capsulitis, right shoulder impingement, and bone marrow edema of the posterolateral humeral head
Outcome: compensated
Award amount USD: 80484

AI-assisted case summary:
Amall Ali filed a petition for compensation under the National Vaccine Injury Compensation Program on October 10, 2017, alleging that her influenza vaccine on January 15, 2016, caused her to suffer various shoulder injuries, including distal rotator cuff tendinopathy, subacromial bursitis, adhesive capsulitis, and bone marrow edema. The respondent, the Secretary of Health and Human Services, filed a Rule 4(c) Report stating that he did not contest entitlement, agreeing that the injury was consistent with Shoulder Injury Related to Vaccine Administration (SIRVA) and was caused-in-fact by the flu vaccine. Based on the respondent's concession and the evidence, the Chief Special Master found Amall Ali entitled to compensation. Subsequently, on April 5, 2018, a decision awarding damages was issued. The respondent proffered an award of $75,000.00 for pain and suffering, plus $5,484.91 to satisfy a New York State Medicaid lien, for a total award of $80,484.91. Amall Ali, identified as a competent adult, agreed with the proffered award. The case was resolved by stipulation.

Theory of causation field:
Off-Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_17-vv-00289-0
Date issued/filed: 2018-02-09
Pages: 2
Docket text: PUBLIC DECISION (Originally filed: 10/10/2017) regarding 19 Ruling on Entitlement. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00289-UNJ Document 37 Filed 02/09/18 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-0289V
Filed: October 10, 2017
UNPUBLISHED
AMALL ALI,
Special Processing Unit (SPU);
Petitioner, Ruling on Entitlement; Uncontested;
v. Causation-In-Fact; Influenza (Flu)
Vaccine; Shoulder Injury Related to
SECRETARY OF HEALTH AND Vaccine Administration (SIRVA)
HUMAN SERVICES,
Respondent.
Bruce W. Slane, Law Office of Bruce W. Slane, P.C., White Plains, NY, for petitioner.
Amy P. Kokot, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
Dorsey, Chief Special Master:
On March 1, 2017, 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 her receipt of an influenza (“flu”) vaccine on January 15,
2016, caused her to suffer “distal rotator cuff tendinopathy of the right shoulder,
subacromial bursitis, subdeltoid bursitis, adhesive capsulitis, right shoulder
impingement, and bone marrow edema of the posterolateral humeral head.” Petition at
1. The case was assigned to the Special Processing Unit (“SPU”) of the Office of
Special Masters.
On October 6, 2017, respondent filed his Rule 4(c) Report in which he states that
he does not contest that petitioner is entitled to compensation in this case. Rule 4(c)
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-00289-UNJ Document 37 Filed 02/09/18 Page 2 of 2
Report at 1. Specifically, respondent stated that petitioner’s alleged injury is consistent
with a shoulder injury related to vaccine administration (“SIRVA”) caused-in-fact by the
flu vaccine she received on January 15, 2016. Id. at 4. Further, respondent did not
identify any other causes for petitioner’s SIRVA, and records show that petitioner
suffered her condition for more than six months. Id. Therefore, based on the record as
it now stands, 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
2

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DOCUMENT 2: USCOURTS-cofc-1_17-vv-00289-1
Date issued/filed: 2018-04-05
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 1/2/2018) regarding 32 DECISION Stipulation/Proffer. Signed by Chief Special Master Nora Beth Dorsey. (rp) Service on parties made.
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Case 1:17-vv-00289-UNJ Document 40 Filed 04/05/18 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 17-289V
Filed: January 2, 2018
UNPUBLISHED
AMALL ALI,
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.
Bruce William Slane, Law Office of Bruce W. Slane, P.C., White Plains, NY, for petitioner.
Amy Paula Kokot, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
Dorsey, Chief Special Master:
On March 1, 2017, 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 her receipt of an influenza (“flu”) vaccine on January 15, 2016,
caused her to suffer “distal rotator cuff tendinopathy of the right shoulder, subacromial
bursitis, subdeltoid bursitis, adhesive capsulitis, right shoulder impingement, and bone
marrow edema of the posterolateral humeral head.” Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On October 10, 2017, a ruling on entitlement was issued, finding petitioner
entitled to compensation for her shoulder injury. On December 29, 2017, respondent
filed a proffer on award of compensation (“Proffer”) indicating petitioner should be
awarded $75,000.00 as well as $5,484.91to satisfy petitioner’s State of New York
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-00289-UNJ Document 40 Filed 04/05/18 Page 2 of 5
Medicaid lien. Proffer at 2. In the Proffer, respondent represented that petitioner
agrees with the 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 compensation:
(1) A lump sum payment of $75,000.00 in the form of a check payable to
petitioner.
(2) A lump sum payment of $5,484.91, representing compensation for
satisfaction of the State of New York Medicaid lien, payable jointly to
petitioner and to:
New York State Department of Health
P.O. Box 415874
Boston, MA 02241-5874
Attn: Antoinette Titus, Case Worker
HMS, Inc.
Estate & Casualty Recovery Unit
antoinette.titus@hms.com
Recovery Case #: 113293
Petitioner agrees to endorse this payment to the New York State Department of
Health. 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.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-00289-UNJ Document 40 Filed 04/05/18 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
AMALL ALI, )
)
Petitioner, )
) No. 17-289V (ECF)
v. ) Chief Special Master Dorsey
)
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
I. Compensation for Vaccine Injury-Related Items
On October 10, 2017, Chief Special Master Dorsey issued a Ruling on Entitlement
finding that petitioner was entitled to vaccine compensation for her Shoulder Injury Related to
Vaccine Administration (“SIRVA”). Based on the evidence of record, respondent proffers that
petitioner should be awarded $75,000.00. This amount represents all elements of compensation
to which petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Respondent further proffers that petitioner, Amall Ali, should be awarded funds to satisfy
a State of New York Medicaid lien in the amount of $5,484.91, which represents full satisfaction
of any right of subrogation, assignment, claim, lien, or cause of action the State of New York
may have against any individual as a result of any Medicaid payments that the State of New
York has made to or on behalf of Amall Ali 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
January 15, 2016, under Title XIX of the Social Security Act. Petitioner agrees.
1

Case 1:17-vv-00289-UNJ Document 40 Filed 04/05/18 Page 4 of 5
II. Form of the Award
Respondent recommends that the compensation provided to petitioner be made through
two lump sum payments as described below:
(1) A lump sum payment of $75,000.00 in the form of a check payable to petitioner.1
(2) A lump sum payment of $5,484.91, representing compensation for satisfaction of
the State of New York Medicaid lien, payable jointly to petitioner and to:
New York State Department of Health
P.O. Box 415874
Boston, MA 02241-5874
Attn: Antoinette Titus, Case Worker
HMS, Inc.
Estate & Casualty Recovery Unit
antoinette.titus@hms.com
Recovery Case #: 113293
Petitioner agrees to endorse this payment to the New York State Department of Health.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
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
HEATHER L. PEARLMAN
Assistant Director
Torts Branch, Civil Division
1 Should petitioner die prior to the entry of judgment, respondent reserves 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.
2

Case 1:17-vv-00289-UNJ Document 40 Filed 04/05/18 Page 5 of 5
s/Amy P. Kokot
AMY P. KOKOT
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Ben Franklin Station
Washington, DC 20044-0146
Tel: (202) 616-4118
Dated: December 29, 2017
3